Paediatric study Flashcards
What’s the concern surrounding Meconium Aspirate?
Asphyxiated babies can gasp and aspirate the meconium prior to delivery, which is thick and causes mechanical obstruction, chemical pneumonitis and inactivation of surfactant
Treatment of meconium aspirate. What is a risk factor?
Tx; -Mechanical ventilation -Surfactant therapy RF: -increasing gestational age
How does cleft lip/palate usually get diagnosed? Best treatment?
Dx occurs in antenatal US screening. Tx of surgical repair at 3 months reccommended.
Long term issues of cleft lip/palate?
middle ear infection Otitis media with effusion Speech Difficulty Orthodontic problems
What is choanal atresia?
Rare bony obstruction between the nasal cavity and the nasopharynx Respiratory success and cyanosis occur as babies are obligate nose breathers.
Prevention of infants with surfactant deficiency?
Antenatal Corticosteroids: Promote surfactant synthesis and lung maturation. Maximum benefit given 24hrs prior.
Treatment of infants with surfactant deficiency?
Surfactant Therapy: given down tracheal tube Prophylactic: elective intubation and surfactant given in the first few minutes after birth OR early selective OR rescue (once they develop RDS) + antenatal corticosteroids + Oxygen therapy
What is RDS
Respiratory distress Syndrome -commonest respiratory disorder in preterm newborns. -Caused by a deficiency in surfactant production or function, >> stiff lungs >>>alveolar collapse >>> poor gas exchange.
Clinical Features of RDS are?
Tachypnea Chest retractions Nasal flaring Expiratory grunting ?cyanosis
Whats the way to know if a child has issues breathing due to a respiratory issue or due to a congenital heart problem?
Cyanosis that is not improved when an infant is given oxygen is likely to be due to congenital heart disease with right to left shunting.
What is the APGAR scoring system
Mesures the infants condition at birth (0-3 require rapid resuscitation or they will die)/ HR Respiration Tone Reflex to suction Colour
A baby with a birth weight of <10th centile is SGA. This can be familial or due to IUGR (intrauterine growth retardation). What are the common causes of this.
-Multiple pregnancy -Placental insufficiency -Maternal smoking -Congenital infections (rubella, toxoplasmosis) -Genetic syndromes (Downs syndrome)
What are babies with IUGR at risk for in the first few days
Hypoglycaemia and hypothermia due to low glycogen stores and a lack of subcutaneous fat.
What are we trying to avoid by giving babies IM/oral vitamin K at birth, 1 and 6 months?
Vit K deficiency can lead to poor synthesis of vit-k-dependent clotting factors and subsequant bleeding. “haemorrhagic disease of the newborn”
What is spina bifida?
Failure of the neural tube to close normally.
