Paeds - neonatal medicine

Question 1

3 main presentations of hypoxic ischemic encephalopathy

Answer 1

Developmental delay
Seizures
Abnormal neuro signs

Question 2

Special management of HIE?

Answer 2

Mild hypothermia - wrap infant in cool blanket

Question 3

Important investigation to confirm diagnosis of HIE

Answer 3

Amplitude EEG

Question 4

What is the prognosis of HIE with moderate symptoms and…

• normal at 2 weeks
• symptomatic at 2 weeks

Answer 4

normal at 2 weeks = recovery

Symptomatic at 2 weeks –> unlikely to recover

Question 5

RDS - findings on CXR?

Answer 5

Ground glass

Question 6

Main Mx points (4) for RDS

Answer 6

1) ambient O2 high in incubator
2) homeostasis
3) Abx
4) surfactant therapy

Question 7

Mx of PDA

Answer 7

Prostaglandin synthesise inhibitor –> surgical ligation

Question 8

What is the pulse like in PDA

Answer 8

bounding pulse

Question 9

Mx of child born at <35 weeks for feeding?

Answer 9

NGT feeding

Question 10

If a PREM child is breastfeeding, how should you manage them?

Answer 10

supplement with calcium, phosphate, protein and calories

iron

Question 11

What supplement is necessary in all PREM babies? and for how long?

Answer 11

Iron 6 months corrected age

Question 12

3 step management of necrotising enterocolitis

Answer 12

stop feeding
Parenteral nutrition
Broad spec Abx

Question 13

How can retinopathy of prematurity be avoided? what causes it?

Answer 13

Screening ophthalmologist in all PREM babies

Question 14

Presentation of anaemia of prematurity

Answer 14

FTT
Abdominal distension
Pallor

Question 15

3 causes of prolonged neonatal jaundice

Answer 15

Biliary atresia!!!!!!
CF
Congenital hepatitis

Question 16

Signs of severe kernicterus?

Answer 16

Arched back (increased tone)

Question 17

2 ways to measure Br?

Answer 17

Transcutaneous and serum

Question 18

management of neonatal jaundice

Answer 18

Phototherapy

Exchange transfusion

Question 19

RF for pneumonia in neonates?

Answer 19

Maternal pyrexia
Chroioamnionitis
prolonged ROM

Question 20

CXR in TTPN?

Answer 20

Fluid in horizontal fissure

Question 21

Management of Meconium aspiration

Answer 21

Supportive

If severe - suction and surfactant

Question 22

CXR in meconium aspiration

Answer 22

Overinflation + patchy consolidation nd collapse

Question 23

Dx of diaphragmatic hernia

Answer 23

antenatal USS

Question 24

Mx of diaphragmatic hernia

Answer 24

Suction and surgery

Question 25

Presentation fo TOF?

Answer 25

Cyanotic after feeds + chocking

DROOLING

Question 26

Mx of neonatal gonorrhoea

Answer 26

Cephalosporin

Question 27

Ddx for neonatal seizures

Answer 27

HIE
hypoglycaemia
Sepsis - ?meningitis
Cerebral infarction

Question 28

Ix for neonatal seizure

Answer 28

Glucose
Blood cultures
(sepsis 6)
USS (haemorrhage)/MRI head

Monitor EEG

Question 29

Causes of neonatal hypoglycaemia - name five

Answer 29

• maternal GDM
• Sepsis
• Hypothermia
• Poor feeding in PREM
• IUGR (poor glycogen stores)

Question 30

Mx of neonatal hypoglycaemia

Answer 30

IV 5% dextrose

Question 31

Top 3 DDx for neonatal collapse

Answer 31

1) Sepsis
2) Congenital heart disease
3) salt losing crisis in CAH

Question 32

Mx of cleft lip and palate prior to surgery

Answer 32

Special teats/feeding devices

Orthodontist referral