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TAS > Neonatal > Flashcards

Neonatal Flashcards

1
Q

Where are calcifications in CMV?

A

periventricular

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2
Q

What are long term complications of CMV?

A

sensorineural deafness
learning disabilties

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3
Q

What is characteristic of herpes simplex infection?

A

Hepatosplenamegly
Cranail USS with diffuse oedema

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4
Q

What is fetal varicella syndrome?

A

Low birth weight
Cicatrical skin - pale yellow dermatomal scars
Limb hypoplasia
Microcephaly
Chorioretinitis

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5
Q

Which treatment should a non-immune pregnant woman receive if contacts chicken pox?

A

Varicella zoster immunoglobulin

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6
Q

When does polycyntheia occur in neonates?

A

Venous haematocrit >65%

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7
Q

When do you treat neonatal polycyaethmia ?

A

Symptomatic
Venous haematocrit > 70 with no symptoms

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8
Q

What is treatment for polycytheamia ?

A

partial exchange transfusion with removal of blood and replacement of 0.9% sodium chloride to reduce haemocrit to 50%

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9
Q

Which medication is first line to treat neonatal seizure

A

phenobarbital

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10
Q

What is phenobarbital MoA

A

activating the gamma-aminobutyric acid GABA A receptor

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11
Q

When and where is surfactant produced

A

lipoprotein syntethesize in type 11 pneumocystis from 24 weeks

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12
Q

What organisms cause early onset sepsis

A

Group B strep
E.coli
Listeria monocytes
Haemophilus

non-bacteria - herpes, enterovirus

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13
Q

Cause of late onset sepsis

A

coagulase-negative staphylococci
E.Coli
Klebsiella
S.aurues

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14
Q

Risk factors for sepsis

A

Forceps delivery
Chorioamniotisis
Intrauterine monitoring
Maternal GBS colonisation
Intrapartum fever
Preterm delivery
Prolonged rupture of membranes >18 hours
Meconium-stained fluid

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15
Q

What does a blood test in NEC show?

A

Metabolic acidosis

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16
Q

What causes respiratory distress syndrome?

A

Defiency of surfactant - higher surface tension at the alveolar surface
Preterm infant airways - lack sufficient cartilage to remain patent = collapse lungs an increased airway resistance

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17
Q

Prevention of RDS

A

Antenatal glucocorticoid to induce endogenous surfactant formation
Exogenous surfactant replacement therapy
Resp. support - CPAP

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18
Q

What benefits are there to human breast milk in neonates

A

Reduced risk of NEC
Reduced risk of systemic infection

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19
Q

What is patency of PDA maintained by

A

High blood flow
Hypoxia
Locally derived prostaglandin E2

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20
Q

What type of shunt is a PDA

A

left to right

Increased pulmonary blood flow
Pulmonary oedema a
CCF

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21
Q

What type of murmur is a PDA

A

pan systolic at left sternal edge \
loud second heart soul
gallop rhythm
bounding pulse from wide pulse pressure

22
Q

Management of pDA

A

Most close spontaneously
Restricted fluid
Indomethacin or ibuprofen - decrease production of pGE2

23
Q

What is indomethacin ass. with

A

more nephrotoxicity
NEC
GI heamorrhage
platelet dysfunction
Impaired cerebral blood flow

24
Q

Do neonates have more IgG antibodies then mum

A

Yes - transplacental transfer of antibodies

25
Q

Which antibody does breast milk contain

A

IgA - passive immune protection
No igG

26
Q

What are the clinical diagnostic factors for NEC

A

Abdominal distension and tenderness
Bilious aspirates
Bloody stools
Intramural air (pneumatosis intestinal) on abod Xray

27
Q

WHAt are risk factors of NEC

A

Prematurity
HIE - IUGR, PDA
Feeding - rapid increase in enteral feeds, formula milk
Infection

28
Q

Management of NEC

A

Stop feeds and place lore bore nano tube for intestinal decompression
Braod spectrum ABX
Surgery - bowel perforation

29
Q

What causes periventricular-intraventicular haemorrhage

A

Rupture of fragile capillary network in subependymal matriculates of developing brain

30
Q

When is transient tachypnoea of newborn more common

A

C-section

31
Q

Why is TTPN more common in c-sections

A

Absence of thoracic squeezing of lung liquid from chest
Clearance of metal lung fluid dependent on rebasorption of alveolar flu via sodium channels - influcend by level of circulation catecholamines.
There are lower catecholamines following elective delivery

32
Q

What conditions increase risk of thoracic air leaks?

A

RDS
Meconium aspiration syndrome
Congenital diaphragmatic hernia
Previous pneumothorax
Pulmonary hypoplasia

33
Q

Why do air leaks syndrome occur?

A

Damage to respiratory epithelium - allows the air to enter interstitial space causing pulmonary interstitial emphysema

34
Q

What affects pulmonary development in gestational diabetes mums

A

IGF - 1 - potentiated undifferentiated cells In lungs

35
Q

What is Hirchsprung disease

A

Congenital absence of submucosa or myenteric plexus

Meissner - submuscosal
Auerback - myenteric is muscular layer between circular and longitudinal layers

36
Q

what are the conditions tested in newborn screening

A

sickle cell disease
CF
congenital hypothyroidism
maple syrup urine disease
phenylyketonuria
MCADD
isovaleric acidemia
glutamic acuduria type 1
homocysturia

37
Q

When does screening for CF on newborn screening test become unreliable

A

after 8 weeks

can test others up to 1 year

38
Q

What is forced vital capacity

A

total amount of air exhaled with forced expiration

39
Q

what is forced expiratory in first second FEV1

A

measures large airway obstruction

40
Q

Risk factors for hemorrhagic disease of newborn

A

Prematurity
Complicated deliveries
Delayed feeding
Breast fed

41
Q

Pathophysiology of hemorrhagic disease of newborn

A

Vit K dependent clotting factors are deficient at birth - don’t cross placenta (2, 7, 9, 10)
Vit K given to activate them

42
Q

Clinical presentation of haemorrhagic disease of newborn

A

Bleeding - intracranial (Seizure) , meleana
Umbilical stump bleeding

43
Q

Management of hemorrhagic disease of newborn

A

Prevention - iM vit K

Treatment - IV vit K +/- FFP if severe

44
Q

Meconium aspiration syndrome cause

A

Causes mechanical obstruction of bronchioles
preventing gas exchange
Cause inflammatory pneumonitis

45
Q

Types of congenital diaphragmatic hernias

A

Posterolateral Bockdarek hernia - most common, left side
Anterior Morgani hernia
Hiatus hernia

46
Q

Clinical presentation of congenital diaphragmatic hernias

A

polyhydramnios
significant respiratory depression
reduced breath sounds on side of hernia
pulmonary hypoplasia
displaced heart sounds

47
Q

How do you increase Co2 clearance on a ventilator

A

Decrease ventilator rate

48
Q

What is the max of PIP in preterm and normal

A

not max 25
not max 30

49
Q

When do cerebral blood vessels strengthen?

A

After 30 weeks

50
Q

What results will neonatal allomune thrombocytopenia show

A

Low PLT
Normal anticoagulant study

51
Q

Types of ToF

A

A - oesophageal atresia
B - proximal fistula, distal atresia
C - proximal atresia, distal fistula - most common
D - proximal and distal fistula with both atresia
H - double fistula

TAS (18 decks)

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