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Y3 OBS AND GYNAE > Sick Term Infants > Flashcards

Sick Term Infants Flashcards

1
Q

What is the time period for classifying a new baby as a neonate?

A

Up to 28 days

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2
Q

What is the most common cause of neonatal death?

A

Prematurity

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3
Q

What are the components of the APGAR score?

A 
Appearance
Pulse
Grimace (reflex irritability)
Activity (tone)
Respirations
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4
Q

What is a normal APGAR score?

A

8 or 10

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5
Q

How is appearance scored on APGAR?

A

Blue or pale = 0
Blue in extremities = 1
No cyanosis = 2

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6
Q

How is pulse scored on APGAR?

A

Absent = 0
Less than 100 = 1
More than 100 = 2

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7
Q

How is grimace scored on APGAR?

A

No response = 0
Feeble cry when stimulated = 1
Cry or pull away when stimulated = 2

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8
Q

How is activity scored on APGAR?

A

No activity = 0
Some flexion = 1
Flexed arms and legs that resist extension = 2

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9
Q

How is respiration scored on APGAR?

A

No respiration = 0
Weak, irregular, gasping = 1
Strong cry = 2

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10
Q

List important parts of the maternal history to ask about during newborn clinical assessment

A

PMHx
Pregnancy issues
Drugs
Infection risks

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11
Q

List important parts of the fetal history to ask about during newborn clinical assessment

A

Fetal gorwth
Fetal anomaly
Delivery
Resuscitation

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12
Q

List the important examinations involved in a newborn clinical assessment

A

Inspect: tone, arousal, colour, vomit, feeding, seizures
AB: respiratory rate, effort, colour, sats (95%)
C: heart rate, CRT, BP

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13
Q

What is a normal respiratory rate for a neonate?

A

40-60 breaths/min

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14
Q

What is a normal heart rate for a neonate?

A

120-160/min

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15
Q

List aspects of initial management in an ABCDE assessment

A

AB: oxygen
C: fluids, inotropes, umbilical access
D: glucose management, acid-base balance
E: temperature, antibiotics

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16
Q

What are the 4 main causes/groups of causes of a sick term infant?

A

Congenital abnormality
Metabolic disorder
Pregnancy/Birth-related
Infection

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17
Q

List the main bacterial infections that affect neonates

A 
Group B Strep.
E. coli
Listeria
Staph. aureus
Staph. epidermidis
18
Q

List the main viral infections that affect neonates

A 
Cytomegalovirus
Parovirus
Herpes virus
Enterovirus
Toxoplasma gondii
HIV
Syphilus
19
Q

List the TORCH infections which are commonly associated with congenital anomalies

A 
Toxoplasmosis
Other (syphilis, varicella-zoster, parvovirus B19)
Rubella
Cytomegalovirus (CMV)
Herpes
20
Q

List the most common sites of infection found in sick term infants

A 
Blood stream (bacteraemia,septicaemia)
CNS (meningitis)
Respiratory (pneumonia)
GU (UTI)
GI (NEC)
Skin, bone
21
Q

Give a cause of neurodevelopmental problems shortly after delivery that requires immediate resuscitation in the newborn

A

Hypoxic ischaemic encephalopathy

Multi-organ damage due to tissue hypoxia

22
Q

List respiratory problems that can be seen in the newborn shortly after delivery

A

Transient tachypnoea of newborn (TTN)

Pneumothorax (spontaneous or secondary to resusc)

23
Q

What is transient tachypnoea of newborn? What is a major risk factor?

A

Inability of the newborn’s lungs to expel or absorb amniotic fluid during and following delivery
Cesarean delivery

24
Q

State a cardiac problem that is a common cause of heart failure in the newborn

A

Hydrops foetalis

25
Q

What is hydrops foetalis?

A

Accumulation of fluid in at least 2 compartments (ascites, pleural effusion, abdominal swelling etc.)

26
Q

What are the two main types of hydrops foetalis?

A

Immune (due to Rhesus disease)

Chromosomal

27
Q

State a cardiac problem that is due to a failure to adapt to postnatal life

A

Persistant pulmonary hypertension of newborn

Pressure in lungs does not drop, causing hypoxia

28
Q

List common cardiac-related congenital diseases found in the newborn

A 
Tetralogy of fallot
Transposition of great arteries
Coarctation of aorta
Total anomolous pulmonary venous drainage
Hypoplastic heart
29
Q

What is a common clinic sign of coarctation of aorta?

A

Absent femoral pulses

30
Q

List the main components of tetralogy of fallot

A 
"Don't DROP the baby"
Defect (VSD) 
Right ventricular hypertrophy 
Overriding aorta 
Pulmonary stenosis
31
Q

What is total anomolous pulmonary venous drainage (TAPVD)?

A

Four pulmonary veins drain abnormally to the right atrium, instead of the left, by way of an abnormal (anomalous) connection

32
Q

What is hypoplastic heart?

A

Left ventricle is underdeveloped leading to reduced pumping action of the heart

33
Q

List common respiratory-related congenital diseases found in the newborn

A

Tracheo-oesophageal fistula

Diaphragmatic hernia

34
Q

What is a common sign on imaging of tracheo-oesophageal fistula?

A

NG tube can’t pass down oesophagus as it isn’t formed properly

35
Q

List common neuro-related congenital diseases found in the newborn

A

Microcephaly

Spina bifida

36
Q

State a common renal-related congenital disease found in the newborn

A

Potter’s syndrome

Kidney’s fail to develop in the womb leading to reduced amniotic fluid production

37
Q

State a common muscular-related congenital disease found in the newborn

A

Congenital myotonic dystrophy

Weak muscles and a lack of muscle tone

38
Q

List common metabolic congenital diseases found in the newborn

A

Hypoglycaemia

Acidosis

39
Q

List risk factors for hypoglycaemia in the neonate

A

Maternal diabetes
SGA or LGA
Prematurity
Difficult birth

40
Q

List signs of hypoglycaemia in the newborn

A 
Jitteriness
Cyanosis
Apnea
Hypothermia
Poor body tone
Poor feeding
Lethargy
Seizures
41
Q

List some conditions tested for on the Guthrie card or heel prick test

A

PKU
Sickle cell anaemia
Cystic fibrosis
Congenital hypothyroidism

Y3 OBS AND GYNAE (44 decks)

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