Brainscape's Knowledge GenomeTM

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


See full index

Paediatrics > Premature / LBW / NICU > Flashcards

Premature / LBW / NICU Flashcards

1
Q

What type of small babies can you get

A

SGA
- Could be genetic or due to IUGR
LBW
IUGR

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

What is IUGR

A

If still in womb
<10th centile
Suggest something happening in womb to compromise blood flow / sick baby

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

What causes LBW

A 
Idiopathic
Placental insufficiency
Chromosomal
Infection - TORCH / CMV / syphillis
MCMA twins
Malformation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes placental sufficiency

A 
Maternal IHD
High BP 
PET 
Abruption 
DM
Systemic
Sickle cell  
Smoking / alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common problems in LBW

A

Perinatal hypoxia - increased haematocrit, bilirubin and plasma viscosity
= Polycytheaemia as hypoxia = produce more
Hypoglycaemia
Hypothermia
Thrombocytopenia - BM concentrating on making RBC

NEC
GI - as blood flow to more important organs in stress
Nutrition
Meconium aspiration syndrome as stressed
IRDS as less surfactant
Infection

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

What are long term problems of LBW

A 
DM
Hypertension
Reduced Growth 
IHD
Obesity 
Renal failure
Stroke
Retinopathy 
Lung - asthma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is mild LBW and extreme

A

LBW <2.5kg
VLBW <1.5kg
Extreme <1kg

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

What is symmetric LBW

A

OFC and weight in the same percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes symmetric

A 
1st trimester insult
Affects all DNA
Chromosomal 
Infection - TORCH 
Teratogenic drug 
Severe smoke / alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Will symmetric LBW improve

A

Unlikely as will never have enough cells

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

What is asymmetric

A

OFC spares

Weight <10 centile

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

What causes asymmetric LBW

A

3rd trimester insult
Placental insufficiency - PIH
Will have catch up growth

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

Why is LBW associated with hypothermia

A

Lack of fat stores

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

Why is LBW associated with hypoglycaemia

A

No glycogen reserve as IUGR throughout pregnancy so constantly used up

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

What does the hypoxic state in utero of LBW babies cause

A

Increased haematocrit 20-22 (normal 18-20)
Increased plasma viscosity (VTE / slow circulation)
Polycythaemic to increase RBC as hypoxic
Increased bilirubin as have to break down
Thrombocytopenia as BM making RBC

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

How do you treat the hypoxic state of LBW babies

A

Partial exchange transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why does premature make you more prone to infection

A

IgG transfer in 3rd trimester
Immune system is underdeveloped
Interventions in premature
Can be caused by chorioamnitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you treat infection

A

Prophylactic penicillin and gentamicin to cover strep and staph / gram -ve E.coli
Diff Ax if think meningitis

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

Do you worry more about pre-term but appropriate for gestational age or the pre-term SGA

A

Pre-term appropriate gestational age

SGA baby will have been under stress in the womb so produce natural steroids to mature lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Neonatal abstinence syndrome

A

OK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What has decreased infant mortality

A 
Obstetric care
Housing
Nutrition 
Immunisation
Ax
NHS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is most important in LBW babies

A

Nutrition

More prone to food intolerance and gut unable to absorb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes pre-term babies

A 
Idiopathic 
Smoking / alcohol / drugs 
Over or underweight
FH 
Malnutrition
Infection - chorioamnitis
PET
DM
APH
Polyhydramnios
Twins
Malformation
PPROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is term

A

37-42

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Mild prematurity

A

32-37

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Moderate

A

28-32

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Extreme

A

<28 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What Is important if premature

A 
Nutrition
Fluid - dextrose
TPN if long term
Syringe feed
NG
Vitamins ABIDEK
Iron at 28 days 
Establish feet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Complications of pre-term

A 
IRDS
Bronchopulmonary dysplasia
Minor resp issues
IVH
Periventricular leucomalacia
Post haemorrhagic hydrocephalus
Hypoxic ischaemic encephalopathy 
Neonatal jaundice 
NEC
PDA
Infection 
Low BP 
Hypothermia
Hypoglycaemia 
Nutrition as poor feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are long term complications of pre-term

