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Neonates Flashcards

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1
Q

What is Caput succedaneum

A

Oedema collecting on the scalp, outside the periosteum.
**Does cross the future lines

  • pressure to a specific area of the scalp during a traumatic, prolonged or instrumental delivery
  • no treatment and resolves after a few days
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2
Q

Cephalohaemaotma/traumatic subperiosteal haematoma

A

Collection of blood between the skull and the periosteum
*Does not cross the suture lines

Cx - damage to blood vessels during a traumatic birth

Sx - discolouration of skin

Mx - usually resolves within a few months
- monitor for anaemia and jaundice

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3
Q

Cx of facial paralysis in neonates and Sx

A
  • Delivery can damage facial nerve - forceps delivery

Sx - weakness on one side of face

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4
Q

Mx of facial nn damage

A

Conservative - returns after a few weeks

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5
Q

What is Erb’s palsy and Cx

A
  • C5-C6 injury in brachial plexus

Cx - shoulder dystocia, traumatic or instrumental delivery and large brith weight

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6
Q

Px of Erbs palsy

A
  • Weakness in shoulder abduction and external rotation, arm flexion and finger flexion

***waiters tip - internally rotated shoulder, extender elbow, flexed wrist and lack of movement

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7
Q

Mx of Erb’s palsy

A
  • Resolves in a few months
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8
Q

Cx of Fracture clavicle at brith

A

Cx - shoulder dystocia, traumatic birth, large brith weight

Sx - lack of movement and symmetry
- asymmetry of shoulder - affected lower than normal
- pain and distress on movement

Mx - conservative immobilisation

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9
Q

Px of fracture clavicle at birth

A
  • Lack of movement and symmetry
  • Asymmetry of shoulder - affected lower than normal
  • pain and distress on movement
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10
Q

Mx of fracture clavicle at birth

A
  • Conservative immobilisation
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11
Q

Cx of neonatal sepsis

A
  • Group b strep (most common), E coli, listeria, staph…
  • Group B colonise vaginal canal - mother given prophylactic antibiotics
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12
Q

Sx of neonatal sepsis

A
  • Fever, reduced tone and activity, poor feeding, resp distress, vomiting, tachy, hypoxia, jaundice, seizure, hypoglycaemia
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13
Q

Red flag sx in neonatal sepsis

A
  • sepsis in mother, signs of shock, seizures, mechanical ventilation in term baby, resp distress, sepsis in another baby
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14
Q

Mx of neonatal sepsis

A
  • Blood cultures before AB
    1st line - **Benzyl pen and gentamicin
  • 2 or more features of sepsis - begin AB
  • one red flag begin AB
  • LP
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15
Q

What is Hypoxic Ischaemic encephalopathy and Cx

A
  • Baby not getting enough oxygen to brain

Cx - Maternal shock, intrpartum haemorrhage, prolapsed cord causing compression of the cord, nuchal cord - causing hypoxia at birth

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16
Q

Sx of hypoxic ischaemic encephalopathy

A
  • Can cause permanent brain damage and cerebral palsy
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17
Q

Mx of hypoxic ischaemic encephalopathy

A
  • Supportive care
  • therapeutic hypothermia - reduced inflammation and neurone loss after hypoxic injury, reducing the risk of disability
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18
Q

Neonatal jaundice criteria

A
  • Abnormally high levels of bilirubin in the blood
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19
Q

Cx of neonatal jaundice

A

*Increased bilirubin - haemolytic disease, haemorrhage, sepsis, G6PD deficiency, polycythaemia, normal jaundice pattern

*reduced clearance - prematurity, breast milk jaundice, cholestasis, biliary atresia, Gilberts

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20
Q

Most common cx of neonatal jaundice 5

A

Physiological jaundice

Beast milk jaundice

Breastfeeding jaudince

Haemolytic disease

Infections

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21
Q

Sx of neonatal jaundice

A
  • Jaundice 2-7days after birth - resolves within 10 days
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22
Q

Mx of neonatal jaundice

A
  • Plot bilirubin chart to decide for phototherapy or exchange transfusion
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23
Q

Jaundice 1st 24hrs of birth

Study These Flashcards
A
  • Always pathological
  • Sepsis
24
Q

Physiological jaundice

Study These Flashcards
A

Immature liver - increasing risk of Kernicterus - brain damage due to high bilirubin

