neonatology Flashcards
(110 cards)
1
Q
what is an inguinal hernia
A
weakness in the muscle around the groin, resulting in a loop of bowel bulging through
2
Q
in babies, is an inguinal hernia congenital or acquired
A
congenital
3
Q
how does an inguinal hernia present in babies
A
bulging of the testes
4
Q
complications of inguinal hernias
A
bowel obstruction and perforation
5
Q
what is a meconium ileus
A
neonatal bowel obstruction of the distal ileum due to abnormally thick and impacted meconium
6
Q
what does meconium ileus usually indicate
A
cystic fibrosis
7
Q
investigation of a meconium ileus
A
x-ray with contrast
8
Q
what must be ruled out in a baby with bilious (green) vomiting
A
malrotation
9
Q
investigation for malrotation
A
upper GI contrast and follow through
10
Q
what is jejunal atresia
A
congenital abnormality characterised by obliteration of the lumen of the jejunum
11
Q
what is associated with duodenal atresia
A
down syndrome
12
Q
clinical presentation of jejunal atresia
A
abdominal distension and bilious vomiting within the first 24 hrs after birth
13
Q
investigation of jejunal atresia
A
x-ray
14
Q
what is intraventricular haemorrhage
A
bleeding into the ventricles inside the brain
15
Q
who is at most risk of intraventricular haemorrhage in neonates
A
premature infants
16
Q
what is the most common type of intraventricular haemorrhage in neonates
A
germinal matrix
17
Q
at what point in gestation does the risk of interventricular haemorrhage significantly decrease
A
35-36 weeks as the germinal matrix baso disappears at this point
18
Q
what is necrotising enterocolitis
A
where part of the bowel becomes necrotic
19
Q
who is at risk of necrotising enterocolitis
A
premature neonates
20
Q
what can cause necrotising enterocolitis
A
premature baby being fed too early
21
Q
pathophysiology of necrotising enterocolitis
A
serious intestinal injury to a relatively immature gut resulting in perforation
22
Q
clinical presentation of necrotising enterocolitis
A
intolerance to feeds
vomiting
distended, tender abdo
absent bowel sounds, blood in stools
23
Q
what is used to investigate suspected necrotising enterocolitis
A
abdo x-ray
24
Q
clinical signs of necrotising enterocolitis
A
(on abdo x-ray)
dilated loops of bowel
bowel wall oedema, gas
25
what can gas in the peritoneal cavity indicate
bowel perforation
26
management of necrotising enterocolitis
nil by mouth, clindamycin, cefotaxime
IMMEDIATE referral to surgical team
27
what is hydrocephalus
CSF buildup within the brain and spinal chord
28
what causes hydrocephalus
over production of CSF or problem with drainage
29
clinical presentation of hydrocephalus
enlarged or rapidly increasing head circumference
bulging anterior fontanelle
poor feeding and vomiting
30
management of hydrocephalus
ventriculoperitoneal shunt
31
what is neonatal hypoglycaemia
BGL < 2.6
32
name some factors that may contribute to neonatal hypoglycaemia
preterm, small for gestational age, low birth weight
infant of diabetic mother
hypothermia
infection/sepsis
neonatal abstinence syndrome
33
clinical presentation of neonatal hypoglycaemia
lethargy
jitteriness
seizure activity
34
management of neonatal hypoglycaemia
early feed and keeping baby warm to prevent
feeding: enterally if safe, IV glucose if not
35
who does neonatal respiratory distress affect
75% of infants born before 29 weeks
36
pathophysiology of respiratory distress of the newborn
not enough surfactant so high surface tension in the alveoli
lung collapse -> inadequate gas exchange
37
clinical presentation of respiratory distress of the newborn
tachypnoea, grunting, intercostal recession, nasal flaring, cyanosis
38
investigation for respiratory distress of the newborn
CXR
39
clinical finding of investigation of respiratory distress of the newborn
ground glass appearance and air bronchograms
40
how to prevent respiratory distress in potentially preterm babies
steroids
41
management of neonatal respiratory distress
surfactant replacement, ventilation
42
name 2 metabolic causes of neonatal respiratory distress
acidosis
hypoglycaemia
43
name 2 haematological causes of neonatal respiratory distress
polycythaemia, blood loss/anaemia
44
name 3 neurological causes of neonatal respiratory distress
seizures
intracranial bleed
withdrawal
45
name a congenital cause of neonatal respiratory distress
congenital lung malformations
46
define preterm
a birth that occurs before 37 weeks of gestation
47
define a term birth
between 37-42 weeks of gestation
48
define post-term birth
occurs after 42 weeks of gestation
49
what is defined as a normal birth weight
2.5kg - 4kg
50
when, during gestation, does most weight gain occur
3rd trimester
51
at what part during labour is the baby in a hypoxic environment
during contractions
52
what is used to measure perinatal adaptation
APGAR score
53
why is vitamin K offered in the newborn period
prevents haemorrhagic disease of the newborn
54
what is haemorrhagic disease of the newborn
vitamin K dependent clotting disorder
55
what is the preferred route of administration of vitamin K during the new born period
IM
56
