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Child Health 2020 > Year 4 Neonatology > Flashcards

Year 4 Neonatology Flashcards

1
Q

when is term?

A

37 - 41 +6 weeks

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2
Q

what is pre-term?

A

before 36 weeks

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3
Q

when is there foetal loss?

A

under 22 weeks

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4
Q

when is post-term?

A

beyond 43 weeks

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5
Q

what is LBW?

A

<2500g

SGA <10th centile

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6
Q

what are all neonates given at birth?

A

vitamin K

iron + multivitamins

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7
Q

what does the heel prick test screen for?

A

9 congenital conditions:

  • sickle cell disease
  • CF
  • congenital hypothyroidism
  • phenylketonuria
  • MCADD
  • maple syrup disease
  • IVA
  • GA1
  • homocystin
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8
Q

how long do the results for the heel prick test take to come back?

A

6-8 weeks

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9
Q

what can over-inflation of the lungs at birth lead to?

A

BPD

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10
Q

breathing support options

A 
low flow nasal/ high flow
CPAP
BiPAP
ventilation
oscillation
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11
Q

how long should cord clamping be delayed?

A

at least 1 minute

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12
Q

how long is the neonatal period?

A

first 28 days of life

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13
Q

when should steroids be given to the mother?

A

two doses prior to delivery <36 weeks (either dex or betamethasone?)

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14
Q

what do steroids reduce the risk of?

A

RDS
sepsis
IVH
NEC

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15
Q

when should magnesium sulphate be given?

A

to the mother for delivery <34 weeks

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16
Q

why is caffeine given to neonates?

A

given to pre-terms to prevent apnoeic epsiodes and for neuroprotection

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17
Q

what is NEC?

A

widespread necrosis of the small and large intestine

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18
Q

when does NEC typically occur?

A

in the neonatal period after recovering from RDS

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19
Q

presentation of NEC

A

neonate with lethargy, bloody stools, bilious vomit, abdominal distension, apnoea, bradycardia

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20
Q

management of NEC

A

parenteral nutrition stop feeding
antibiotics (vanc + cefotaxime)
surgery if severe or perforation (bowel resection +/- stoma)

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21
Q

diagnosis of RDS

A

CXR and airbronchogram (ground glass appearance)

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22
Q

management of RDS

A

low level oxygen

natural surfactant within 6 hours of birth (curosurf)

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23
Q

what sats should be aimed for in RDS?

A

85-93% to prevent the development of ROP

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24
Q

what is surfactant?

A

phospholipid with apoproteins

25
Q

what is interventricular haemorrhage?

A

bleeding into the germinal matrix

26
Q

when do most IVHs occur?

A

first day of life

27
Q

what is a RF for IVH?

A

RDS due to hypoxia, acidosis and hypotension making the cerebral circulation more unstable

28
Q

management of IVH

A

steroids
graded 1-4
vit K deficiency

29
Q

who is screened for ROP?

A

<1500g or <32 weeks

30
Q

management of ROP

A

diode laser therapy
cryotherapy
intravitreal VEGF

31
Q

what can cause neonatal abstinence syndrome?

A 
opiates
methadone
BZDs
cocaine
amphetamines
alcohol
nicotine
cannabis
SSRIs
32
Q

when do most NAS occur?

A

within 3-72 hours

33
Q

presentation of NAS

A 
irritability
increased tone, tremors, seizures
sweating
pyrexia
poor feeding
loose stools
34
Q

management of NAS

A

monitored with NAS chart for 3 days

if severe give magnesium sulphate in opiate withdrawal or phenobarbitone in non-opiate withdrawal

35
Q

appearance of foetal alcohol syndrome

A 
microephaly
thin upper lip
smooth flat philtrum
short palpable fissure
LD
behaviour
hearing
vision problems
cerebral palsy
36
Q

when is jaundice pathological?

A

first 24 hours of life

prolonged >2 weeks

37
Q

when does physiological/ breast feeding jaundice occur?

A

2-5 days

38
Q

causes of jaundice in the first 24 hours?

A 
sepsis
ABO incompatibility
RhD incompatibility
congenital spherocytosis
G6PD deficiency
39
Q

unconjugated prolonged jaundice causes

A

physiological/breast feeding
hypothyroidism
galactosaemia

40
Q

conjugated prolonged jaundice causes

A

biliary atresia

neonatal hepatitis

41
Q

management of jaundice

A

plot bilirubin levels of threshold charts
phototherapy
exchange transfusions

42
Q

how does phototherapy work?

A

converts unconjugated bilirubin into isomers

43
Q

what is kernicterus?

A

accumulation of unconjugated bilirubin in basal ganglia (acute bilirubin encephalopathy)

choreoathetoid CP + SNHL

44
Q

signs of BPD?

A

oxygen requirement beyond 36 weeks + evidence of pulmonary parenchymal disease on CXR

45
Q

what is healing in BPD associated with?

A

continued lung growth over 2-3 years

often wheezy

46
Q

what protection should babies with BPD be given?

A

monthly injections to protect against RSV

47
Q

management of nappy rash

A

sudocream (+ clotrimazole if candida)

48
Q

presentation of sepsis

A 
resp distress
apnoea
jaundice
temp
poor feeding
49
Q

management of febrile baby

A 
cultures
LP 
CXR
urine microscopy
septic screen
50
Q

management of neonatal sepsis

A

gent + benzylpenicillin

51
Q

what is a cephalohaemtoma?

A

subperiosteal bleed (collection of blood between the skull and periosteum)

52
Q

does a cephalohaematoma cross suture lines?

A

no

53
Q

management of cephalohaemtoma

A

resolves spontaneously

monitor for jaundice and anaemia

54
Q

what is caput succedaenum?

A

oedema collection outside of the periosteum

55
Q

does caput succedaneum cross suture lines?

A

yes

56
Q

management of caput succedaneum

A

nothing

usually from traumatic delivery

57
Q

what are milia?

A

white/cream papules on forehead, nose and cheeks

resolve spontaneously/ milk spots

58
Q

CI to breastfeeding

A

HIV +ve mother
amiodarone
antithyroid (carbimazole)
opiates

59
Q

neonatal screening questions?

A

has the baby passed meconium?
feeling okay?
FH of heart, eye or hip problems

Child Health 2020 (22 decks)

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