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Paeds AM > Neonatology > Flashcards

Neonatology Flashcards

1
Q

What score is used for newborns?

A

Apgar

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2
Q

What does the apgar score look at?

A 
Appearance
Pulse
Grimace
Activity
Respiration
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3
Q

What is the maximum score for Apgar?

A

10

2 for each category

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4
Q

What is a low, moderate low and normal apgar?

A

0-3 very low
4-6= moderate low
7-10= normal

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5
Q

What are some common birth injuries?

A 
Caput succedaneum
Cephalohaematoma
Facial paralysis
Erb's palsy
Fractured clavicle
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6
Q

What is caput succedaneum?

A

Oedema collection on scalp

Crosses sutures lines and normally no discolouration

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7
Q

What is caput succedaneum associated with?

A

Traumatic, prolonged or instrumental delivery

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8
Q

What is cephalohaematoma?

A

Traumatic subperiosteal haematoma

Does not cross suture lines and commonly causes skin discolouration

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9
Q

What are the complications of cephalohaematoma?

A

Anaemia

Jaundice as it breaks down

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10
Q

What is facial paralysis associated with?

A

Forceps delivery

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11
Q

What is Erbs palsy?

A

Injury to C5/6 nerve repps

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12
Q

What is Erbs palsy associated with?

A

Shoulder dystocia
Traumatic or instrumental delivery
Large birth weight

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13
Q

What is the presentation of Erbs palsy?

A

Weakness of shoulder abduction and external rotation, arm flexion and finger extension

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14
Q

What is a fractured clavicle associated with?

A

Shoulder dystocia
Traumatic or instrumental delivery
Large birth weight

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15
Q

What investigations are done for a fractured clavicle?

A

US

XR

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16
Q

What can cause neonatal hypoglycaemia?

A 
Maternal DM 
IUGR
Prematurity
Hypothermia
Sepsis
Inborn errors or metabolism
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17
Q

What is the management of neonatal hypoglycaemia?

A

Monitoring

IV 10% glucose

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18
Q

What is hypoxic ischaemic encephalopathy?

A

Hypoxia during birth casing encephalopathy

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19
Q

What is the presentation of hypoxic-ischaemic encephalopathy?

A 
Mild= poor feeding, general irritability
Moderate= poor feeding, lethargy, hypotonia
Severe= reduced consciousness, apnoea, flaccid, reduced reflexes
20
Q

What are the risks with hypoxic ischaemic encephalopathy?

A

Death- up to 50%

Cerebra palsy up to 90%

21
Q

What is the management of hypoxic ischaemic encephalopathy?

A

Supportive

Theraputic hypothermia

22
Q

What is the mechanism of action of therapeutic hypothermia?

A

Reduce inflammation and neurone loss after acute hypoxic injury

23
Q

What is neonatal abstinence syndrome?

A

Withdrawal symptoms in neonates of mothers with substance abuse

24
Q

What substances cause NAS?

A 
3-72 hours= opiates, alcohol, SSRIs
24 hours-21 days= methadone, BZDs
Cocaine
Alcohol
Nicotine
25
Q

What is the presentation of NAS?

A 
Irritability, not settling
Tremors, seizures
Sweating, unstable temperature 
Tachypnoea
Poor feeding
Hypoglycaemia
26
Q

What is the management of NAS?

A 
Monitoring and support 
SSRI= doesn't require medical mx 
Mod to severe
-opiate= oral morphine sulphase
-non opiate= oral phenbarbitone
27
Q

What causes jaundice <24 hours?

A

Always pathological
Sepsis
HAemolysis

28
Q

What causes jaundice 24 hours-2 weeks?

A 
Physiological
Breast milk
Polycythaemia
Sepsis
HAemolysis
Caphalohaematoma
29
Q

What causes jaundice >2 weeks?

A 
Breast milk
Hypothyroid
Pyloric stenosis
Cholestasis
HAemolysis
Infection
Hepatitis
30
Q

What causes physiological jaundice?

A

Short RBC lifespan
Relative polycythaemia
Relative immaturity of liver function

31
Q

What investigations are done for jaundice?

A

FBC, blood film
Split bilirubin
Direct Coombs test
Suspect nfection= blood and urine cultures

32
Q

How and when is jaundice treatment?

A

Treatment threshold charts
Unconjugated= phototherapy
Severe= exchange transfusions

33
Q

What is a complication of jaundice?

A

Kernicterus

34
Q

What is kernicterus?

A

Brain damage due to excessive unconjugated bilirubin

Floppy, drowsy abby with poor feeding

35
Q

What are the complications of kernicterus?

A

Cerebral palsy
Learning difficulties
Deafness

36
Q

What causes transient tachypnoea of the newborn?

A

Delay in clearance of foetal lung fluids

37
Q

What is a risk factor for transient tachypnoea of the newborn?

A

C section

38
Q

What is the presentation of transient ytcahypnoea of the newborn?

A

Within first few hours
Tachypnea, grunting
Normal gases

39
Q

What is the investigation and management of transient tachypnoea of the newborn?

A

CXR= hyperinflation, fluid in horizontal fissue

Supplementary oxygen

40
Q

Who is meconium aspiration seen in?

A

Post term babies more commonly

41
Q

What is the presentation of meconium aspiration?

A

Cyanosis, apnoea
Increased work of breathing
Grunting

42
Q

What is the management of meconium aspiration?

A

Suction
Airway support
Surfactant

43
Q

What is sepsis?

A

Life threatening organ dysfunction caused by dysregulated host response to infection

44
Q

What are the causative bacteria of sepsis in neonates?

A

Group B strep= most common
E. coli
Listeria

45
Q

What is the presentation of sepsis?

A 
Fever or hypothermia
Non speficic
Jaundice
Mottled skin, cyanosis
Reduced conciousness
Reduced tone
Poor feeding, change in behaviour, inconsolable
46
Q

What is the management of sepsis?

A

Sepsis 6

47
Q

What antibiotics are given in neonatal sepsis?

A

IV ben pen and gentamicin

Paeds AM (28 decks)

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