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Paeds AM > Term admissions to ICU > Flashcards

Term admissions to ICU Flashcards

1
Q

What is the most common cause of sepsis in neonates?

A

Group B strep
E. coli
Listeria

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2
Q

What are the complications of group B strep sepsis?

A

MEningitis
DIC
Pneumonia and resp collapse
Hypotension and shock

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3
Q

What are the risk factors for sepsis in neonates?

A

Prolonged rupture of membranes
Maternal pyrexia
Maternal group B strep carriage

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4
Q

What are the signs and symptoms of sepsis in neonates?

A 
Pyrexia or hypothermia
Poor feeding
Lethargy
Early jaundice
Hypo/hyperglycaemia
Asymptomatic
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5
Q

What is the management of sepsis in neonates?

A

Admit
Partial sepsis screen- FBC, CRP, culture and blood gas
Consider CXR and LP
IV penicillin and gentamicin
-add metronidazole if surgical/abdo concerns
Fluid management, treat acidosis

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6
Q

What is the most common reason for NNU admission?

A

Resp distress

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7
Q

What are the causes of respiratory distress?

A

Sepsis
Transient tachypnoea of newborn
Meconium aspiration

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8
Q

What is transient tachypnoea of newborn?

A

Self limiti g common condition in 1st few hours

Delay in clearance of foetal lungs

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9
Q

What are the features of transient tachypnoea of newborn?

A

Grunting
Tachypnoea
Normal gases

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10
Q

What is the management of transient tachypnoea of newborn?

A

CXR
Supportive- fluids, O2, airway
antibiotics

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11
Q

What are the risk factors for meconium aspiration?

A

Post dates
Maternal DM or hypertension
Difficult labour

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12
Q

What are the features of meconium aspiration?

A 
Cyanosis
Increased work of breathing
Grunting
Apnoea
Floppy
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13
Q

What investigations should be done for meconium aspiration?

A

Blood gas
Sepsis
screen
CXR

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14
Q

What is the management of meconium aspiration?

A

Suction below cords
Airway support
Fluids and IV antibitocs
Surfactant- meconium deactivates normal surfactant

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15
Q

What investigations should be done for a blue baby?

A 
Exam and history
Sepsis screen
Blood gas and blood glucose
CXR
Pulse ox
ECG
Echo
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16
Q

What is a characteristic pulse ox of cardiac defect?

A

Always <100%, as can never be 100 due to venous mixing

17
Q

What are the cardiac defect differentials?

A 
Transposition of great vessels
Tetralogy of Fallot
Total anomalous pulmonary venous drainage
Hypoplastic left heart syndrome
Tricuspid atresia
Truncus arteriosus
Pulmonary atresia
18
Q

What is the management of hypoglycaemia?

A

Monitor
Enteral feeds
IV 10% glucose
Resistant- glucagon, steroids

19
Q

What are the common causes of hypoglycaemia?

A

Maternal DM

Intraauterine growth restriction

20
Q

What is the management of hypothermia?

A

Incubator
Sepss screen and antibiotics
Thyroid function
Monitor glucose

21
Q

What are the causes of birth asphyxia?

A 
Placental
Long, difficult delivery
Umbilical cord prolapse
infection
Neonatal airway problem
Neonatal anaemia
22
Q

What are the 3 types of birth asphyxia?

A

Mild
Moderate
Sever

23
Q

What are the 2 stages of birth asphyxia?

A

Acute-CEll damage, happens in minutes

Reperfusion injury- can last days to weeks, due to toxins released from damaged cells

24
Q

What is the management of birth asphyxia?

A

Supprot- fluid resus, monitor, cardiac and rest support, treat any seizures
Theraputic hypothermia, esp in moderate

25
Q

What are the common surgical problems of the neonate?

A 
Oesophageal atresia
Duodenal atresia
Failure to pass stool
Abdo wall defect
Diaohragmatic hernia
26
Q

What are the common causes of failure to pass stool?

A 
Constipation
Large bowel atresia
Imperforate anus
Hirschsprungs disease
Meconium ileus
27
Q

When and where are diaphragmatic hernias normally?

A

Males > females

Left 90%

28
Q

What is the management of diaphragmatic hernia?

A

Intubation and hernia

Surgery

Paeds AM (19 decks)

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