The premature infant & neonate Flashcards
1
Q
What are the systemic features of necrotising enterocolitis
A
temperature instability apnoeas bradycardia lethargy metabolic acidosis thrombocytopaenia
2
Q
What are the abdominal signs of necrotising enterocolitis
A
Increased pre-feed nasogastric aspirates abdo distention vomiting bloody stools abdominal tenderness peritonism
3
Q
What may you see on abdo x ray in an infant with necrotising enterocolitis/
A
Distended bowel loops
pneumotosis intestinalis
portal vein gas
pneumoperitoneum- perf
4
Q
Which infants are most at risk of NEC
A
- prematurity
- low birth weight
5
Q
What is the management of NEC
A
- NBM
- NGT for decompression
- IV TPN
- IV antibiotics:
6
Q
Which antibiotics would you normally use in NEC
A
Ampicillin/gentamicin or cefotaxime.
Plus metronidazole or clindamycin.
consider antifungals if lots of previous abx
7
Q
What are the complications of NEC
A
- perforation
- acquired short bowel syndrome
- DIC
- sepsis and shock
- strictures
8
Q
What preventative measures can be done to prevent nec
A
- small drops of human milk
- slow feeds with small increments
- trophic feeding rather than prolonged bowel rest
9
Q
What conditions are assessed for on the routine heel prick test.
A
Metabolic conditions
- Phenylketonuria
- MCADD
- Maple syrup urine disorder
- Isovaleric acidaemia
- Glutaric aciduria type 1
- Homocystinuria
Other
- Sickle cell disease
- cystic fibrosis
- congenital hypothyroidism
