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child health > the preterm baby > Flashcards

the preterm baby Flashcards

1
Q

what is a late pre-term baby ?

A

betweenn 34-36 weeks

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2
Q

what is an early pre-term baby ?

A

less than 28 weeks

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3
Q

when is the coordination nof suck swallow breath established ?

A

at about 34 weeks

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4
Q

why are preterm babies at a higher risk of hypothermia ?

A

little fat
SA> weight
thermoregulatory problems

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5
Q

what are the causes of hypothermia ?

A

apnea

bleeding tendencies

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6
Q

what is the resuscitation protocol for preterm babie s?

A 
temperature control 
ABC 
Cord clamp and Vitamin K 
Monitoring 
CPAP , intubation and 1st dose of surfactants
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7
Q

what are the two needs for the administratio nof surfactants ?

A

prophylactic and rescuse

both the neonate must be ventilated

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8
Q

what factors reduce the chances of RDS ?

A

IUGR

maternal corticosteroids which are given on two doses

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9
Q

at what time is RDS diagnosed ?

A

eithin 4 hours of life

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10
Q

what are the differential diagnosis of RDS ?

A

pneumonia

sepsis

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11
Q

what are the x-ray findings in nRDS ?

A

small lung volume
ground glass opacities
air bronchograms

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12
Q

what are the short term problems associated with the lungs of a preterm baby ?

A

RDS
pneumothorax
apnea of prematurity

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13
Q

what are the causes of apnea of prematurity ?

A

either
central
or
obstructive

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14
Q

what is the main risk factor for apnea ?

A

VLBW ( less than a kilo )

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15
Q

what are the first line antibiotics for neonataes ?

A

amoxicillin

gentamicin

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16
Q

what are the long term problems of the lungs of a preterm baby ?

A

BPD
Asthma
increased risk of resp infections
re-hospitalization

17
Q

what are the short term problems associated with the brain ?

A

GMH-IVH
Diffuse WM injury ( periventricular leukomalacia )
encephalopathy

18
Q

what are the long term problems associated with the brain of a preterm ?

A

CP

cognitive, learning and behavioural problems

19
Q

how is a diagnosis of GMH-IVH made ?

A

routine ultrasound done on day 2

20
Q

what are the riskk factors associated with IVH ?

A

perinatal asphyxia
Severe RDS
Pneumothorax and hypercarbia

21
Q

what is the most appropriate management for a progressive IVH ?

A

serial lumbar puncture

if continues - VP shunt

22
Q

what are the short term problems involving the heart ?

A

PDA

23
Q

what phenomenon is associated with PDA ?

A

steal phenomenon

24
Q

what is the clinical picture of PDA ?

A

apnea
bounding pulse
difficulty in weaning off ventilation

25
Q

what is the treatment of PDA ?

A

if medically indicated :

ibuprofen or indomethacin

26
Q

what are the short term and long term problems involving the gut ?

A

short term : NEC

long term : strictures , short gut ( malapsorption)

27
Q

when should enteral feeding in a preterm newborn be started ?

A

day 1 is stable using the mother’s breast milk ( trophic feeding)

28
Q

what is the caloric intake in preterm formula ?

A

100kcal in 100 mls

29
Q

what are the three phases of nutrition of the newborn ?

A

TPN + gut priming
transition
full enteral

30
Q

what is the presentation of NEC ?

A

bile stained gastric aspirate and vomiting
shock and apnea
fresh blood in stools
distended abdomen

31
Q

what are the predisposing factors for NEC ?

A

Cows milk formula
prematurity
BActerial infection

32
Q

what is the management for NEC ?

A 
TPN stop any oral intake 
free drainage NGT 
triple antibiotic ( 1st line along with metronidazole)
33
Q

what are the short term problems associated with the preterms eyes ?

A

retinopathy of prematurity

34
Q

what is the management for ROP ?

A

periodic reviews ever 1-2 weeks

criteria for laser therapy

child health (40 decks)

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