Paeds at a glance Flashcards
What is early onset sepsis and what are the most common causative organisms?
Sepsis in the first 7 days. E. Coli and group B streptococcus are main pathogens, but can also be: Gram negative Listeria Staph Aureus viral (herpes).
How common is jaundice in newborn babies? When is it concerning?
Up to 50% of newborn babies have physiological jaundice due to the high RBC mass and delayed conjugation by the liver - so bilirubin is unconjugated and therefore cannot be excreted.
It is concerning when it is present <24 hours or >14 days.
How is meconium aspirate investigated and what are its managements of the different complications/outcomes?
Investigated with CXR - shows patchy opacities throughout.
Pneumonitis - prolonged oxygen for several days. Mechanical ventilation may be necessary.
Why does cyanosis occur in meconium aspiration?
Because there is persistent pulmonary hypertension, and therefore right-to-left shunting across the patent duct and hence cyanosis.
What is the likely agent to cause pneumonia in a neonate?
Group B streptococcus.
What are common causes of respiratory distress after birth in term babies?
Meconium aspiration Small pneumothorax Pneumonia Transient tachypnoea of the newborn Breast milk aspiration Airway obstruction - choanal atresia (occluded nostrils) Congenital lung malformations
What are the presenting features of group B streptococcus sepsis in the newborn?
What is the treatment?
First 12 hours = pneumonia, persistent pulmonary hypertension of the newborn (PPHN) or shock.
Treatment = ventilation support and antibiotics.
What is a cause of jaundice <24 hours?
ABO blood group incompatibility or infection.
What do antenatal steroids reduce the risk of?
Incidence of respiratory distress syndrome
Intraventricular haemorrhage
What are brain complications of prematurity?
Intraventricular haemorrhage leading to hydrocephalus.
Sustained hypotension leading to periventricular leucomalacia.
What is chronic lung disease in premature infants?
It is bronchopulmonary dysplasia - damage to the lungs from mechanical ventilation and oxygen treatments. It requires long term oxygen treatments for the infant.
When does the mature suck-swallow pattern develop? How is it managed before this?
32-34 weeks and therefore before 34 the infant is fed by a nasogastric tube.
What does respiratory distress syndrome look like on CXR?
Ground glass appearance due to alveolar collapse.
When is surfactant production mature?
35-36 weeks.
What makes respiratory distress syndrome less severe?
Antenatal corticosteroids
IUGR infants who are stressed and therefore have endogenous corticosteroid release.
Labour - this stimulates surfactant production and therefore the RDS is self-limiting, lasting for 5-7 days.
