Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

paediatrics > Common Post-Natal Problems > Flashcards

Common Post-Natal Problems Flashcards

1
Q

What types of problems are common post-nataly?

A
  • Skin
  • Jaundice
  • Hypoglycaemia
  • Hypothermia
  • Feeding
  • GI
  • Respiratory
  • Cardiovascular
  • ENT
  • Ophthalmology
  • Genito-urinary
  • Neurology
  • Orthopaedic
  • Genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 components of the energy triangle?

A
  • Pink (hypoxia)
  • Warm (hypothermia)
  • Sweet (hypoglycaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 3 things can affect a neonate’s skin?

A
  • Colour
  • Rashes
  • Birthmarks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give examples of why a baby’s skin may change colour.

A
  • Jaundice
  • Pallor
  • Plethora
  • Cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give examples of types of rashes that occur in neonates.

A
  • Benign
  • Milia
  • Milaria
  • Eryhtema toxicum neonatorim
  • Infections
  • Sebaceous naevus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give examples of birthmarks that can present in neonates.

A
  • Capillary haemangiomas
  • Mongolian blue spots
  • Port wine stains
  • Stork marks
  • Giant melanocytic naevi
  • Café au lait spots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who does physiological jaundice occur in?

A

Most new-borns especially pre-terms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why does physiological jaundice occur?

A

A combination of increased red cell breakdown and immaturity of the hepatic enzymes causes unconjugated hyperbilirubinaemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can exacerbate physiological jaundice?

A

It is exacerbated by dehydration, which can occur if establishment of feeding is delayed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does jaundice within 24 hours of life suggest?

A

Always pathological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is it important to recognise and treat neonatal unconjugated hyperbilirubinaemia?

A

Recognition and treatment of severe neonatal unconjugated hyperbilirubinaemia is important to avoid bilirubin encephalopathy or kernicterus (brain damage due to deposition of bilirubin in the basal ganglia).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is it important to evaluate conjugated hyperbilirubinaemia early?

A

Early evaluation of conjugated hyperbilirubinaemia (>20 mmol/L) is important to allow early (<6weeks) diagnosis and treatment of biliary atresia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why can jaundice occur in the first 24 hours of life?

A
  • Haemolytic (G6PD or spherocytosis)

- TORCH (congenital infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why may jaundice occur between the 2nd day and 3rd week of life?

A
  • Physiological (goes after 1st week)
  • Breast milk
  • Sepsis
  • Polycythaemia
  • Cephalohematoma
  • Crigler-Najjar syndrome
  • Haemolytic disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why may jaundice occur after the 3rd week of life?

A
  • Breast milk
  • Hypothyroidism
  • Pyloric stenosis
  • Cholestasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is jaundice treated?

A

-Treat the underlying cause
-Hydrate
-Phototherapy (NICE guideline charts)
-Exchange transfusion
Immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What babies are at risk of hypoglycaemi?

A

Limited glucose supply

  • Premature babies
  • Perinatal stress

Hyperinsulinism
-Infants of diabetic mothers

Increased glucose utilisation

  • Small and large for gestational age
  • Hypothermia
  • Sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the symptoms of neonatal hypoglycaemia?

A
  • Jitteriness
  • Hypothermia
  • Temperature instability
  • Lethargy
  • Hypotonia
  • Apnoea, irregular respirations
  • Poor suck/feeding
  • Vomiting
  • High pitched or weak cry
  • Seizures
  • Asymptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is hypoglycaemia defined as?

A

Blood sugars <2.6mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we test neonates blood sugars?

A
  • Bedside testing (can be inaccurate if high, low, poor perfusion, polycythaemia)
  • Lab sample for testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can babies lose heat?

A
  • Evaporation
  • Conduction
  • Convection
  • Radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is radiation heat loss?

A

Loss of heat from the body surface to a cooled surface that is not in direct contact, but in close proximity to the body (cold objects near to baby)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is convection heat loss?

A

Loss of heat from body surface to cooler air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is conduction heat loss?

A

Loss of heat from the body surface to cooler surface in direct contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is evaporation heat loss?

A

Loss of heat when liquid is converted to vapour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How are babies resuscitated in response to cold stress?

A
  • Dry quickly
  • Use warm towels/blankets
  • Provide radiant warmer heat
  • Use heated/humidified oxygen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are tongue ties?

A
  • Short thickened frenulum’s that are attached anteriorly to the base of the tongue
  • They restrict tongue protrusion beyond the alveolar margins or heavy grooving of tip of tongue and/or feeding is affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How are tongue ties managed?

A
  • Usually no treatment necessary

- If it impacts feeding then a frenotomy must be performed

29
Q

What type of feeding should be promoted?

A

Breast feeding

30
Q

What GI problems may occur in the post-natal period?

A
  • Vomiting
  • Posseting
  • Mucous vomits
  • GOR
  • Cows milk protein allergy
  • Bilious vomiting
  • Failure to pass meconium
  • Bloody stools
  • Blood in vomit
31
Q

What is the commonest reason for admission to NNU?

A

Respirator distress

32
Q

How are neonate assessed for respiratory distress?

A

Increased effort

  • Grunting
  • Retractions
  • Nasal flaring
  • RR
  • Colour
  • Oxygen sats
33
Q

What areas should be assessed for retractions?

