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MS4 - OnG > Newborn Lectrues > Flashcards

Newborn Lectrues Flashcards

1
Q

Preterm birth def?

A

<37 weeks

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2
Q

Low birth weight defs

A

Low: <2500 g

Very Low: <1500 g

Extremely low: <1000 g

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3
Q

Why preterm neonates more prone to infection

A

Low IgG

Absent IgM/IgG

Absent adaptive immune system

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4
Q

Necrotising Enterocolitis sx

A

loss of apetite

distended tender abdomen

sepsis

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5
Q

Mx of necrostising enterocolitis

A

stop enteral feeds

give broadspectrum abx

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6
Q

Necrotising enterocolitis complications

A

high mortality

short gut syndrome

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7
Q

what rash is this?

A

Erythema toxicum

  • central papule (yellow), erythamatous peripheral
  • last days up to a week
  • everywhere but palms and soles
  • caused by esinophils
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8
Q

What rash is this?

A

Haemangioma (birth mark)

aka strawberry naevi

Endothelia tumour

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9
Q

What rash is this?

A

Blue spot

over sacrum, buttocks and lower limb

fades by 4 years

melanocyte infiltiration

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10
Q

What is this rash

A

Salmon patch

aka angel kiss

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11
Q

What is this rash

A

Portwine stain ( capillary malformation)

if in trigeminal could lead to intercranial arterial calcification

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12
Q
A

a- barlow

b- ortolani

  • detects hop displacement
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13
Q

What is this?

A

Cephalhaematoma

subperipheral haemorrhage due to forceps in delivery

Resolves by 6th week

Increased jaundice

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14
Q

Vitmin K for newborns?

A

Breast milk doesnt have it

Could cause bleeding disorder

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15
Q

Mx of neonatal jaundice

A

If billirubin high use phototherapy (blue light breaks H bonds, making it polar, allowing its removal)

If very high, use exchange transfusion

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16
Q

Blood test for neonates screening?

A

Guthrie test

5-7th day by midwife

Phylketonuria, TSH, haemoglobulinopathies, CF

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17
Q

Signs of resp distress in neonates

A

Cyanosis

High RR

Subcostal recession

Expiratory grunting

Nasal flaring

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18
Q

Respiratory distress syndrome management

A

Surfactant therapy

or antinatal steroids

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19
Q

what is Transient tachypnoea (TTN)

A

term infants with mature lungs, delay in clearing the lung fluid

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20
Q

Risk factor for transient tachypnoea of newborn

A

Caesarean section

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21
Q

Mx of transient tachypnoea of newborn

A

nasal CPAP, o2, stop feeds

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22
Q

What is Meconium aspiration syndrome

A

Fetal hypoxia/distress -> meconium passed inside utero -> fetal aspiration

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23
Q

Consequences of Meconium aspiration syndrome

A

Airway obstruction

Chemical pneumonitis

Surfactant inactivation

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24
Q

How to diagnose an air leak in newborn

A

trans-illumination

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25
Q

What is laryngomalacia

A

soft immature larynx cartilage collapses

casues inspiratory stridors

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26
Q

Which immunoglobulin is passed through the placenta

A

IgG

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27
Q

What factors increase the affinity of Haemoglobin for O2 on Hb oxygen dissociation curve

A

Increased pH

Decreased temperature

Decreased 2,3 dihydroxybutanedioic DPG acid

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28
Q

How are maternal and fetal 2,3 DPG levels different?

A

30% higher in mother than fetus

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29
Q

Blood vessels within the placenta

A

Umbilical vein

2* Umbilical arteries

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30
Q

Origin of umbilical arteries

A

Iliac artery

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31
Q

3 vessels that change between fetus and newborn stages

A

Ductus arteriosus (Pulmonary-aorta)

Foramen Ovale (R-L atria)

Ductus venosus (umbilical v. - inferior vena cava)

32
Q

After birth what happens to: Umbilical vein

A

Ligamentum teres (umbilicus to liver)

Mesentery becomes falciform ligament

33
Q

After birth what happens to: Ductus arteriosus

A

Ligamentum arteriosus

34
Q

What causes the closure of ductus arteriosus

A

mediated by prostoglandin inhibition and rise in PaO2

35
Q

After birth what happens to: umbilical arteries

A

constict, some parts remain patent supplying the urinary bladder

36
Q

Cerebral palsy

A

Non progressive disorder of movement and posture caused by injury to IMMATURE brain

37
Q

Def of Birth asphyxia

A

Interruption of delivery of o2 to fetus causing:

  • delayed breathing
  • Low HR
  • Acidosis
  • Impaired muscle tone and reflexes
38
Q

How to identify birth asphyxia

A

Apgar score

Cord gas: pH<7.15

39
Q

Apgar score

A

HR: Absent 0, <100 1, 100 2

Resp effort: Absent 0, gasp/irreg 1, regular 2

Muscle tone: limp 0, some flexion 1, acitve 2

Response: nil 0, grimace 1, cry/cough 2

Central colour: white 0, blue 1, pink 2

40
Q

Apgar score interprrtation

A

Repeated at 1, 5 and 10th minutes

8-9 good condition

<5 bad news!!