A 
Chronic lung - asthma / bronchiolitis
Anaemia of prematurity
Metabolic bone disease
Retinopathy
Cerebral palsy 
Low IQ / learning difficulties 
Hearing and visual
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How do you screen for long term issues

A

Cranial USS

Retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What causes IRDS

A 
Deficiency of alveolar surfactant
Lungs can't expand
Collapse
Large pressure needed to inflate
Leads to inadequate gas exchange, hypoxia and hypercapnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does this cause

A 
Respiratory distress
- Tachypnoea
- Grunting
- Nasal flaring 
- Cyanosis
- Recession 
Exhaustion
Resp failure - hypoxia/. hypercapnia
34
Q

What are RF for IRDS and what is protective

A 
Pre-term
- Surfact produced >24 weeks 
Maternal DM
- Hyperinsulin in baby inhibits cortisol 
C-section
Male 
Perinatal asphyxia 
2nd born twin

Protective - stresses baby = cortisol production

  • PPROM
  • IUGR
  • Maternal HTN
  • Antenatal steroid
35
Q

How do you Dx

A 
Blood gas
CXR 
- Widespread bilateral change
- Indistinct heart border
- Air bronchogram
- Ground glass opacity 
- May see tube if intubated
36
Q

How do you prevent

A

Antenatal steroid
12 hours apart if any threat
Stresses lung to prevent
Delayed cord clamping

37
Q

How do you Rx

A 
O2 - nasal or mask or just flow to maintain pressure
CPAP - open and inflate lung 
Support ventilation if blood gas worsens
May need intubation 
Endotracheal surfactant once intubated
38
Q

Complications of RDS / increased risk

A 
Pneumothorax
Infection 
Apnoea
IVH
Pulmonary haemorrhage
NEC 
Renal failure

Long term
Chronic lung
Retinopathy due to hypoxia
Neuro, hearing and visual

39
Q

When do you use CPAP

A

If only problem is keeping airway open

40
Q

What is Ddx of IRDS

A 
Sepsis = important 
TTN
Meconium aspiration
Congenital lung
Persistent pulmonary hypertension 
Cardiac
41
Q

What causes bronchopulmonary dysplasia

A

Lung overstretch e.g. ventilation

Causes oxygen toxicity

42
Q

What does bronchopulmonary dysplasia cause

A 
Persistent hypoxia
Difficulty weaning of ventilation 
Infection due to tube
Severe bronchiolitis
Atelactisis - collapse
Poor feeding
43
Q

How do you treat

A

Steroids
Surfactant
High calories feed

44
Q

What are complications

A 
GORD
Feeding issue 
Decreased IQ
Cerebral palsy 
Asthma
45
Q

What causes minor respiratory issues and what can underlying issue be

A

Baby forget to breath
Babies are mouth breather’s
Can be a pre-drome of illness

46
Q

What minor issues is there

A

Apnoea >15s
Desaturation
Bradycardia
Irregular breathing

47
Q

How do you treat

A

Attach apnoea monitors to premature baby
IV Caffeine - neuroprotective and stimulates resp
CPAP

48
Q

What is most common limiting factor for poor prognosis in pre-term

A

Intra-ventricular haemorrhage

49
Q

When does IVH occur

A

First 72 hours

50
Q

How does it present

A

Seizure
Bulging fontanelle
Cerebral irritability

51
Q

How do you Dx

A

Cranial USS as fontanelle hasn’t closed
MRI
Bloods

52
Q

How do you Rx

A

Ante-natal steroid

Treat haemorrhagic shock

53
Q

What do you do if hydrocephalus / raised ICP

A

Drainage

Shunt

54
Q

What are complications

A

Post haemorrhagic hydrocephalus if clot occlude
Decreased IQ
Cerebral palsy

55
Q

What is periventricular leucomalacia

A

White matter surrounding ventricles deprived O2 and blood

56
Q

What types of intracranial haemorrhage I there

A

IVH = most common in pre-term
SAH
Subdural after forceps

57
Q

What causes hypoxic ischaemic encephalopathy

A 
SUSPECT IF ANY OF THESE EVENTS 
Brain injury 2 prolonged hypoxia / asphyxia / resp distress
IVH
PML
Placental insufficeincy
Cord prolapse
Long delivery
Abruption
Maternal hypoxia / shock 
Infection
Anaemia
58
Q

