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🍉paeds > common postnatal problems > Flashcards

common postnatal problems Flashcards

1
Q

Describe the different colors you could see a neonate?

A
  • Yellow (Jaundice - see separate deck)
  • Pale
  • Red (Plethora - Polycythaemia)
  • Cyanosed
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2
Q

cause of jaundice in the first 24hours

A

Haemolytic ( e.g. G6PD deficiency, spherocytosis )

Sepsis

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3
Q

2nd day – 2nd/3rd wk cause of jaundice

A 
Physiological 
Dehydration/poor feeding
Breast milk (second 2)
Sepsis
Polycythaemia
Bruiding e.g. cephalohaematoma
Haemolytic 
Crigler-Najjar Syndrome
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4
Q

Prolonged jaundice (>2 weeks term, >3 weeks preterm): causes

A 
Breast milk
Cholestasis e.g. biliary atresia!!
Sepsis (each one)
Haemolytic 
Hypothyroidism
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5
Q

treatment of jaundice in baby?

A 
Treat underlying cause
Hydrate 
Phototherapy – NICE guideline charts
Exchange transfusion
Immunoglobulin
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6
Q

It’s very common (50-70%) for babies to develop a red maculopapular rash after birth.(v rare in preterm tho neonates) What do we call this and how is it managed?

A

Erythema Toxicum

Reassure, it clears by it’s self within 1-2wks

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7
Q

Babies of races with pigmented skin are often born with blue-grey patches on lower back/buttocks, What is this?

A

Mongolian blue spots

Due to accumulation of melanocytes

Leave it an it will fade

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8
Q

Sometimes babies are born with light pink marks on the back of the neck or midline of face, what do we call this and what do we do?

A

Stork Marks (or Naevus Simplex)

It’s just dilated capillaries, leave it and it will disappear within 2 yrs

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9
Q

port wine stain- Present at birth, flat or slightly raised.

what is it called?

pathophysiology?

associated with what conditions?

A

Naevus flammeus- doesn’t regress!1

Caused by dilated, mature capillaries in the superficial dermis.

Sturge Weber
Klippel-Trenaunay

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10
Q

Raised and bright red, with discrete edges, occurring in any part of the body. (Fahriya had this)
- what is it called?

A

Capillary haemangioma / Strawberry naevus

a cluster of dilated capillaries which appears within the first month after birth.

Usually regresses after one year of age.

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11
Q

Babies often present hypothermic following birth, how do we prevent this?

A

During resuscitation:

  • Dry quickly
  • Remove wet linens
  • Use warmed towels
  • Provide a radiant warmer
  • Use heated/humidified O2
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12
Q

what RF for babies to have hypoglycaemia?

A
  • Premature
  • Diabetic mum –> Hyperinsulinaemia
  • Hypothermia
  • Sepsis
  • Small/Large for Gestational Age
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13
Q

how to diagnose a baby as hypoglycaemiac?

A

Bedside skin prick glucose

blood sugar <2.0 mmol/l we send for a lab sample to confirm

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14
Q

What might a hypoglycaemic baby look like?

A 
Jittery or lethargic
Hypothermic 
Hypotonic! 
Apnoea or irregular breathing 
Poor feed and vomiting 
High pitched weak cry

If bad –> Seizures

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15
Q

What is a “tongue Tie”

A

A short or thick frenulum, it may be attached too anteriorly to the base of tongue

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16
Q

What’s the problem of a tongue tie and how do we treat it?

A

They can make feeding difficult

In which case we would do a frenotomy

17
Q

3 DDxs for neonatal resp distress

A
  • Transient tachypnoea of Newborn (TTN)
  • Sepsis
  • Meconium Ileus
18
Q

What is ttn?

A

a delay in clearing foetal lung fluids

Looks like grunting, tachypnoea, O2 requirement but normal gasses

19
Q

How can you test for and treat TTN?

A

CXR can spot the fluids & hyperinflation

O2, airway support, fluid and maybe Abx

20
Q

areas to assess for retraction in RDS?

A

Substernal

Subcostal

Intercostal

Suprasternal

21
Q

wha can indicate coarctication of the aorta?

A

Absent/weak femoral pulses

Very important that the femoral pulses are palpated during the newborn examination

22
Q

What are the types of Cleft lip/palate?

A

Incomplete
complete
Unilateral
Bilateral

23
Q

what causes cleft lip?

A

Maxillary & Medial Nasal processes fail to fuse around wk 5

24
Q

What do we do with a cleft lip baby?

A

Use special bottle/teat

Check for airway problems

Check for ass anomalies with hearing screen, cardio exam, echo & exam for signs of trisomies

25
Q

What is the most common problem picked up on ophthalmology exam in babies?

what cancer can cause it?

A

Lack of red reflex, usually meaning cataracts

We can do lens removal and give an artificial lens

can also be?
Retinoblastoma
Rare eye cancer which can be successfully treated if picked up early
Laser therapy, chemo, surgical removal of eye

26
Q

Mum finds some bloody mucousy discharge in her baby girls nappy?

A

Probably pseudomenstruation

Very common and due to hormones from mum. It’ll clear up itself

27
Q

Spinal Dimples can be a sign of nothing or a sign of something more serious, when and how would we investigate?

A

US & MRI if:

  • Large
  • hairy tuft
  • Red or swollen
  • Off midline
  • Above sacral area
  • Pigmented
  • Tender
  • Fluid

can be:
spina bifida occulta which is the least serious form of spina bifida +/- tethered cord.

28
Q

What are the 2 common benign causes of a newborn with a swollen head?

A

Cephalohaematoma (Haemorrhoage under pericranium)

Caput Seccedaneum (Serosanguinous fluid collecting subcu)

29
Q

What characterises a Cephalohaematoma?

A

Localised, soft, non-translucent
Peaks at DoL 3/4

Limited by cranial bones (usually parietal bone)

haemorrhage is beneath the pericranium

30
Q

How long does a cephalohaematoma take to disappear and does it have any complciations?

A

no treatment is required and resolution occurs in 3-4 weeks

Can lead to jaundice via haemolysis of the haemorrhage

NOT associated with intracranial bleeds

31
Q

What characterises a Caput Succedaneum?

A

Serosanguinous fluid
Subcu
Poor margins

Over midline & suture lines
Ass with head moulding

32
Q

What are the types of Talipes?

A

Physiological - I.e. you can straigten the foot - only needs physio
Fixed - Needs Ortho i.e. strapping, casting or surgery

33
Q

How do we confirm and treat a DDH?

A

US to confirm dislocation
Pavlik harness & Surgical reduction

All to relocate head of femur into acetabulum

34
Q

Name 5 causes of failure to pass stool in a newborn?

A 
Constipation
Large bowel atresia 
Imperforate anus 
Hirshsprung's disease 
Meconium Ileus (from CF)
35
Q

how does trisomy 21/ downs present

A 
Low set ears, 
upward slanting palpebral fissures, 
epicanthic folds, 
single palmar creases, 
wide sandal gap
Hypotonia
Cardiac defects
Learning problems
Haematological problems
Thyroid problems

🍉paeds (42 decks)

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