NEonatal presenations 2 Flashcards

1
Q

3 DDxs for neonatal resp distress

A
  • Transient tachypnoea of Newborn (TTN)
  • Sepsis
  • Meconium Ileus
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2
Q

What is ttn?

A

a delay in clearing foetal lung fluids
Looks like grunting, tachypnoea, O2 requirement but normal gasses

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3
Q

How can you test for and treat TTN?

A

CXR can spot the fluids & hyperinflation

O2, airway support, fluid and maybe Abx

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4
Q

What could lead to Meconium Aspiration?

A

Post-date
Maternal DM or HTN
Difficult Labour

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5
Q

How would meconium Aspiration present?

A

Cyanosis
High work of breathing + grunting
Apnoea
Floppiness

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6
Q

What would do if you suspect meconium aspiration?

A

Blood gas
CXR - hyperinflation, flat diaphragm & patchy areas of collapse

Also do a septic screen in case

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7
Q

Whats in a septic screen?

A

FBC
U&Es
Glc
Blood culture
CXR
LP
Urine dipstix & culture

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8
Q

How do you treat meconium aspiration?

A

Suction the meconium
Intubate & ventilate
IV fluids & Abx
Surfactant
NO or ECMO

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9
Q

Any complications of meconium aspiration?

A

Persistant Pulm HTN of Newborn (PPHN)

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10
Q

How can you treat neonatal hypoglycaemia?

A

Enteral Feeds
IV 10% glc
Fluids
Glucagon
Hydrocortisone

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11
Q

Birth Asphyxia is a serious problem in which low O2 at birth –> Multiorgan failure. What could cause it?

A
  • Placental problems
  • Cord Prolapse
  • Infection
  • Neonatal Airway abnormality
  • Long, difficult delivery
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12
Q

What are the phases of birth asphyxia?

A

Stage 1 = cell damage occurring within minutes

Stage 2 = reperfusion injury due to toxins from damaged cells (Days or weeks)

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13
Q

How do you classify birth asphyxia?

A

Mild
Mod
Severe

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14
Q

How do you manage a baby with birth asphyxia?

A

Fluid restriction (prevent cerebral oedema)
Monitor U&Es + C & LFTs for organ failure

Resp support (O2, intubate, ventilate etc)

Cardiac support

Treat any seizures

Therapeutic Hypothermia!

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15
Q

Which babies get diaphragmatic hernias?

A

Male > Female
Ass with some syndromes

Mostly left

Also associated with pulm hypoplasia

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16
Q

How do you manage a diaphragmatic hernia?

A

Intubate at birth
Resp support (O2, intubation, ventilation etc)
Surgery