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Paediatrics > Neonatology > Flashcards

Neonatology Flashcards

1
Q

What are the categories of term admissions?

A 
Sepsis
Resp
Cardiac
Hypoglycaemia
Hypothermia
Jaundice
Birth asphyxia
Surgical problems
Neonatal abstinence syndrome
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2
Q

What are some symptoms of neonatal sepsis?

A 
Baby pyrexia or hypothermia
Poor feeding
Lethargy/irritable
Early jaundice
Tachypnoea
Hypo/hyperglycaemia
Floppy
Asymptomatic
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3
Q

What are some risk factors for neonatal sepsis?

A

Premature rupture of membranes (PROM)
Maternal pyrexia
Maternal Group B Strep (GBS)

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4
Q

What are some tests you’d run in presumed sepsis?

A 
FBC
CRP
Blood cultures
Blood gas
Maybe CXR and LP
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5
Q

What is the first line treatment for presumed sepsis?

A

IV penicillin and gentamicin

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6
Q

What is 2nd line treatment for presumed sepsis?

A

IV vancomycin and gentamicin

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7
Q

What would you add to second line treatment for presumed sepsis if there is surgical or abdominal concerns?

A

Metronidazole

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8
Q

What are the most common causes of neonatal sepsis?

A 
Group B Strep
E. Coli
Listeria
Coag-neg Staphylococci
Haemophilus influenzae
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9
Q

What is the onset usually like for GBS sepsis?

A 
Early onset (up to 1 week)
Recurrence up to 3 months
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10
Q

What are some possible complications of GBS sepsis?

A 
Meningitis
DIC
Pneumonia
Respiratory collapse
Hypotension
Shock
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11
Q

What is TORCH used for?

A

Congenital infections

Toxoplasmosis
Other
Rubella
Cytomegalovirus (CMV)
Herpes Simplex Virus (HSV)
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12
Q

What are some consequences of congenital infection?

A 
IUGR
Brain calcifications
Neurodevelopmental delay
Visual impairment
Recurrent infections
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13
Q

What are the main causes for repsiratory distress in the NNU?

A

Sepsis
Transient Tachypnoea of the Newborn (TTN)
Meconium aspiration

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14
Q

How does TTN usually resolve?

A

Self-limiting

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15
Q

How does TTN present?

A 
First few hours of life
Grunting
Tachypnoea
Oxygen requirement
Normal gases
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16
Q

What causes TTN?

A

Delayed clearance of foetal lung fluids

17
Q

How do we manage TTN?

A

Antibiotics
Fluids
O2
Airway support

18
Q

What are some risk factors for meconium aspiration?

A

Post dates
Maternal diabetes
Maternal hypertension
Difficult labour

19
Q

What are some symptoms of meconium aspiration?

A 
Cyanosis
Increased effort for breathing
Grunting
Apnoea
Floppiness
20
Q

How would we investigate meconium aspiration?

A

Blood gas
Septic screen
CXR

21
Q

What are the 5 T’s of cyanotic congenital cardiac disease?

A 
Truncus arteriosus
Transposition of Great Arteries
Tricuspid atresia
Tetralogy of Fallot
Total anomalous pulmonary venous drainage (TAPVD)
22
Q

How do we manage hypoglycaemia?

A 
Start IV 10% Glc
Increase fluids
Increase glucose concentration
Glucagon
Hydrocortisone
23
Q

How do we manage hypothermia?

A 
If unable to maintain temp on PNW then admit and place in incubator
Sepsis screen
Antibiotics
Thyroid function
Blood Glc
24
Q

What are the main causes of birth asphyxia?

A 
Placental problem
Long difficult
Umbilical delivery
Umbilical cord prolapse
Infection
Neonatal airway problem
Neonatal anaemia
25
Q

What are the immediate effects of birth asphyxia?

A

Cell damage occurs within minutes from lack of blood flow and O2

26
Q

What is reperfusion injury?

A

Consequence of birth asphyxia
Toxins release from damaged cells
Lasts days or weeks

27
Q

How do we manage hypoxic ischaemic encephalopathy?

A 
Therapeutic hypothermia
Treat seizures
Fluid resuscitation
Resp and cardio support
Monitor for liver/renal failure
28
Q

What are some causes of failure to pass stool?

A 
Large bowel atresia
Imperforate anus
Hirchsprungs disease
Meconium plug
Meconium ileus
29
Q

What is Hirchsprung’s disease?

A

Absence of ganglia in bowel causing loss of peristalsis

30
Q

What is a meconium plug?

A

Poo enclosed in a mucus coat which is often more difficult for your baby to pass

31
Q

What is the usual cause of diaphragmatic hernia?

A

Pulmonary hypoplasia

32
Q

What is Neonatal abstinence syndrome (NAS)?

A

Withdrawal from physically addictive substances taken by the mother in pregnancy

33
Q

What is the Finnegan score?

A

Assesses 21 of the most common signs of neonatal drug withdrawal syndrome
Scored on the basis of pathological significance and severity of the adverse symptoms

34
Q

How do we treat NAS?

A

Comfort (e.g. swaddling)
Morphine
Phenobarbitone

35
Q

How so we monitor NAS and consequences?

A

Finnegan scores
Urine toxicology
Investigate maternal co-morbidities
Social and discharge planning

36
Q

What is a normal respiratory rate from birth to 1 year?

A

30-60 per minute

37
Q

What is a normal respiratory rate from 1-3 years?

A

24-40 per minute

38
Q

What is a normal respiratory rate for 3-6 years?

A

22-34

39
Q

What is a normal respiratory rate for 6-12 years?

A

18-30

Paediatrics (25 decks)

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