Brainscape's Knowledge GenomeTM

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


See full index

Paediatrics > Prematurity > Flashcards

Prematurity Flashcards

1
Q

What are the causes of prematurity?

A
  1. Unknown (most common)
  2. Smoking
  3. Low socio-economic status
  4. Malnutrition
  5. History of - prematurity, infection, PET, DM, polyhydramnios, closely spaced pregnancy, multiple pregnancy, uterine malformations, placental issues, PROM.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is this describing?

<37/40 completed weeks gestation.

A

Preterm

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

What is this describing?

<2500g regardless of gestational age, may not be SGA if preterm.

A

Low birth weight

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

What is this describing?

<1500g regardless of gestational age, may not be SGA if preterm.

A

Very low birth weight

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

What is this describing?

<1000g regardless of gestational age, may not be SGA if preterm.

A

Extremely low birth weight

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

What is this describing?

Birth weight below the 10th percentile for gestational age.

A

Small for gestational age (SGA)

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

What is this describing?

Failure of growth in utero which may/may not result in a baby being SGA.

A

Intrauterine growth restriction (IUGR)

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

What is this describing?
All growth parameters in an infant are small, suggesting foetus was affected from early pregnancy either due to chromosomal abnormalities or being constitutionally small.

A

Symmetrical SGA

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

What is this describing?
Weight of an infant is affected but length and head circumference spared. Usually due to IUGR and an insult later in pregnancy (placental/PET).

A

Asymmetrical SGA

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

What are the causes of symmetrical SGA?

A

Malnutrition, maternal hypoxia, alcohol, smoking, chromosomal, congenital infection.

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

What are the causes of asymmetrical SGA?

A

PET, thrombosis/infarction (sickle cell)

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

What causes hypothermia in a premature infant and how is it managed?

A
  1. Thin skin, large body surface area, limited SC fat.

2. Humidified incubator, hat on head.

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

What causes infection in a premature infant and how is it managed?

A
  1. Less passive immunity as maternal Igs cross placenta at 30/40.
  2. IV Abx, antibodies against specific infection, prophylactic anti-fungal.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes feeding difficulties in preterm infants, what can it cause, and how is it managed?

A
  1. No suck and swallow reflex until 34/40.
  2. Necrotising enterocolitis
  3. <34/40 TPN with milk via NG tube, breastmilk preferred as formula can increase risk of NEC.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What will all babies born <28/40 have and how is it defined?

A
  1. Apnoea

2. Pause of breathing of >20s

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

What are the causes of apnoea of prematurity?

A
  1. Immature respiratory drive

2. GORD, infection, seizures, hypoxia

17
Q

What is the management of apnoea of prematurity?

A
  1. Mechanical ventilation, surfactant
  2. Caffeine daily to stimulate respiratory centre of brain.
  3. Most resolve by 34/40 and caffeine is stopped.
18
Q

What type of brain bleed can occur in prematurity?

A

Intraventricular haemorrhage

19
Q

What is the cause of intraventricular haemorrhage in neonates?

A

Prematurity

20
Q

What is the pathophysiology of intraventricular haemorrhage in prematurity?

A

Small vessels in subpendymal germinal matrix rupture. Matrix prominent between 24-34/40 then regresses by term, so it is rare in term neonates.

21
Q

What are the risk factors for intraventricular haemorrhage in prematurity?

A
  1. Hypertension
  2. Hypotension
  3. High pCO2
  4. Low O2
22
Q

What is this a presentation of?

Usually asymptomatic. Seizures, bulging fontanelle, prolonged apnoea, Hb drop. Premature infant.

A

Intraventricular haemorrhage

23
Q

How is intraventricular haemorrhage of prematurity diagnosed?

A

Cranial USS, babies born <32/40 have 3 scans in 1st week of life.

24
Q

What is the management for intraventricular haemorrhage of prematurity?

A
  1. Reduce risk factors.

2. If hydrocephalus is increasing, drain using LP or shunt, otherwise it is self-resolving.

25
Q

What is this describing?

Abnormal proliferation of retinal blood vessels of premature babies.

A

Retinopathy of prematurity

26
Q

What are the risk factors for retinopathy of prematurity?

A
  1. Low birth weight, prematurity

2. Large fluctuations of oxygen, prolonged oxygen therapy.

27
Q

How is retinopathy of prematurity diagnosed?

A
  1. Screening through initial ophthalmoscopy with pupil dilation.
  2. Screen all at <32/40 or weight <1500g
28
Q

What are the complications of retinopathy of prematurity?

A

Vitreous haemorrhage, retinal detachment, blindness, visual problems.

29
Q

What is the management for retinopathy of prematurity?

A
  1. Usually resolves spontaneously
  2. Treat for severe stages with diode laser therapy under GA
  3. Consider bevacizumab (anti-VEGF)
30
Q

What is this describing?

Serious acute inflammatory bowel condition that occurs in the 2nd/3rd week of life in premature babies.

A

Necrotising enterocolitis

31
Q

What is the cause of necrotising enterocolitis of prematurity?

A
  1. Necrosis of the bowel due to lack of blood flow.

2. Associated with prematurity, hypoxia, formula milk feeds.

32
Q

What is this a presentation of?
Early - bile stained aspirates from stomach, abdominal distension, bloody stools, poor feeding, lethargy, vomiting.
Late - abdominal discolouration, perforation, peritonitis, shock, DIC.

A

Necrotising enterocolitis

33
Q

How is necrotising enterocolitis of prematurity diagnosed?

A
  1. Clinical diagnosis
  2. Abdominal x-ray - dilated bowel, pneumatosis intestinalis (gas in bowel wall), bowel perforation (free air in abdomen)
34
Q

How is necrotising enterocolitis of prematurity prevented?

A
  1. Introduce feeds gradually
  2. Breast milk
  3. Probiotics
35
Q

What is the active management for necrotising enterocolitis of prematurity?

A
  1. Stop oral feeding (except probiotics), replace with TPN.
  2. Analgesia
  3. Culture faeces, crossmatch (risk of anaemia)
  4. Abx - cefotaxime and vancomycin
36
Q

What is the surgical management for necrotising enterocolitis of prematurity?

A

If bowel perforation - conservative with peritoneal drainage or laparotomy to remove affected bowel and temporary stoma.

Paediatrics (148 decks)

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