Neonatology Flashcards
when does the CVS develop in embryology?
end of the 3rd week
oxygenated blood via the umbilical vein (in utero) is carried by what?
ductus venosus
what is the ductus arteriosus?
protects the lungs against circulatory overload
allows the right ventricle to strengthen
carries low oxygen saturated blood
ductus venosus connects what 2 vessels?
umbilical vein
IVC
ductus venosus carries what kind of blood
mostly oxygenated
ductus venosus, ductus arteriosus, umbilical vein and umbilical arteries become what after birth?
ligaments
physiological jaundice can lead to what serious complication?
Kernicterus
what is Kerniterus?
toxic - deposits in the brain of fat soluble bilirubin
causes cerebral palsy, learning difficulties etc
if a baby is small for dates - what are the possible causes?
small for gestational age (SGA)
intra-uterine growth restriction
pre-eclampsia
chromosomal (edwards syndrome)
foetal infection
twin pregnancy
what are common problems a small for dates baby may present with?
perinatal hypoxia
hypoglycaemia
hypothermia
thrombocytopenia
preterm respiratory problems
RDS (respiratory distress syndrome)
how do you treat RDS
prevention (antenatal steroids)
surfactant
early intubation
broncho-pulmonary dysplasia
is a form of chronic lung disease that affects newborns (mostly premature) and infants. It results from damage to the lungs caused by mechanical ventilation (respirator) and long-term use of oxygen
brain issues in preterm babies
intra-ventricular haemorrhage
Persistent ductus arteriosus
additional blood to the pulmonary circulation
you get systemic ischaemia
necrotising entero-colitis
ischaemia and inflammatory changes
necrosis of the bowel
parenteral nutrition
Jaundice is always abnormal (needs investigating) if it occurs when?
within 24 hours of birth
Jaundice within 24 hours of being born is likely to be:
haemolytic (G2PD, Rh incompatibility)
TORCH (congenital infection)
what does TORCH stand for in congenital infections?
toxoplasmosis
rubella
CMV
HSV
2nd day to 3rd week jaundice causes:
breast milk jaundice
physiological jaundice (usually gone after a week)
sepsis
haemolytic disorders
jaundice after 3rd week causes:
cholestasis
pyloric stenosis
biliary atresia
phototherapy in jaundice does what?
makes bilirubin into a water soluble isomer
making it able to be excreted
where do stork marks appear?
back of the neck
midline of the face
(they gradually fade)
hypoglycaemia can occur when:
premature babies
perinatal stress
what are the symptoms of hypoglycaemia in neonates?
jitteriness
temperature instability
lethargy
hypotonia
poor suck/feeding
vomiting
seizures
how do you treat developmental dysplasia of the hip
relocate the femur to acetabulum so hip develops normally
Pavlik harness
what are some defects associated with trisonomy 21:
dysmorphism (low set ears, single palmar creases)
hypotonia
cardiac defects
learning problems
thyroid problems
how do you treat a baby with sepsis?
IV penicillin and gentamicin (1st line)
Vancomycin (2nd line)
neonatal sepsis bacteria:
group B strep
E.coli
listeria
haemophilus influenzae
complications of sepsis in a neonate
hepatomegaly/jaundice/hepatitis
cataracts/ retinitis
microcephalous
deafness
hydrocephalus
splenomegaly
what is TTN?
transient tachypnoea of the newborn
what are the cases of respiratory distress in the newborn?
respiratory distress syndrome (surfactant deficiency)
transient tachypnoea of the newborn
meconium aspiration
sepsis
how do you investigate the ‘blue baby’?
exam and history
sepsis screen
blood gases and glucose
CXR
ECG
echo
differentials for cyanosis in babies
tricuspid atresia
truncus arteriosus
pulmonary atresia
