neonates

Question 1

Inhaled nitric oxide reduces the need for ECMO by how much?

Answer 1

40%

Question 2

what is suggestive of PPHN

Answer 2

pre and post ductal difference >20%

pre-ductal sats <90%

Question 3

Nitric oxide has a short half life because??

Answer 3

bind to Hb

Question 4

HFOV is indicated in which circumstances

Answer 4

rescue for failed conventional ventilation
improved gas exchange in air leak syndromes
decrease ventilator related injury

Question 5

What are the pitfalls of Newborn screening

Answer 5

1) doesn’t pick up high TSH (hyperthyroidism and panhypopit)
2) In CF doesn’t test all genes - will miss 5%
3) doesn’t test all metabolic disease will miss lysosomal storage disorders

Question 6

what are the target saturation at what minutes after birth in neonatal resus?

Answer 6

1 min 60-70%
2min 65-85%
3min 70-90%
4min 75 -90%
5min 80-90%
10min 85-90%

Question 7

what is the dose of adrenaline in neonatal resus IV and ETT?

Answer 7

IV 0.1-0.3mL/kg 1:10,000

ETT 0.5-1mL/kg 1:10,000

Question 8

what is the ratio of compressions to breaths in neonatal resus?

Answer 8

3:1

90 compressions to 30 breaths per min

Question 9

how can you measure UAC and UVC position

Answer 9

UAC = (weight x 3) +9
ideal position T6-9

UVC = (weight x 1.5) + 5.5
ideal T9-10, junction ductus venous & IVC

Question 10

what is the definition of ELBW, VLBW, LBW, SGA

Answer 10

ELBW = <10th centile

Question 11

What is the most important complication of BPD

Answer 11

pulmonary hypertension

Question 12

what is surfactant produced and by which cells?

Answer 12

produced 24/40, type 2 alveolar cells

Question 13

how does steroids increase surfactant production?

Answer 13

binding to intra-cytoplasmic receptor and increasing DNA transcription

Question 14

what is artificial surfactant made of?

Answer 14

DPPC + SPB and SPC

Question 15

what Long term outcome doesn’t surfactant and antenatal steroids influence?

Answer 15

development of BPD

Question 16

what are the pro’s of caffeine

Answer 16

increases central drive
increases contractility diaphragm 
decreases BPD
decreases ROP
Less toxic that aminophylline

Question 17

term baby born by traumatic delivery and develops apnoea at 24hrs of age. ?diagnosis

Answer 17

subdural most common

Question 18

indications of HIE and classification

Answer 18

mild - hypertonia, dilated pupils, tacchycardic
mod - hypotonia, constricted pupils, seizures
severe - comatose, no reflexes

Question 19

indications for cooling

Answer 19

acidosis pH 35/40
within 6hrs of birth

Cool 33.5 degrees 72hrs

Question 20

contraindications to cooling

Answer 20

80%
congenital abnormalities
coagulopathy

Question 21

outcomes of HIE

Answer 21

mild - nil
mod - 5% mortality, 20% morbidity
severe - 75% mortality, 90+% morbidity

Question 22

what CP is associated with IVH

Answer 22

athetoid CP

Question 23

Neuro sequelae for IVH

Answer 23

Only grade 3-4

Question 24

Survival stats for pre-terms

Answer 24

23/40 25% survival, 90% disability
24/40 65% survival, 75% disability
25/40 85% survival ~50% no disability
28/40 95% survival

Question 25

Premature babies are at risk of osteopenia prematurity because?

Answer 25

transplacental passage of Calcium and Phosphate >24/40

Question 26

Vitamin D supplementation is associated with which outcomes?

Answer 26

lower pneumonia lower T2DM lower rates infleunza lower asthma exaccerbations

Question 27

Probiotics decrease NEC but they have no impact on?

Answer 27

Rates of sepsis

Question 28

how do you calculate mean airway pressure?

Answer 28

(Pip x i-time) + (PeeP x e-time) / i-time + e-time

Question 29

what is a normal I;E ratio

Answer 29

1:2

Question 30

How can you calculate GIR

Answer 30

(dextrose % x IV rate) / (6 x weight) | formula has dextose concentration of 7%

Question 31

what is the biggest risk factor for hospitalisation in RSV

Answer 31

chronological age

Question 32

what is the duration of sleep for babies

Answer 32

16hrs, mostly REM sleep

Question 33

indications for Palavizumab

Answer 33

BPD infants | congenital heart disease with sign left to right shunts especially pulmonary hypertension

Question 34

what are the results for Palavizumab

Answer 34

reduced hospitalisation by 50% (10% to 5%) | DOES NOT reduce need for ventilation or mortality

Question 35

what are there TORCH infections and specific differentiating signs for each

Answer 35

``` Toxo - hydrocephalus CMV - periventricular calcification Rubella - cardiac lesions PDA, PS Syphilis - rhinitis and desquamation VZV - Cicatricial skin lesions, hypoplastic limbs ```

Question 36

treatment congenital CMV

Answer 36

valganciclovir 6months = better outcomes

Question 37

Management of bay to Hep B + mother

Answer 37

HBIG and HB vaccine within 12 hrs of birth | plus 2,4, 6 months

Question 38

management of baby born to mother with chickenpox

Answer 38

give ZIG 7 days prior and 2 days post | if preterm give 2-28 days post birth