name some risk factors for having a preterm birth
past history of preterm births
abnormally shaped uterus
multiple pregnancy
IVF
smoking, alcohol, drugs
interval <6 months between pregnancies
57
name some ways we can manage neonatal hypothermia
wraps/bags
skin-skin care
transwarmer mattress
incubators
58
why are neonates at an increased risk of nutritional compromise (4)
limited reserves
gut immaturity
immature metabolic pathways
increased demands
59
when does retinopathy of prematurity usually occur
6-8 weeks after delivery
60
define the neonatal period
the first 28 days of life
61
scoring system of APGAR
total score of 1-10
62
what does APGAR stand for
appearance
pulse
grimace
activity (muscle tone)
respiration
63
name 3 respiratory problems of a term infant
transient tachypnoea of the newborn
pneumothorax
congenital respiratory disease
64
give 2 examples of congenital respiratory diseases
tracheo-oesophageal fistula
diaphragmatic hernia
65
who is TTN most common in
term infants delivered by caesarean
66
what is TTN
transient tachypnoea of the newborn
67
management of TTN
nothing - resolves over the first 24 hours of life
68
what causes TTN
fluid in the lungs doesnt clear away after birth
69
CXR of TTN
shows fluid in the horizontal fissure
70
what causes early onset neonatal sepsis
bacteria acquired before and during delivery
71
organisms associated with early onset neonatal sepsis
group B strep
gram negatives
72
what causes late onset neonatal sepsis
bacteria acquired after delivery
73
organisms associated with late onset neonatal sepsis
coagulase negative staph
gram negatives
staph aureus
74
name 3 risk factors of neonatal sepsis associated with premature infants
immature immune enviro
intensive care enviro
indwelling tubes and lines
75
name some symptoms of neonatal sepsis
temperature instability
reduced tone and activity
poor feeding
vomiting
76
what is the most common cause of jaundice within the first 24 hours of life
neonatal sepsis
77
management of neonatal sepsis
benzylpenicillin and gentamicin
78
what causes neonatal jaundice
hyperbilirubinemia
79
name some risk factors for developing significant hyperbilirubinaemia
lower gestational age, jaundice within first 24 hrs, haemolysis, G6PD deficiency, diabetic mothers
80
pathophysiology of neonatal jaundice
reticuloendothelial cells maintain normal RBCs by destroying old and abnormal cells
81
name 5 causes of unconjugated neonatal jaundice
physiological
breast milk jaundice
haemolysis
hypothyroidism
infection/sepsis
82
what may be the earliest sign of hypothyroidism in neonates
persistent jaundice
83
clinical presentation of breast milk jaundice
persistent jaundice in an otherwise healthy, breast-fed baby
84
management of breast milk jaundice
reassurance
85
what causes physiological jaundice to be exaggerated in preterm babies
immature liver
86
how long does physiological jaundice usually lasy
around 2 weeks
87
name 4 causes of conjugated neonatal jaundice
biliary atresia
hepatitis
TPN
genetic conditions
88
name 2 genetic conditions that may cause neonatal jaundice
CF, down syndrome
89
define prolonged jaundice in a term baby
lasting longer than 14 days
90
define prolonged jaundice in a preterm baby
lasting longer than 21 days
91
what neonatal jaundice is always pathological
jaundice in the first 24 hours
92
investigations for early neonatal jaundice (3)
FBC, SBR, DCT
93
investigations of prolonged neonatal jaundice (4)
FBC, LFTs, SBR, TFTs
94
management of early neonatal jaundice
phototherapy
adequate hydration
95
how does phototherapy help treat neonatal jaundice
lowers serum bilirubin level by transforming it into water soluble without conjugation in the liver
96
name 2 rare complications of prolonged neonatal jaundice
encephalopathy
hearing impairment
97
name 3 possible complications of using phototherapy to treat neonatal jaundice
increased water loss
circadian rhythm disorder
bronze baby syndrome
98
clinical presentation of biliary atresia
pale, clay-coloured stools and dark urine
99
management of biliary atresia
portoenterostomy before 3 months of age
100
what is neonatal abstinence syndrome
withdrawal symptoms that happens in neonates of mothers that used substances in pregnancy
101
name some substances that can cause neonatal abstinence syndrome
opiates
methadone
benzos
alcohol
SSRIs
102
clinical presentation of neonatal abstinence syndrome
irritability, tremors, seizures
sweating, unstable temp, tachypnoea
poor feeding, hypoglycaemia
103
how is neonatal abstinence syndrome measured
modified finnegan score
104
management of neonatal abstinence syndrome
mums breastmilk for weaning
oral morphine
105
what is birth asphyxia
when a baby doesn't receive enough oxygen before, during or just after birth
106
name some causes of birth asphyxia
maternal shock
intrapartum haemorrhage
prolapsed chord
nuchal chord
107
what is a nuchal chord
where the chord is wrapped around the neck of the baby
108
name a complication of birth asphyxia
hypoxic ischaemic encephalopathy
109
what is another name for neonatal hypotonia
floppy baby
110
what is neonatal hypotonia
baby with low muscle tone
