Lecture 23 Neonatology (Physiology, prematurity, Common postnatal, term admissions to NNU) Flashcards
What are the symptoms of neonatal sepsis
Pyrexia or hypothermia Poor feeding Lethargy or irritable Early jaundice Tachypnoea Hypo or Hyperglycamia Floppy
What are the risk factors for neonatal sepsis
Premature Rupture of Membrane
Maternal Pyrexia
Maternal GBS arriage
What is the management of presumed sepsis
FBC, CRP, blood cultures and blood gas
IV penicillin and gentamicin (1st line)
Gentamycin and vancomycin (2nd line)
Fluid and treat acidosis
What are the commonest causes of neonatal sepsis
Group B strep E.coli Listeria Coag-neg staphylococci H. influenzae
Name complications of GBS sepsis
Meningitis
DIC
Pneumonia and respiratory collapse
Hypotension and shock
Name the 5 main causes of congenital infection
Toxoplasmosis Other Rubella Cytomegalovirus Herpes simplex virus
Name consequences of congenital infections
Brain calcification
Neurodevelopmental delay
Visual impairment
Bone and blood abnormalities
Name the causes of respiratory distress in a new born
Sepsis
Transient tachypnoea of the newborn
Meconium aspiration
What is the clinical presentation of transient tachypnoea of a new born
Grunting
Tachypnoea
Oxygen requirement
Delay in clearance of foetal lung fluid
What is the management of TTN
Antibiotics
Fluids
O2
Airway support
What are the risk factors for meconium aspiration
Post-dates
Maternal diabetes
Maternal hypertension
Difficult labour
What are the symptoms of meconium aspiration
Cyanosis Increased work of breathing Grunting Floppiness Apnoea
How would you investigate a neonate if meconium aspiration is detected
CXR
Blood gas
Septic screen
What is the Hyperoxia test
Infant is placed in 100% oxygen for 10 minutes. If the baby remains cyanotic then the cyanosis is secondary
What are the 5 causes of cyanotic congenital cardiac disease
Truncus arterious Transpostion of Great Arteries Tetralogy of Fallot Tricuspid Atresia Total anomalous pulmonary venous return (
