neuro kids Flashcards
large head small body what you thinking
hydrocephalus
stillbirth
death of a baby after 24 weeks gestation, before or during birth.
neonatal death
Death of a baby within the first 28 days of life
perinatal death
Stillbirth plus early neonatal death (from 28 week’s gestation to first 7 days of life).
cosackie a virus causes hand foot and mouth disease what does cocksackie b virus cause
myocarditis
liver biopsy for what codntion associated with asprin
reye syndrome
management of coarctation of the aorta
Coarctation is monitored via echocardiography and antihypertensives are used to control blood pressure if needed
Most cases requiring intervention are corrected via angioplasty and stent insertion
Severe cases require surgery
Neonates presenting in shock due to critical coarctation require prostaglandin to keep the ductus arteriosus patent until the defect is corrected
radiofemoral delat - turner
maintainance fluids in children
1st 10kg of bodyweight at 100ml/kg/day
2nd 10kg of bodyweight at 50ml/kg/day
Remaining bodyweight at 20ml/kg/day
The fluid type routinely used is 0.9% sodium chloride + 5% dextrose. Potassim is added as required depending on their U&Es.
Fluids deficit replacement in children
Firstly you should calculate the percentage dehydration. This is done either by one of the following ways:
If their normal weight is unknown: Estimating their level of dehydration based on clinical signs from a fluid (hydration status) assessment
If their normal weight is known:
subtracting their current (dehydrated) weight from their normal weight
dividing the result by their normal weight, and then
multiply it by 100
You can then work out the fluid deficit (in ml) by multiplying the % dehydration by their weight (kg) then multiplying that by 10
Deficit replacement fluids should then be given spread out over a 24-48 hour period in children in addition to normal maintenance fluids
Acute fluid resuscitation in children
Boluses in paediatrics are given at 10-20ml/kg at a time
The fluid used is 0.9% sodium chloride
10ml/kg boluses should be used when treating children who are in heart failure or are trauma victims
Senior support should be sought if a child has not responded to 2 boluses
Fluids
what keeps PDA open
alprostadil PGE1
what closes PDA
indomethacin
signs of PDA - has to be open for more than 4 weeks of life
NSAIDs inhibit prostaglandin synthesis which normally help maintain ductal patency.
A persistent ductus arteriosus may be asymptomatic or present with signs of heart failure.
The classical murmur heard is a continuous ‘machine-whirring’ murmur throughout the cardiac cycle.
signs of PDA - has to be open for more than 4 weeks of life
NSAIDs inhibit prostaglandin synthesis which normally help maintain ductal patency.
A persistent ductus arteriosus may be asymptomatic or present with signs of heart failure.
The classical murmur heard is a continuous ‘machine-whirring’ murmur throughout the cardiac cycle.
An 8 week old baby boy is brought to A&E with projectile vomiting. His mother says he has been vomiting after every feed for the last week, sometimes large volume vomits and one that hit the wall about a meter away when she was burping him. He has still been breastfeeding well and is otherwise well. He has had no fever, diarrhoea, rash, cough or difficulty in breathing. He was born at 39 weeks by spontaneous vaginal delivery after an uncomplicated pregnancy, and is the family’s first baby.
On general inspection, he is smiling and alert. He is pink and well perfused and moving all 4 limbs spontaneously. His chest is clear with heart sounds I + II. His temperature is 36.7 degrees. On palpation, there is a smooth olive-sized mass in the left epigastric region.
In severe cases, which acid-base abnormality would be seen in this condition?
pyrloric stenosis - Typically occurs in babies aged 6-8 weeks old - males
hypochloremic hypokalemic metabolic alkalosis
porjectile vomit, good appetitie and olive shaped mass
loss of stomach hydrochloric acid.
loss of cl obvs , loss of H+ causes alklalosis and increased renal re-absorption of H+ in exchnage for potassium so low potassium
dx
Pyloric stenosis is definitively diagnosed with an abdominal ultrasound to visualise the hypertrophic sphincter
An 8 week old baby boy is brought to A&E with projectile vomiting. His mother says he has been vomiting after every feed for the last week, sometimes large volume vomits and one that hit the wall about a meter away when she was burping him. He has still been breastfeeding well and is otherwise well. He has had no fever, diarrhoea, rash, cough or difficulty in breathing. He was born at 39 weeks by spontaneous vaginal delivery after an uncomplicated pregnancy, and is the family’s first baby.
On general inspection, he is smiling and alert. He is pink and well perfused and moving all 4 limbs spontaneously. His chest is clear with heart sounds I + II. His temperature is 36.7 degrees. On palpation, there is a smooth olive-sized mass in the left epigastric region.
In severe cases, which acid-base abnormality would be seen in this condition?
pyrloric stenosis - Typically occurs in babies aged 6-8 weeks old - males
hypochloremic hypokalemic metabolic alkalosis
porjectile vomit, good appetitie and olive shaped mass
loss of stomach hydrochloric acid.
loss of cl obvs , loss of H+ causes alklalosis and increased renal re-absorption of H+ in exchnage for potassium so low potassium
dx
Pyloric stenosis is definitively diagnosed with an abdominal ultrasound to visualise the hypertrophic sphincter
Mx of pyloric stenosis
Management of pyloric stenosis is surgical with a pyloromyotomy to cut the pyloric sphincter to widen the outlet
Until the procedure, the baby should be nil-by-mouth and kept on IV fluids
Severely dehydrated babies may require acute fluid resuscitation
