the preterm baby

Question 1

what is a late pre-term baby ?

Answer 1

betweenn 34-36 weeks

Question 2

what is an early pre-term baby ?

Answer 2

less than 28 weeks

Question 3

when is the coordination nof suck swallow breath established ?

Answer 3

at about 34 weeks

Question 4

why are preterm babies at a higher risk of hypothermia ?

Answer 4

little fat
SA> weight
thermoregulatory problems

Question 5

what are the causes of hypothermia ?

Answer 5

apnea

bleeding tendencies

Question 6

what is the resuscitation protocol for preterm babie s?

Answer 6

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

Question 7

what are the two needs for the administratio nof surfactants ?

Answer 7

prophylactic and rescuse

both the neonate must be ventilated

Question 8

what factors reduce the chances of RDS ?

Answer 8

IUGR

maternal corticosteroids which are given on two doses

Question 9

at what time is RDS diagnosed ?

Answer 9

eithin 4 hours of life

Question 10

what are the differential diagnosis of RDS ?

Answer 10

pneumonia

sepsis

Question 11

what are the x-ray findings in nRDS ?

Answer 11

small lung volume
ground glass opacities
air bronchograms

Question 12

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

Answer 12

RDS
pneumothorax
apnea of prematurity

Question 13

what are the causes of apnea of prematurity ?

Answer 13

either
central
or
obstructive

Question 14

what is the main risk factor for apnea ?

Answer 14

VLBW ( less than a kilo )

Question 15

what are the first line antibiotics for neonataes ?

Answer 15

amoxicillin

gentamicin

Question 16

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

Answer 16

BPD
Asthma
increased risk of resp infections
re-hospitalization

Question 17

what are the short term problems associated with the brain ?

Answer 17

GMH-IVH
Diffuse WM injury ( periventricular leukomalacia )
encephalopathy

Question 18

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

Answer 18

CP

cognitive, learning and behavioural problems

Question 19

how is a diagnosis of GMH-IVH made ?

Answer 19

routine ultrasound done on day 2

Question 20

what are the riskk factors associated with IVH ?

Answer 20

perinatal asphyxia
Severe RDS
Pneumothorax and hypercarbia

Question 21

what is the most appropriate management for a progressive IVH ?

Answer 21

serial lumbar puncture

if continues - VP shunt

Question 22

what are the short term problems involving the heart ?

Answer 22

PDA

Question 23

what phenomenon is associated with PDA ?

Answer 23

steal phenomenon

Question 24

what is the clinical picture of PDA ?

Answer 24

apnea
bounding pulse
difficulty in weaning off ventilation

Question 25

what is the treatment of PDA ?

Answer 25

if medically indicated : | ibuprofen or indomethacin

Question 26

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

Answer 26

short term : NEC | long term : strictures , short gut ( malapsorption)

Question 27

when should enteral feeding in a preterm newborn be started ?

Answer 27

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

Question 28

what is the caloric intake in preterm formula ?

Answer 28

100kcal in 100 mls

Question 29

what are the three phases of nutrition of the newborn ?

Answer 29

TPN + gut priming transition full enteral

Question 30

what is the presentation of NEC ?

Answer 30

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

Question 31

what are the predisposing factors for NEC ?

Answer 31

Cows milk formula prematurity BActerial infection

Question 32

what is the management for NEC ?

Answer 32

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

Question 33

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

Answer 33

retinopathy of prematurity

Question 34

what is the management for ROP ?

Answer 34

periodic reviews ever 1-2 weeks | criteria for laser therapy