Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MK SR INDEX CASES CHILD HEALTH > Pre-term Infant > Flashcards

Pre-term Infant Flashcards

1
Q

Define Term vs Preterm neonate

A

term 37 weeks on

Preterm:
early preterm before 32 weeks
late preterm 34-37 weeks
ex-preterm past 37 corrected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define low birth weight neonate

A

LBW - <2500g

VLBW – 1500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define IUGR neonate

A

IUGR - <5th percentile for growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define neonate

A

first 28 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define Caput succedaneum

A

birth injury Bruising & oedema extending beyond the

margins of skull bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define Cephalhaematoma

A

birth injury Haematoma below periosteum, confined to margins of skull sutures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define chignon

A

birth injury
Oedema and bruising after Ventouse
delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of Birth Injuries

A
  • Caput succedaneum
  • Cephalhaematoma
  • Chignon
  • Bruising to face and limbs
  • Forceps marks
  • Brachial nerve palsies
  • Erb’s palsy
  • Fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are neonates resuscitated with air not oxygen?

A

sats in utero are 60-70% in arterial blood
why they are blue when born
takes about 10 min to get 90%

resuscitated with air not oxygen
because the problem
is about expanding the lungs mechanically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Transient Tachypnoea of the Newborn?

A

Self-limiting tachypnoea, some respiratory distress in term babies

due to Slow resorption of lung fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk factors for Transient Tachypnoea of the Newborn?

A

Caesarean delivery, maternal diabetes, quick delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Meconium Aspiration Syndrome

A
  • Distressed fetusmayinhale meconium immediately after delivery causing lung injury
  • Small airway obstruction, atelectasis
  • Inactivation of surfactant

meconium contains mostly bile acids, as waste has gone back to maternal circulation
causes chemical pneumonitis, inactivation of surfactant, obstruction and VQ mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical features of Meconium Aspiration Syndrome

A

Respiratory distress, hypoxia,

hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of Meconium Aspiration Syndrome

A

Respiratory support (may need ECMO)

treatment complications, such as Pneumothorax or Persistent Pulmonary Hypertension of newborn (PPHN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Xray evidence of Meconium Aspiration Syndrome

A

Patchy infiltrates, overdistension, flattened diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Early onset neonatal sepsis

A
  • Within 48 hours of birth
  • Bacteria ascend from birth canal, invades amniotic fluid and infects the fetus
  • Pneumonia and septicaemia
  • Risk factors
  • Prolonged or premature rupture of membranes • Maternal fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

late onset neonatal sepsis

A
  • After 48 hours of birth
  • Source of infection – infant’s environment
  • Nosocomial infections an inherent risk
  • Indwelling catheters
  • Coagulase negative staphylococcus (CONS) commonest
  • Consider fungal infections if prolonged antibiotic use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Features of Listeria monocytogenes neonatal infection

A
  • Transmitted to mother in food (soft cheese, undercooked poultry)
  • Mild flu like illness in mother
  • Meconium staining of liquor

NB: green liqior before 34 weeks is listeria not meconium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Differential for eye infections in neonate

A
  • Conjunctivitis: Sticky eyes by D3,4
  • Purulent discharge with swelling of eyelids within 48hrs of birth is Gonococcal infections
  • Purulent discharge with swelling of eyelids at 1-2 weeks of age is Chlamydia trachomatis
20
Q

Differential causes of neonatal seizure

A
  • HIE Hypoxic Ischaemic Encephalopathy
  • Septicaemia/meningitis
  • Metabolic: Hypoglycaemia, Hypo/per natremia, Hypomagnesemia, Hypocalcaemia, Inborn errors of metabolism
  • Drug withdrawal
  • Kernicterus
  • Congenital infections
21
Q

Describe bilirubin metabolism

A

RBC breakdown product heme broken into bilirubin.

Binds to albumin unconjugated

goes to liver, conjugated

excreted in urine or intestine

22
Q

Differential for Jaundice <24 hours of age

A
  • Unconjugated (indirect), can rise rapidly and reach high levels: Rhesus haemolytic disease, ABO incompatibility
  • G6PD deficiency
  • Spherocytosis
  • Congenital infections
23
Q

Differential for Jaundice 2 days-2/3weeks

A
  • Physiological jaundice
  • Breast milk jaundice
  • Dehydration
  • Infections
  • Bruising and polycythaemia
24
Q

Breastmilk vs breast feeding jaundice

A

breastfeeding jaundice - lack of breast milk, dehydration
OR
breastmilk jaundice - prolonged jaundice, slows enterohepatic cycle down

25
Q

Management of Jaundice

A 
Phototherapy
• Light from blue green band converts unconjugated bilirubin to harmless
pigment
• Eyes are covered
• Triple phototherapy if jaundice severe

Exchange transfusion
• Blood from baby removed in small aliquots
• Twice the blood volume is exchange