A
  • Substernal
  • Subcostal
  • Intercostal
  • Suprasternal
34
Q

How can cleft lips vary?

A
  • Can be incomplete (small gap in lip) or complete (continue into the nose)
  • Can be unilateral (left sided unilateral is most common) or bilateral (85% have palatal involvement)
35
Q

Why do cleft palates occur?

A

Maxillary and medial nasal processes fail to merge, usually around 5 weeks gestation

36
Q

What issues may cleft lip and palate lead to?

A

Feeding issues

  • Special bottles and teats
  • Can still attempt breast feeding

Airway problems
-70% experience respiratory distress

Associated anomalies

  • Need hearing screen
  • Need cardiac echo
  • Remember trisomies
37
Q

What should always be checked in an ophthalmological check of neonates?

A

Red light reflexes

38
Q

How does cataracts present?

A

Lens opacification

39
Q

What may cataracts lead to?

A

If left untreated then blindness

40
Q

How is cataracts managed?

A
  • May require no treatment

- May require lens removal and artificial lens

41
Q

What is retinoblastoma?

A

Rare eye cancer which can be successfully treated if picked up early

42
Q

How is retinoblastoma treated?

A
  • Laser therapy
  • Chemotherapy
  • Surgical removal of the eye
43
Q

What genito-urinary issues can occur in neonates?

A

Pseudomenstruation

  • Bloody mucous in nappy
  • Occurs in girls due to hormones from mum which are still circulating in baby

Urate brick powdery deposits
-Essentially uric acid crystals can occur in the urine

44
Q

What can spinal dimples suggest?

A
  • Can reveal a more serious abnormality involving the spine and/or spinal cord, such as spina bifida occulta which is the least serious form of spina bifida
  • Dimples may also be indicative of a possible kidney problem
45
Q

When should spinal dimples be investigated with ultrasounds and MRIs?

A

If the dimple is:

  • Red
  • Swollen
  • Off midline
  • Higher than sacral area
  • Pigmented
  • Tender
  • Accompanied by fluid
46
Q

What is cephalohaematolmas?

A
  • Localised swelling over one or both sides of the head

- Softly, non translucent swelling

47
Q

What are the limits of cephalohaematomas?

A

Cranial bones usually parietal bone

48
Q

Where is the haemorrhage in cephalohaematomas?

A

Beneath the pericranium

49
Q

When do cephalhaemotomas become maximal in size?

A

By the 3rd to 4th day of life

50
Q

What is the treatment for cephalohaematomas?

A

No treatment required, resolution usually occurs within 3-4 weeks

51
Q

Why can cephalohaematomas lead to prolonged jaundice?

A

Occasionally, if the haematoma is very large, the increased haemolysis results in increased or prolonged neonatal jaundice

52
Q

What is caput succedaneum?

A
  • Serosanguinous, subcutaneous fluid collection with poorly defined margins
  • Scalp swelling that extends across the midline and over suture lines and associated with head moulding
53
Q

What causes caput succedaneum?

A

Pressure of presenting part of the scalp against the dilating cervix during delivery

54
Q

What is the management for caput succedaneum?

A

Does not usually cause complications and resolve over the first few days

55
Q

What is talipes?

A

-Medial (varus) or lateral (valgus) deviation of the foot is often positional and requires no treatment other than physiotherapy

56
Q

How is fixed talipes managed?

A
  • More vigorous manipulation
  • Strapping
  • Casting
  • Possible surgery
57
Q

What may babies with significant talipes also have?

A

Developmental dysplasia of the hips

58
Q

What are the deformities associated with talipes?

A
  • Cavus
  • Adduction
  • Varus
  • Equinus
59
Q

What is the goal of DDH treatment?

A

Relocate the head of the femu to acetabulum so hip develops normally

60
Q

How is DDH treated?

A
  • Pavlik harness

- Surgical reduction

61
Q

What dysmorphic features are associated with trisomy 21?

A
  • Low set ears
  • Downwards slanting palpebral fissures
  • Epicanthic folds
  • Single palmar creases
  • Wide sandal gap
62
Q

What conditions is trisomy 21 associated with?

A
  • Hypotonia
  • Cardiac defects
  • Learning problems
  • Haematological problems
  • Thyroid problems
63
Q

What is plethora?

A

Red skin usually caused by polycythaemia which makes the blood viscous

64
Q

What is cyanosis?

A

Blue tinge to the skin associated with poor oxygenation/peerfusion

65
Q

What is erythema toxicum?

A

-Maculo-papular rash which occurs in 30-70% of term babies but very rare in pre-term babies

66
Q

What is the treatment for erythema toxicum?

A
  • Fades by end of 1st week and no treatment required

- Cause is unknown

67
Q

What are Mongolian blue spots?

A
  • Blue grey pigmentations often located on the lower back and buttocks
  • They ae an accumulation of melanocytes and are therefore very common in races with pigmented skin
68
Q

What are stork marks?

A

-Naevus simplex are light colour capillary dilatations commonly found on the back of the neck but may be in the midline of the face

69
Q

What is the outcome of stork marks?

A

Gradually fade usually within 1-2 years

paediatrics (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions