Paeds chem

Question 1

common problems due to low birth weight?

Answer 1

-respiratory distress syndrome
-retinopathy of prematurity
-intraventricular haemorrhage
-PDA
-necrotising enterocolitis

Question 2

what is renal function like in babies?

Answer 2

-all parts of kidney function less well than adults
-functionality of GFR reached at 2 years
-low GFR for surface area
-less reabsorption due to short proximal tubule
-reduced concentrating ability because short loops of henle & DCT
-persistent sodium loss as DCT is relatively aldosterone insensitive

Question 3

what nephrons will ex prem babies have?

Answer 3

wont have full complement of nephrons

Question 4

why do babies lose weight in first few days

Answer 4

they have high total body water
-even higher in pre-term babies
-they lose fluid via urine/stool

Question 5

why do babies have high uncontrollable water loss?

Answer 5

-high SA to body weight ratio
-increased skin blood flow
-higher metabolic/respiratory rate
-trans-epidermal fluid loss (skin immature barrier)

Question 6

what may hypernatraemia in babies be due to?

Answer 6

-common in first 2 weeks
-dehydration
-overly concentrated milk formula

Question 7

why does hyponatraemia occur in first 4-5 days?

Answer 7

-excess total body water (intake)
-rarely SIADH due to infection or haemorrhage

Question 8

why does hyponatramia occur after fisrt 4-5 days?

Answer 8

-loss of sodium due to immature tubular function
-facticious eg. hyperglycaemia
-congenital adrenal hyperplasia (hypoglycaemia, addisonian crisis

Question 9

cause of jaundice within 1st 24hrs of life?

Answer 9

acute haemolysis
sepsis

Question 10

cause of jaundice after first 2 weeks?

Answer 10

hepatobiliary failure