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PAEDS SC1 > neonates > Flashcards

neonates Flashcards

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1
Q

newborn screening

A 
PKU 
Homocystinuria 
MSUD
Congenital toxo 
Congenital hypothyroidism 
GALACTOSAEMIA
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2
Q

caput succedaneum

A

brusing and odeam of the presenting part
Resolves within few days
EXTENDS BEYOND SKULL MARGIN

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3
Q

Caphalhaematoma

A

heamatoma from bleeding bellow the periosteum
invovles parital bone
CONFINED TO SKULL MARGINS

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4
Q

Cignon

A

from vacum deliveries - odeam and brusing of head

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5
Q

what is the risk of getting NEC if you dont breast feed

A

6X

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6
Q

what is the risk of getting Gastroenteritis if you dont breast feed

A

5X

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7
Q

what is the risk of getting Resp distress, otitis media, ecema and wheeze if you dont breast feed

A

2 times increase

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8
Q

number one cause of prematurity

A

spontaneous - 45%
delivery / maternal infection - 30%
PROM - 25%

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9
Q

RDS RF

A

Males , 2nd born and materneral DM

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10
Q

RDS Dx

A

Ground glass apperance and AIR BRONCHOGRAM

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11
Q

TTP Dx

A

fluid in the horizontal fissure

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12
Q

Conenital pneumonia Dx

A

Non specific patchy infiltrates
Neutropenia
Trachal aspiration and
Gram stain for Dx

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13
Q

when does RDS present

A

48-72 hours after birth in resp distress

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14
Q

Treatment RDS

A

CPAP
Artifical surfactant
3. pretreat mom at risk w. corticosteroids

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15
Q

complications of RDS

A

RIPBBN

Retinopathy of prematurity
Intracentricular Heamorrage e

BPD
Barotrauma - from postive pressure ventillation

NEC

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16
Q

apnea of prematurity

A

20sec no breath
normal in preterms
Adnormal if term / worsening / no hx

Cause
- poor resp drive or airway problem or BOTH

STIMULATE
O2 / CAP
CAFFINE

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17
Q

BPD

A

infants with low birth weight and those who receive prolonged mechanical ventilation to treat respiratory distress syndrome (RDS).

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18
Q

Dx BPD on X-ray

A

Streaky intersitial marking
Atelectasis
Cyst
hyperinfilated

Diganosed at age 28 weeks old

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19
Q

NEC CLINICAL EARLY THEN LATE

A 
Early 
- feeding difficulties 
- delayed gastric emptying 
Distension 
- bloody stools

Lateral

  • interestinal perforation
  • peritonitis
  • abdo erythema
  • shock
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20
Q

RF NEC

A

PReterm

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21
Q

Dx

A

pneumoatosis intestinalis - hten take US every 60 minutes to see if it become walled off or bowl necrosis

