Neonatology at a Glance

Question 1

Kernicterus

Answer 1

= bilirubin-induced brain dysfunction

Kernicterus, from bilirubin deposition in the brain from Rhesus haemolytic disease

Question 2

Stillbirth: aldur, þyngd

Answer 2

Fetal death >1000g or >28 weeks

Question 3

Neonatal mortality
Post-neonatal mortality
Infant mortality

Answer 3

neonatal: á fyrstu 4 vikum (27 completed days)
post-neonatal: 28d-1ár
infant: dauði á 1. ári

Question 4

Intrauterine growth restriction (IUGR)

Answer 4

failure of a fetes or infant to achieve his or her genetic growth potential

Question 5

Intrauterine growth restriction (IUGR)

greiningaratriði (4)

Answer 5

a) estimated feral weight of less than 10th centime for gestation
b) a reduced feral growth velocity
c) presence of oligohydramnios (deficiency of amniotic fluid)
d) abnormal doppler waveform in the middle cerebral artery compared with the umbilical artery

3 eða fleiri af þessum ultrasaound features þurfa að vera til staðar

Question 6

What is the significance of birthweight in adult life?

Answer 6

Infants of low birthweight are at higher risk of:
Diabetes type 2
Coronary heart disease
Hypertension 
Stroke

Question 7

Tocolytics

Answer 7

Lyf til að seinka fæðingu, draga ur contractions

Notað til að kaupa tima fyrir sterana að virka

Question 8

Apgar score:

Hvað er verið að meta? (5)

Answer 8

Heart rate
Respiration
Muscle tone
Reflex irritability (response to stimulation)
Color

Question 9

Eðlileg hjartslattartiðni nybura?

Answer 9

> 100 slög/min

Question 10

I hvaða tilfellum a ekki að hefja endurlifgun nybura?

Answer 10

• meðgöngutimi styttri en 23 vikur eða þyngd minni en 400g

- anencephaly eða trisomy 13/18

Question 11

Hvenær a að hætta endurlifgun?

Answer 11

Ef hjartslattur hefur aldrei fundist fyrstu 10 minutur lífs

Question 12

Hypoxemia getur valdið?

Answer 12

Ischemic damage
Apnea
Pulmonary hypertension

Question 13

Hyperoxemia getur valdið?

Answer 13

Retinopathy of prematurity (ROP)

Tissue damage vegna free radicals

Question 14

Hvað a oxygen saturation að vera i nýburum?

Answer 14

Preterm: 90-95%
Term: >95%

Question 15

CPAP: hvað? gerir hvað?

Answer 15

Continuous positive airway pressure

Kemur i veg f alveolar collapse i lok utöndunar og stabilises brjóstvegginn

Question 16

CPAP: complications

Answer 16

• Pneumothorax
• Feeding difficulties due to gaseous distension of the stomach
• Often poorly tolerated by term infants

Question 17

ECMO: hvað? hvað er gert?

Answer 17

Extracorpeal membrane oxygenation

Infants placed on heart-lung bypass for up to several days to allow the lungs to recover

Question 18

ECMO: aukaverkanir

Answer 18

Intraventricular hemorrhage (vegna anticoagulation need)

Question 19

ECMO: hvað þurfa börnin að uppfylla?

Answer 19

34 vikna meðganga eða lengri

> 2 kg við fæðingu

Question 20

Eftir hvaða viku meðgöngu lifa flest börn an langvarandi skemmda?

Answer 20

30 viku meðgöngu

Question 21

Surfactant:

• samsetning
• frumur
• áhrif
• framleiðsla hvenær
• skortur veldur

Answer 21

• 90% lipið, 10% protein
• type II pneumocytes
• minnkar yfirborðsspennu -> kemur i veg f samfall alveoli og bætir lung compliance -> ⬇️work of breathing
• seint a 2. trimester og snemma a 3. trimester
• respiratory distress syndrome (RDS)

Question 22

Respiratory distress syndrome:

Önnur nöfn

Answer 22

Hyaline membrane disease

Surfactant deficient lung disease

Question 23

RDS:

Risk factors

Answer 23

- Prematurity
Aðrir
- maternal diabetes mellitus
- sepsis
- hypoxemia and acidemia
- hypothermia

Question 24

RDS:

Pathology

Answer 24

• collapsed terminal air saccules
• overdistended terminal airways
• inflammatory cells in lumen
• interstitial edema + protein leak
• hyaline membranes distal/terminal
• necrotic damage to epithelial cells

Question 25

Corticosteroids:

Aukaverkanir (systemic gjöf)

Answer 25

Short term: high BP, hyperglycemia, increased risk of sepsis
Long term: Cushingoid facies, hypertrophic cardiomyopathy, osteopenia, failure to grow length/head, increase in cerebral palsy