Neonatal Flashcards Preview

3 - PAEDS > Neonatal > Flashcards

Flashcards in Neonatal Deck (20)
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1
Q

Physiological causes of neonatal jaundice

A

Immature liver function, RBC breakdown
Forceps delivery, Cephalhaematoma
Presents 2-3 days post delivery

2
Q

At what concentration does bilirubinaemia become symptomatic

A

> 200 micromol/L

3
Q

Pathological causes of neonatal jaundice

A

<24 hrs - G6PD deficiency, congenital infection

Sepsis, polycythaemia, Crigler-Najjar, Gilbert’s syndrome

4
Q

Causes of prolonged neonatal jaundice

A

breast milk
Hypothyroidism
GI - biliary atresia, choledochal cyst

5
Q

Presentation of Kernicterus

A

Bilirubin encephalopathy:
change in tone and crying
Arched, stiff back
Seizures

6
Q

Neonatal jaundice Investigations?

A

Transcutaneous - >205.2 measure serum

Measure serum immediately if visibly jaundiced

7
Q

Management of jaundice

A

Physiological - reassure and observe
Pathological - phototherapy
Encephalopathy - exchange transfusion, hydration, IV immunoglobulin

8
Q

Birth Asphyxia / Hypoxic Ischaemic Encephalopathy

A

Perinatal asphyxia –> neuronal death
Severe cases –> learning difficulties, HIE
If infant recovers by 2 weeks, then good prognosis

9
Q

Name some vascular birthmarks

A

Haemangioma
Port wine stains
Macular stains (salmon patches)

10
Q

name some pigmented birthmarks

A

Moles
Café au lait spots
Mongolian blue spots

11
Q

Describe the features of Cephalhaematoma

A

Swelling, confined by skull sutures
most commonly affects parietal bone
will resolve by itself over time. May cause transient jaundice

12
Q

Explain Rh sensitisation

A

Rh-ve mother, with Rh+ve first child –> sensitised

Her anti-Rh(D) antibodies attack and haemolyse fetal RBCs

13
Q

Effects of Rh incompatibility on the child

A

Anaemia –> cardiomegaly and failure
Hepatosplenomegaly –> hypoalbuminaemia –> oedema
Haemolysis –> jaundice and kernicterus (severe)

14
Q

Treatment of Rh incompatibility

A

Injection of Anti-D after 1st pregnancy
OR
Injections of Anti-D at 28 weeks and at birth

Anti-D mops up Rh+ve cells and removes them

15
Q

Short term risk for premature babies

A

Hypothermia
Hypoglycaemia + hypocalcaemia –> convulsions
ARDS –> ventilation –> bronchopulmonary dysplasia

16
Q

Long term risks for premature babies

A

Developmental impairment
cerebral palsy
Hearing impairment (1/4)
Retinopathy of Prematurity (66% babies <1.25Kg)

17
Q

At what gestation does sufficient surfactant production begin

A

30 weeks

18
Q

Mx for RDS

A

Ventilate - CPAP, IPVV
Target sats - 91-95% - hyperoxaemia –> RoP
Surfactant replacement therapy
Maternal betamethasone pre-delivery

19
Q

Causes of IUGR babies

A

Pre-eclampsia
Auto-immune disease
congenital
Thrombophilia

20
Q

Management of Talipes/Clubfoot

A

Prompt plaster casting and bracing - Poinseti method

Re-assess at age 3 - surgical correction if persistent/severe