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Y2 Child Health > Neonatology > Flashcards

Neonatology Flashcards

1
Q

when is a baby at term?

A

after 37 weeks completed gestation

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2
Q

when is a baby considered post term?

A

after 41 weeks completed gestation

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3
Q

what is a normal weight for babies?

A

2.5-4.0 kg

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4
Q

what is a baby considered to be if they weigh over 4kg?

A

large for gestational age

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5
Q

what is a baby considered to be if they weight under 2.5kg?

A

small for gestational age

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6
Q

when is the third trimester of pregnancy?

A

from 28 weeks onwards

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7
Q

what hormones increase during labour to help the baby adapt to postnatal life?

A

cortisol

adrenaline

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8
Q

what score is used to assess a babies perinatal adaptation?

A

APGAR score

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9
Q

what is a normal APGAR score?

A

8 or more

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10
Q

what is given to prevent haemorrhagic disease of the newborn?

A

vitamin K

preferably via IM route

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11
Q

why is giving vitamin K especially important in breastfed babies?

A

their milk is not fortified with vit K like formula is

higher risk of bleeding if not given vit K

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12
Q

what is done if a mother has active hep B?

A

immediate vaccination on the day of birth

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13
Q

what is given to particularly high risk babies who’s mothers have active hep B?

A

hep B immunoglobulin IV

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14
Q

can mothers with hep C breastfeed?

A

yes

as long as hep C RNA level is low

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15
Q

can mothers with HIV breastfeed?

A

only if their viral load is undetectable

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16
Q

when would babies be offered the BCG vaccine?

A

if their family is high risk for TB

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17
Q

what vaccines should mother’s to be receive to prevent illness in their baby?

A

pertussis

influenza

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18
Q

when does the routine vaccination schedule start?

A

8 weeks

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19
Q

what vaccines can be given early if the baby is high risk?

A

hep B

BCG

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20
Q

when is a baby considered to be preterm?

A

born before 37 weeks gestation

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21
Q

what should be delayed if a baby is born preterm?

A

clamping the umbilical cord

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22
Q

how should preterm babies be kept warm?

A

in a plastic bag
under a radiant heater
wear a hat

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23
Q

what do preterm babies need to help their lungs adn why?

A

lungs are more fragile

PEEP to gently inflate the lungs

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24
Q

how is there an increased risk of nutritional compromise in a preterm baby?

A

limited nutrient reserves
gut immaturity
immature metabolic pathways
increased demands to meet growth needs

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25
Q

what nutrition do some preterm babies who cannot feed receive?

A

total parenteral nutrition

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26
Q

what are the two types of neonatal sepsis?

A

early onset

late onset

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27
Q

what causes early onset sepsis?

A

bacteria acquired before or during delivery

28
Q

what causes late onset sepsis?

A

bacteria acquired after delivery

29
Q

name some causative organisms of early onset sepsis

A

group B strep

gram negatives

30
Q

name some causative organisms of late onset sepsis

A

coagulase negative staph
gram negatives
staph aureus

31
Q

what risks associated with prematurity increase likelihood of sepsis?

A

immature immune system

ICU environment - indwelling tubes and lines

32
Q

how is neonatal sepsis prevented?

A

hand washing
care of cord
infection screening

33
Q

how is neonatal sepsis managed?

A

antibiotics

supportive care measures

34
Q

what causes primary RDS?

A

surfactant deficiency and structural immaturity of the lungs

35
Q

what causes secondary RDS?

A

damage to the lungs causes by things like intubation or ventilation

36
Q

which babies are more high risk for RDS?

A

preterm

37
Q

what clinical signs may be seen in a baby with RDS?

A 
tachypnoea 
grunting 
intercostal recessions 
nasal flaring 
cyanosis
38
Q

what is the natural history of RDS like?

A

gradual worsening for 2-4 days

gradual improvement

39
Q

what can be given to prevent RDS?

A

maternal steroids

40
Q

name two steroids given to mothers to prevent RDS

A

dexamethasone

betamethasone

41
Q

what treatments can be given to a baby with RDS?

A

surfactant replacement

ventilation

42
Q

name four things that are screened for on the blood spot card

A

cystic fibrosis
hypothyroidism
haemoglobinopathies
metabolic diseases

43
Q

name five metabolic diseases screened for on the blood spot card

A 
PKU 
MCADD
IVA
GA1
HCU
44
Q

name two other screening tests done in newborns

A

hearing screening

hip screening

45
Q

when is the newborn examination carried out?

A

before/around 24 hours old

46
Q

name the 7 things looked at/for in the newborn examination of the head

A 
OFC 
sutures
fontanelles 
marks 
moulding 
cephalohematoma 
caput succedaneum
47
Q

what is OFC?

A

occipital frontal circumference

48
Q

what is the importance of OFC?

A

ensures the baby has grown appropriately

49
Q

what can cause overlapping sutures?

A

moulding

50
Q

what can cause marks on a babies head during birth?

A

forceps

ventouse

51
Q

what causes moulding of a babies head?

A

being born

it is normal

52
Q

what is cephalohaematoma?

A

bleeding between the bone periosteum and the epicranial aponeurosis

53
Q

where is cephalohematoma often found?

A

the parietal bones

limited by suture lines

54
Q

what is caput succedaneum?

A

swelling and oedema in the outer layer of the skin

55
Q

how long does it take for caput succedaneum to settle?

A

no more than 48 hours normally

56
Q

name the 5 things assessed in the eyes in the newborn examination

A 
size 
red reflex 
subconjunctival haemorrhage 
squints 
iris abnormality
57
Q

name the 5 things assessed in the ears in the newborn examination

A 
position 
EAM patency 
tags/pits 
folding 
family history of hearing loss
58
Q

name the 7 things assessed in the mouth during the newborn examination

A 
shape
philtrum 
tongue tie 
palate 
neonatal teeth 
ebsteins pearls 
sucking reflex
59
Q

what can a smooth philtrum be a sign of?

A

foetal alcohol syndrome

60
Q

what is looked for when looking at the palate of a baby?

A

cleft palate

61
Q

what are ebsteins pearls and where are they found?

A

white, pearly collections of skin cells

joint of the palate and the hums

62
Q

what two things are looked for in the face during the newborn examination?

A

facial palsy

dysmorphism

63
Q

what are some signs of respiratory distress in a neonate?

A

nasal flaring
grunting
tachypnoea
in-drawing

64
Q

name 5 things assessed in the newborn examination of the heart

A 
saturations 
pulses 
apex beat 
thrills and heaves 
heart sounds
65
Q

when do babies get a detailed heart scan?

A

20 weeks

Y2 Child Health (18 decks)

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