41
Q

Grades of hypoxis ischaemic encephalopathy

A

I - hyperventilation

II- I + seizures

III- II + comatose

42
Q

Mx of Hypoxic ischaemic encephalopathy

A

total body cooling for 72 hours at 33.5 C

43
Q

Pathology of interventricular haemorrage in newborn?

A

Vascular germinal matrix with fragile vessels in preterm (24-32 weeks)

Fluctuating blood flow

44
Q

Mx of interventicular management of newborn

A

corticosteroid before preterm delivery

45
Q

Main complication post interventricular haemorrhage

A

post haemorrhagic hydrocephalus

46
Q

Prevention of post haemorrhagic hyrocephalus

A

DRIFT
Washing out the ventricles after IVH to remove the neurotoxins

47
Q

Def of periventricular leucomalacia

A

White matter damage

Caused by ischaemia/inflammation

48
Q

Mx of periventricular leucomalacia

A

no treatment

prevention by giving MgSO4 to mother during preterm labour

49
Q

Which brain injuries are more common in full term brain? which ones in preterm?

A

full term: acute hypoxic ischaemia of the basal ganglia (grey matter)

preterm: periventricular white matter / interventricular haemorrhage

50
Q

Bacterial causes of neonatal meningitis

A

Group B strep

E coli

Listeria

51
Q

Long term complications of neonatal meningitis

A

Deafness

Hydrocephalus

Poor neurodevelopment

52
Q

Rx for neonatal meningitis

A

cefotaxime

53
Q

What causes this

A

cutaneous candidiasis

54
Q

Rx for neonatal candida infection

A

Local or oral treatment with nystatin or miconazole

55
Q

Necrotising enterocolitis pathology

A

Injury to mucosa

  • > substrate for bacteria to multiplying the gut
  • > invasion of the gut wall by gas producing bacteria
  • > ileus and perforation
56
Q

Which Hepetitis virus can be passed to fetus and at what stage is it passed?

A

Hep B

Vertical transmission during labour (40% risk)

57
Q

Hep B screening during pregnancy

A

Hep B surface antigen tested in all

If positive, Hep e antigen and antibodies also tested

58
Q

Prevention of neonatal Hep B/e infection

A

If no Hep E : 4 doses of Hep B vaccine + 1 dose of Hep B immunoglobulin

If Hep E present: 4 doses of Hep B vaccine only

59
Q

At what stage is HIV passed to fetus?

A

transplacental

during labour

breast milk

(25% risk)

60
Q

Vaccinations to neonates

A

Hep B

BCG (if going abroad to TB in india/africa)

61
Q

How long is breast feeding recommended for

A

first 6 months of life

62
Q

Newborn screen blood test age

A

5-8 days

63
Q

Which conditions tested for in heel prick test

A

hypothyroid

CF
Sickle cell disease

inherited metabolic disorders ( phenylketonuria, MCADD, etc)

64
Q

Indications for abx for mastitis

A

Infected nipple fissure

Sx not improving >24 hrs with milk removal

Brest milk culture positive

65
Q

Mastitis abx

A

Flucloxicillin

Because its staph, ffs Kav

Another flashcard I have to go through because of you

66
Q

RFs for sudden infant death syndrome

A

prone sleeping

parental smoking

bed sharing

hypethermia

prematurity

67
Q

Foetal alcohol syndrome

A

Hypoplastic upper lip

Microcephaly

Smooth philtrum

68
Q

Philtrum

A

fold on upper lip

69
Q

Pier Robins syndrome 3 fx

A

cleft palate,

retrognathia (abnormal jaw)

glossoptosis (obstruction by tongue)

70
Q

Albinism defect

A

Tyrosinase defect

71
Q

Sx of phenylketonuria

A

Musty odour skin and urine

72
Q

Sx of cystinuria

A

recurrent kidney stones

73
Q

5 alpha reductase deficiency sx

A

female-looking until puberty

penis at twelve syndrome

74
Q

Hormone responsible for male internal reproductive tract development

A

Testosterone

75
Q

Hormone responsible for male external reproductive tract development

A

DHT

MS4 - OnG (5 decks)

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