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22
Q

treatment

A

IV metranidazole and surgery

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23
Q

complication NEC

A

strictures and short bowl syndrome

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24
Q

what age do you get nec

A

w/i days - weeks of birht

BABIES BORN EARLIER GET NEC AT LATER AGES

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25
retinopathy of prematuritis
retinal vessels develop at 32 weeks - therefore preterm are at risk
26
IVH
germinal matric and neurons mirgrate during last few weeks of utero
27
DDX Mekles
technitium 999 pertechnetate
28
Treatment of intussuception
Air contrast barium edema
29
cause of constipation in newborn
``` HHHA Hypothyroidism HYPERcalemia Hirshprund Anal stenosis ```
30
Sepsis clinical and treatment
EARLY 4 days - fuminating multisystem pneumonia - 15-50% - Benzylpenicillin and gentamycin Lat >4 - focal progressive meningitis - 10-20% Treat w/ fluoxacillin and gentamycin
31
chlamydia vs. gonorrhea infection in baby
Chlamydia - 5-14 days | Gonorrhea 2-5 days
32
5 things cafe au lait spots are ass. w.
``` NF1 MArphans Tuberous sclerosis McCune Albright Fanconi anemia ```
33
kassabach Meritt syndrome
Telangetasia and haemaginoma
34
Klippel Trenaunay Syndrome
Capillary malofrmation and overgorwth | bone and limb defect
35
who get umbilicated hernia
Downs Hypothyrpidism PRETERM REFER FOR TREATMENT IF it does not resolve by age 3
36
Sandifers syndrome
GERD ass. w/ lateral head til and back arching resulting in osephagitis
37
cause of GERD
1. Decrease LES 2. inappropiate LES relaxation 3. Large histus hernia 4. dealyed gastric emptying
38
treatment of GERD
Sit up right Thicker formulas H2 antagonist - CIMETIDINE - to help reduce the reflux Resolves w/i 9-18 months and if it does NISSEN FUNDOPLICATION
39
SE of phototheraphy
``` interupt maternal bonding Dehydrating Hyperthermia rentinal deamge Decrease intestinal transiet ```
40
Se of exchange transfusion
``` death infection thrombocytopenia port vein thrombosis NEX Electrolyte imblance Gvs, Host ```
41
when to do exhcnage transfusion vs. phototherphy
UCB >20
42
physiological jaudice of a newborn why?
1. pathway of bilirbunin excretion is not mature 2. extrahepatic circulation 3. 70-90 days in term 4. 40 days in preterm INCREASE HCT than adults CEPHALOHEAMATOA
43
kernicturis
complication of UCB > 25 when it deposits in the basal ganglion pons and cerebellu ``` >25- 30 mg/dl Risk factor ; - PRETERm - Aphyxia - Sepsis ``` PENTAD - MOTOR - OCULOMOTOR _ CHOcLEAR - ID
44
causes of polycythemia
``` Vennous hct is ?65% or more Increase hct = increase viscosity Causes chronic IUGR Excessive transfusion (delayed cord clamping infant of diabetic mom ``` ``` CLinical BRAIN - jitteriness, headache HEART - HTN , PFC REnal GI - NEX HYpoglycemia and Jaudice ```
45
when does heamolytic disease of newborn present
2-4 days
46
causes of RAISED alpha fetal protein
NOT CO TPN Normal Omphalocele Twins Congenital nephorisis Oligohydramniosis Turners Pateau NTD
47
Clinical hydrocephalus
``` The syptoms of INCREASE Intacranial pressure vomitting and decrease LOC anterior fontanelle open and buldging scalp weins are dilated space suture EYES DEVIATED DOWN ( SUN SETTING) ```
48
treatment of hydrocephalus
Acetazolamide plus/minus furosemide Serial lumbar puncture VP shunt
49
Dx hydrocehalus
antenatal US cranial US CT or MRI head circumferance
50
treatment of cleft lip
refer to specialist unit 3 moths - lip repair Palate repair at 9-12 months
51
Wide forehead with a small triangle-shaped face and small, narrow chin
Russell-Silver syndrome
52
high arch palate , micrognathia and prominant tongue
Pierre Robin Syndrome | 0 feeding problem and airway obstruction
53
MEC aspiration Complication
Mechanical obstruction Chemical pneumonitis obstruction pneumothorax
54
overinflated lung with patches of consolidation and collapse
Meconium Aspiration
55
treatment of penumonia in neonates
benzylpenicillin and gentamycin
56
pneumothorax caues
secondary to - MEc aspiration - RDS - mechanical respiration
57
Pneumothorax treatment
small - O2 and 2ICS aspirate | Larger - 5ICS chest drainage
58
PPHT of Newborn causes
birth aphyxia MEC SEPticaemia Resp Distress
59
treatment of PPHN
Mechanical ventilation and cirulatory report inhaled NO - causes pulm arteries to vasodilate and therefore reduce pressures high frequence oscillatory ventilation (HPOV) and ECMO
60
what can BPD result in
Cor pulmonale
61
venous hum
``` benign murmur age >2 infraclavicular area louder on right Muscial hum ASCENTUATED with diastolic inspiration ``` Resloves the murmus - placing child supine - turning child's neck and Compressing jugular vein
62
Stil murmur
AGE 3-5 vibratory low frequency increased in HIGH states Positional change
63
symptoms of Systolic murmur
``` Systolic Short Soft/ low pitch Left Sternal edge Positional changes ```
64
hypoxia (nitrogen washout test
R - L shunt determines presence of disae 100% O2 for 10 minutes if right radial aterial
65
complications of dibaetes in pregnancy
1. Calvical fracture 2. RDS 3. Hypoglycemia - give early feeds or IV glucose if they cant feed 4. Congenital - anencepahly, holoprosencaphaly, meningomylocele, sacral agenesis - small left colon syndrome - CHF (TGV , HOCM) 5. Polycythemia 6. Renal vein thrombosis 7. Jaucine - hyperbilinrunemia 8. Hypocalemia - hyper phosphate/ hypo Mg 9. IU fetal dealth 10. TTP
66
how is congenital diapharamic hernia normally dx
anternatal US Right - more difficult to dx b/c liver and collapse lung have similar apperance Left - fluid filled stomach OR BY POLYHYDRAMNIOS
67
ddx CDH
CAM - cyst adenmatoid malformation pulm sequestration neurenteric and dublicated cyst Cystic teratoma
68
Post natal presentation CDH
first few hours - resp distress - if they have pulm hypoplasia Pulmonary HTN
69
intermediate or early presentation CDH
minutes or few hours of birth with 0 resp distress, tachypnea , cyanosis, sternal recession and marked hypotonia SCAPHOID ABDOMEN
70
Cxray of CDH
fluid dilled loops in chest nasogastric tube Lack of intestinal gas shawdoe If normal you think CAM
71
late presentation of CDH
LESS DRAMATIC w/ better prognosis alveolar development less pulm HTN FLuid filled loops in chest Clinical - vomitting and requesnt chest infection
72
treatmnet of CDH
1. IV access 2. O2 3. Urinary catherter 4. fluids and pressor 5. restricted fluids
73
good prognosis for CDH / normal prognosis
1. present later 2 years of life 2. stomach is NOT in chest 3. less pulm HTN 4. Better prognosis Normal prognosis - 50% mortality
74
CDH is ass. w/
``` PENTAD CANTRELL sternal exophalus Pericardia Coarctation Pericardia Ventircular Arterial septal defect ```
75
treatment of meconium ileus
corrected by doing hydrophilic contrast enema (Gastrograffin) --> softens and inspissated meconium to faciliate package NOTE: IVE ACCESS FLUID CAUSE GASTROGASTRIN CAN CUASE DEHYDRATION Reactal distal ileum -
76
Ladd's band
malrotation
77
treatment of fastroschis
CLING FILM WRAP NGT - antibiotics IV FLUIDS 10-20mls/kg Colon washout with gastrograffin If successful closeure - TPN 2-3 weeks

PAEDS SC1 (13 decks)

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