25
Breast milk/breastfeeding jaundice jaundice
- Breast milk inhibits the livers ability to process bilirubin. - more likely to be dehydrated if not feeding well - can cause slow passage of stool, increase bilirubin in intestine
26
Haemolytic disease of the newborn cx
* Incompatibility between resus antigens on surface of RBCs of mother and foetus Cx - women is Rhesus D positive AB, newborn is resus D antigen positive, blood from mother goes to newborn, causing the antibodies to attack the baby's antigens - increase bilirubin and causing anaemia
27
Mx of haemolytic disease of newborn
-Total bilirubin levels plotted on treatment threshold charts - age vs total bilirubin levels Phototherapy - converts unconjugated bilirubin into a form that can be excreted in bile and urine without requiring conjugation If very high - exchange transfusion
28
Cx of preterm labour
Cx - smoking, alcohol, drugs, overweight or underweight mother, co morbidities, twins, FH
29
Mx of preterm labour
Prophylactic Vaginal progesterone - to discourage labour Cervical cerclage - suture cervix closed Confirmed preterm labour - nifedipine to suppress labour - steroids to reduced morbidity and mortality - IV mg Sulphate - brain protection - Delayed cord clamping to increase circulatory volume
30
Premature birth sx post delivery
Early life sx - resp distress, jaundice, poor feeding, hypoglycaemia, ROP, Long term - learning difficulties, cerebral palsy, hearing and vision impaired, recurrent infections
31
What is ROP
- Affects preterm and low birth weight babies - Abnormal development of below vessels in the retina causing scarring, retinal detachment and blindness
32
Cx of ROP
- Preterm birth - Vessel formation in the retina is stimulated by hypoxia, when. preterm baby is given oxygen it removes growth stimulant - When the hypoxic environment recurs, there is neurovascularisation and scarring causing detachment
33
Ix for ROP
- Screening for babies born before 32 weeks or under 1.5kg
34
Mx of ROP
- Photocoagulation 1st - Cryotherapy and anti VEGF injections
35
What is respiratory distress syndrome
- Inadequate surfactant causes surface tension causing lung collapse causing inadequate gas exchange - Occurs <32 weeks usually
36
Sx of respiratory distress syndrome
- Pneumothorax, infection, apnoea, haemorrhage, chronic lung disease of premature, ROP
37
Ix for resp distress syndrome
CXR - ground glass
38
Mx of respiratory distress syndrome
- Dexamethasone given to mothers to produce surfactant - intubation, ventilation , CPAP, oxygen
39
What is necrotising enterocolitis and Cx
Disorder or preterm neonates where part of the bowel becomes necrotic **Life threatening emergency Cx - unclear - risk with preterm and low BW
40
Sx of NEC
- Intolerance to feeds, vomiting bile, unwell, distended tender abdo, absent bowel sounds, **blood in stool
41
Ix for NEC
- X ray - dilated asymmetrical loops - colon oedema
42
Mx of NEC
- NG tube for decompression, TPN for bowel rest, cover with AB, - Surgical emergency
43
What Neonatal abstinence syndrome and Sx
Withdrawal symptoms that happen in neonates of mothers who used drugs in pregnancy
44
Timing of opiate, SSRI, alcohol withdrawals
3-72 hrs
45
Timing of methadone and benzes
24hrs-21 days
46
Mx of neonatal abstinence syndrome
Morphine sulphate for withdrawals Phenobarbitone - non opiate - poly drug * SSRI don't require treatment
47
Cx of neonatal hypoglycaemia
- preterm** - maternal diabetes, hypothermia, neonatal sepsis,...
48
Neonatal hypoglycaemia sx
Babies often have episode of hypo during first 24 hrs Sx - jittery, irritable, tachypnoea, pallor
49
Episodes of hypoglycaemia in first hrs of birth
- normal - <2.6
50
Mx of asymptomatic hypoglycaemia
- Encourage feeding - No mx needed if no sx
51
Mx of symptomatic hypoglycaemia or very low
NICU for 10% dextrose IV
52
What is APGAR
- Assess health of newborn baby Activity/tone, pulse, grimace/reflexe irritability, appearance, resp rate 0-3 very low 4-6 moderate 7-10 good health
53
When is APGAR completed
1 and 5 mins of birth - if low repeat at 10 mins
54
Persistently low APGAR at 5 or 10 mins
- indicated HIE or cerebral palsy - serve distress
55
Cx of IVH
- Traumatic birth * Haemorrhage that can cause clots in the ventricular system, occluding CSF causing hydrocephalus - can affect neuro Mx - supportive - shunting if raised ICP and hydrocephalus
56
Sx of IVH
- Haemorrhage that can cause clots in the ventricular system, occluding CSF causing hydrocephalus - Can affect neuro
57
Mx of IVH
- Supportive - Shunting if raised ICP and hydrocephalus

Paediatrics (11 decks)

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