paeds stuff

Question 1

CPR diff between kids and adults

Answer 1

In kids:
-Initiating rescue breaths if a child is not breathing properly- do as soon as see no breaths- 5 breaths

• Commencing CPR before going for help if there are no signs of life
• Using a compression to ventilation ratio of 15:2

1min of CPR first if alone before calling rhesus team

Question 2

choking in children? not coughing

conscious:

Answer 2

-5 back blows
-5 thrusts
(chest in infant)
(abdomen if child >1)

Question 3

choking in children? not coughing

unconscious:

Answer 3

open airway
5 breaths
start CPR

Question 4

what to worry about with neonatal jaundice

Answer 4

Babies with jaundice within 24 hours of birth need treatment for sepsis if they have any other clinical features or risk factors.

Question 5

complication of jaundice in a neonate?

Answer 5

kernicterus- brain damage due to high bilirubin levels

cerebral palsy, learning disability and deafness

bilirubin levels need to be monitored in premature babies

Question 6

Haemolytic disease of newborn

Answer 6

mum rhesus d negative
baby rhesus d positive

• baby antigen will make way to mum- and mums body attacks it.
• when mums gets into babies- baby attacks its own body-> anaemia, high bilirubin- jaundice.

Question 7

causes of prolongs jaundice

More than 14 days in full term babies
More than 21 days in premature babies

Answer 7

biliary atresia

hypothyroidism

G6PD deficiency.

Question 8

phototherapy in jaundice?

Answer 8

good for unconjugated

Question 9

what are the prematurity classifications?

Answer 9

Under 28 weeks: extreme preterm

28 – 32 weeks: very preterm

32 – 37 weeks: moderate to late preterm

Question 10

management before birth for a preterm baby?

Answer 10

to delay birth:
-vaginal progesterone

to improve outmode:

• Tocolysis with nifedipine (suppresses labour)
• CCS for mum
• IV magnesium sulphate

Question 11

ccx of preterm labour?

Answer 11

Respiratory distress syndrome
Hypothermia
Hypoglycaemia
Poor feeding
Apnoea and bradycardia
Neonatal jaundice

cerebral palsy
LD
infection

Question 12

what is RDS from?

Answer 12

not enough surfactant

-> hypoxia, hypercapnia and resp distress

Question 13

RDS treatment?

Answer 13

Antenatal steroids (i.e. dexamethasone) given to mothers 
-> increase surfactant production

baby:
intubation and ventilation
Endotracheal tube
Continuous positive airway pressure
Supplementary oxygen

Question 14

RDS ccx?

Answer 14

Pneumothorax
Infection
Apnoea

long term:
Chronic lung disease of prematurity
Retinopathy of prematurity

Question 15

what is necrotising enterocolitis?

Answer 15

affects premature babies

bowel becomes necrotic

• > perforation
• > peritonitis and shock

Question 16

ix of necrotising enterocolitis?

Answer 16

nil by mouth with IV fluids, total parenteral nutrition (TPN) and antibiotics to stabilise them.

Surgical emergency!!

Question 17

prematurity affect on eyes?

Answer 17

retinopathy

blood vessels in the retina can lead to scarring

retinal detachment

blindness.

Babies born before 32 weeks or under 1.5kg should be screened for ROP. Screening is performed by an ophthalmologist. Screening starts at:

0 – 31 weeks gestational age in babies born before 27 weeks

4 – 5 weeks of age in babies born after 27 weeks

Screening should happen at least every 2 weeks and can cease once the retinal vessels enter zone 3, usually at around 36 weeks gestation.

Question 18

substance responsible for NAS?

Answer 18

Opiates
Methadone
Benzodiazepines
Cocaine
Amphetamines
Nicotine or cannabis
Alcohol
SSRI antidepressants

Question 19

mx of NAS?

Answer 19

Oral morphine sulphate for opiate withdrawal

Oral phenobarbitone for non-opiate withdrawal

Question 20

Fetal alcohol syndrome:

Answer 20

Microcephaly

Thin upper lip
Smooth flat philtrum (the groove between the nose and upper lip)

Short palpebral fissure (short horizontal distance from one side of the eye and the other)

LD

cerebral palsy