What does mild HIE present with and how does it resolve

A 
Hyperalert
Hypertonia
Poor feeding 
Irritable 
Acidosis on blood gas / poor
Low APGAR 
Resolve within 24 hours and normal prognosis
59
Q

How does more severe present and how does it resolve

A

Hypotonia
Seizure
Apnoea
Hyporeflexia / absent sucking rreflex etc
Resp depression
Coma
Takes weeks to resolve and usually lasting damage

60
Q

How do you Dx

A

EEG

Flat single line

61
Q

How do you Rx

A 
Neonatal resus and ventilation 
Support circulation 
Support seizure
Support nutrition 
Support acid base balance 
Therapeutic hypothermia for brain protection
62
Q

What are the complications

A 
Cerebral palsy
Epilepsy 
Blind
Deaf
Learning difficulty
63
Q

How does hypoglycaemia present

A 
Hypothermia
Hypotonia 
Lethargy
Infection
Apnoea
Resp difficulty
Poor feeding
Vomiting
High pitched cry
Seizure
Neuro complications
64
Q

What are RF

A 
Physiological in first few hours just encourage feed 
Pre-term
IUGR 
SGA
LGA / macrosomia 
Maternal DM
Maternal BB use 
Sepsis
Hypothermia
Inborn error
Beckwith Weidman
65
Q

What should all irritable babies get

A

U+E
BG
Sepsis screen

66
Q

How do you treat

A 
Dextrogel 
Enteral feed - NG tube 
IV 10% glucose
Regular electrolyte if on fluid
Glucagon 
Hydrocrotisone 
Recheck glucose
67
Q

When is hypo normal

A

Transient in 1st few days

Observe and encourage feed

68
Q

What are RF for hypothermia

A

Premature
LBW
Prolonged resus

69
Q

How do you investigate

A

Sepsis screen
TFT
Monitor blood glucose

70
Q

How do you Rx

A 
Dry
Warm towel
Radiant heater
Heated oxygen
Incubator
71
Q

What are the complications

A

Increased energy demand + O2
Metabolic acidosis as poor perfusion
Pulmonary hypotension

72
Q

What causes hypotonia

A 
Sepsis
Hypothyroid
Jaundice
Prader-Willi
Down
Benzo's
HIE
Cerebral palsy
Neuromuscular
Maternal myasthenia gravis 
Meconium aspiration 
Hypoglycaemia
73
Q

What are neuromuscular causes

A 
Spina bifida
Myasthenia gravis
Muscular dystrophy
Guillian Barre
Spinal muscular atrophy
Cerebral palsy 
DMD - but doesn't present till later
74
Q

What do you do if hypotonic

A

Sepsis screen

Underlying cause - BG / TFT / LFT

75
Q

What do you follow up on

A

Development

76
Q

What causes haemorrhage disease of newborn

A

Vit K defiicency

77
Q

How does it present

A

Bruising
Jaundice
IVH / kidney

78
Q

What causes retinopathy of premature / LBW

A

Abnormal development of retinal blood vessels

Can lead to scarring, retinal detachment and blindness

79
Q

How is it screened of

A

30-31 weeks gestation if born <27 weeks
Or 4-5 weeks if >27 weeks
Screen every 2 weeks until can be seen that developing normal

80
Q

How do you Rx

A

Laser photocoagulation to prevent neovascularisation
Intravitreal VEGF
Surgery if retinal detachment occurs

Paediatrics (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions