Neonatology Flashcards
What are the categories of term admissions?
Sepsis Resp Cardiac Hypoglycaemia Hypothermia Jaundice Birth asphyxia Surgical problems Neonatal abstinence syndrome
What are some symptoms of neonatal sepsis?
Baby pyrexia or hypothermia Poor feeding Lethargy/irritable Early jaundice Tachypnoea Hypo/hyperglycaemia Floppy Asymptomatic
What are some risk factors for neonatal sepsis?
Premature rupture of membranes (PROM)
Maternal pyrexia
Maternal Group B Strep (GBS)
What are some tests you’d run in presumed sepsis?
FBC CRP Blood cultures Blood gas Maybe CXR and LP
What is the first line treatment for presumed sepsis?
IV penicillin and gentamicin
What is 2nd line treatment for presumed sepsis?
IV vancomycin and gentamicin
What would you add to second line treatment for presumed sepsis if there is surgical or abdominal concerns?
Metronidazole
What are the most common causes of neonatal sepsis?
Group B Strep E. Coli Listeria Coag-neg Staphylococci Haemophilus influenzae
What is the onset usually like for GBS sepsis?
Early onset (up to 1 week) Recurrence up to 3 months
What are some possible complications of GBS sepsis?
Meningitis DIC Pneumonia Respiratory collapse Hypotension Shock
What is TORCH used for?
Congenital infections
Toxoplasmosis Other Rubella Cytomegalovirus (CMV) Herpes Simplex Virus (HSV)
What are some consequences of congenital infection?
IUGR Brain calcifications Neurodevelopmental delay Visual impairment Recurrent infections
What are the main causes for repsiratory distress in the NNU?
Sepsis
Transient Tachypnoea of the Newborn (TTN)
Meconium aspiration
How does TTN usually resolve?
Self-limiting
How does TTN present?
First few hours of life Grunting Tachypnoea Oxygen requirement Normal gases
What causes TTN?
Delayed clearance of foetal lung fluids
How do we manage TTN?
Antibiotics
Fluids
O2
Airway support
What are some risk factors for meconium aspiration?
Post dates
Maternal diabetes
Maternal hypertension
Difficult labour
What are some symptoms of meconium aspiration?
Cyanosis Increased effort for breathing Grunting Apnoea Floppiness
How would we investigate meconium aspiration?
Blood gas
Septic screen
CXR
What are the 5 T’s of cyanotic congenital cardiac disease?
Truncus arteriosus Transposition of Great Arteries Tricuspid atresia Tetralogy of Fallot Total anomalous pulmonary venous drainage (TAPVD)
How do we manage hypoglycaemia?
Start IV 10% Glc Increase fluids Increase glucose concentration Glucagon Hydrocortisone
How do we manage hypothermia?
If unable to maintain temp on PNW then admit and place in incubator Sepsis screen Antibiotics Thyroid function Blood Glc
What are the main causes of birth asphyxia?
Placental problem Long difficult Umbilical delivery Umbilical cord prolapse Infection Neonatal airway problem Neonatal anaemia