26
Q

Differential for Prolonged Jaundice (>2 weeks of age)

A
  • Biliary atresia
  • Breast milk jaundice
  • Infections particularly UTI
  • Congenital hypothyroidism
  • Galactosemia
27
Q

Causes of conjugated jaundice

A

Extrahepatic
• Biliaryatresia
• Choledochal cyst

Intrahepatic 
• Cholestasis
• TPN
• Neonatal hepatitis
• Inborn errors of metabolism
Hepatocellular disease
• Metabolic – A1AT def, CF, Dubin-Johnson, Rotor’s, Zellweger’s, Galactosemia 
• Infection – Viral/Bacterial
• TPN
• Neonatal hepatitis
28
Q

Management of Conjugated Jaundice

A
  • No role for phototherapy
  • Phenobarbitone (increases conjugation)
  • Cholestyramine (increases faecal excretion)
  • Ursodeoxycholic acid (improves bile flow)
  • Medium-chain triglycerides feeds
  • Fat-soluble vitamins (ADEK)
  • Dietary restriction
  • Kasai’s procedure
29
Q

Cell types in developing lung function

A
  • Type 1 cells (90%), type 2 cells (10%)
  • Type 2 cells contain surfactant, Type 1 cells facilitate gas exchange
  • Surfactant prevents atelectasis by reducing surface tension
  • Surfactant production starts around 32-34 weeks
30
Q

Pathophysiology of RDS

A
  • Surfactant deficiency -> Atelectasis -> Hypoxaemia -> Respiratory distress
  • Alveoli perfused but not ventilated
  • Lungs difficult to expand, lung compliance decreases
31
Q

Non-RDS causes of surfactant deficiency

A

Hypothermia, acidosis, hypoxaemia

32
Q

Clinical course of RDS

A

First 72 hours
•Increasing distress
•Then spontaneous improvement often heralded by diuresis

Treatment
•Respiratory support (may need mechanical ventilation)

33
Q

CXR in RDS

A

ground glass appearance

34
Q

complications of RDS

A
  • Pneumothorax

* Bronchopulmonary dysplasia (O2 requirement at 36 weeks GA)

35
Q

What is Necrotising Enterocolitis?

A
  • Intestinal injury
  • Unclear etiology – likely multifactorial
  • Preterm infants (<34 weeks) more susceptible
  • Breast milk beneficial
36
Q

Signs of Necrotising Enterocolitis

A

Abdominal distension, rectal bleeding, feed intolerance, bilious aspirate/vomiting, temperature instability, abdominal perforation

37
Q

Lab findings in Necrotising Enterocolitis

A

Thrombocytopenia, Metabolic acidosis, raised inflammatory markers

38
Q

Radiological findings in Necrotising Enterocolitis

A

Distended bowel loops, bowel wall thickening, pneumatosis intestinalis

39
Q

Management in in Necrotising Enterocolitis

A 
Conservative
•NBM
•NG with free drainage
•Antibiotics
•TPN

Surgical
•May need laparotomy
•Bowel resection

40
Q

When does intraventricular haemorrhage occur I§n neonates?

A
  • Premature infants

* D1-3 post life

41
Q

Signs of intraventricular haemorrhage in neonates

A

Seizures may be subtle

•Apnoea, Eye deviation, tongue twitching, eye flickering

42
Q

Cause of Retinopathy of prematurity

A
  • Caused by acute & chronic effects of oxygen toxicity on developing blood vessels of premature babies’ retina
  • Leading cause of blindness in VLBW babies
43
Q

Prevent and treatment of Retinopathy of prematurity

A

Prevention: Cautious use of oxygen

Treatment
•Laser therapy
•Surgery

44
Q

Long term complications of pre-term birth

A
  • Brain: Intracranial haemorrhage – may lead to cerebral palsy
  • Eyes: Retinopathy of prematurity – can be a cause for blindness
  • Heart: Patent Ductus Arteriosus
  • Lungs: Chronic lung disease /BPD
  • Gut: Malnutrition/Necrotising enterocolitis/ Short gut
  • Venous access/ long term development and psychological impact
45
Q

Golden Hour - immediate care of the preterm

What should be done on labour ward?

A
  • Delayed cord clamping
  • Receive the baby in a plastic bag
  • Airway – oxygen/CPAP/mechanical ventilation)
  • Monitor & regulate temperature
  • Move to NNU promptly – monitor spo2, HR, RR (Remember parents)
46
Q

Golden Hour - immediate care of the preterm

What should be done on NNU?

A
  • Resuscitaire
  • Establish intravenous access – central (UVC)/peripheral – start fluids/PN, antibiotics
  • Establish arterial access (UAC) / Xray as required
  • Monitor gases, BP
  • Minimal handling
  • Remember parents

MK SR INDEX CASES CHILD HEALTH (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions