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ADELE-Repro Ramblings > Neonatology > Flashcards

Neonatology Flashcards

1
Q

What is small normal and large for gestation age weight limits?

A

<2.5kg - SGA
2.5-4kg- Normal
>4kg- LGA

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2
Q

what are the 3 shunts in fatal circulation?

A

Ductus venosus
Foramen vale
Ductus arteriosus

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3
Q

What happens to a baby in the third trimester to prepare it for birth?

A

Surfactant production
Accumulation of glycogen-liver, muscle, heart
Accumulation of brown fat- between scapulae and around internal organs
Accumulation of subcut fat
Swallowing amniotic fluid

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4
Q

What does the ductus arterioles become in an adult?

A

Ligamentum arteriosus

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5
Q

What does the ductus venous become in an adult?

A

Ligamentum teres

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6
Q

What is transient tachypnoea caused by?

A

Retained lung fluid due to impacted clearance mechnaisms

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7
Q

What is the main source of heat production in newly born babies?

A

Non shivering thermogenesis

heat produced by breakdown of stored brown adipose tissue in response to catecholamines

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8
Q

Non shivering thermogenesis starts as soon as the baby is out of the vagina TRUE/FALSE

A

FALSE

It is not efficient in the 1st 12h of life

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9
Q

TRUE/FALSE

In the first few hours post birth there is mobilisation of hepatic stores for gluconeogenesis

A

TRUE

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10
Q

Physiological anaemia is lowest at 8-10wks. Why?

A

Adult Hb synthesised more slowly than Fetal Hb broken down

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11
Q

On what day is the neonatal heel prick done?

A

Day 5

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12
Q

What does the BM ahem to be below for it to be counted as hypoglycaemia?

A

<2.6

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13
Q

Name 4 risk factors for neonatal jaundice?

A

SGA
Maternal antibodies
Maternal illness/medication
Potential congenital abnormalities

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14
Q

What are the symptoms of jaundice?

A

Yellowing of skin/sclera of the eyes
Yellowing of the palms of the hands and soles of the feet
Dark, yellow urine (newborn babies should be colourless)
Pale coloured stools (instead of yellow or orange coloured stools)

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15
Q

How long does it take for the adult concentration of haemoglobin to be attained?

A

6-8 months

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16
Q

Causes of pathological unconjugated jaundice

A 
Breast milk
Haemolysis
Infection
Inherited causes
Intestinal obstruction
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17
Q

Causes of pathological conjugated jaundice

A 
Biliary atresia
TPN
Hypothyroidism
a1 antitrypsin
galactosaemia
CF
Trisomy 21
Dubin johnson
Alagille syndrome
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18
Q

Treatment for pathological jaundice

A

Phototherapy (blue light 420-470nm wavelength)
Adequate hydration
Ix and Rx underlying cause

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19
Q

How does phototherapy for jaundice work?

A

Photo-isomerisation of bilirubin

(convert trans bilirubin to the more water soluble cis-form which it excretes in the bile without conjugation)

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20
Q

How many days is classed as prolonger jaundice?

A

> 14 days in a term baby

>21 days in a preterm baby

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21
Q

What is kernicterus?

A

A rare but serious complication of untreated jaundice in babies caused by excess bilirubin damaging the brain or CNS

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22
Q

Unconjugated liver is carried by —- to the liver

A

Albumin

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23
Q

What are the causes of tachypnoea in the newborn?

A 
Sepsis
Withdrawl
Meconium aspiration
TTN
PDA
24
Q

How is NRDS reduced?

A

Use of steroids to mothers during premature labour

25
Q

What are the red flag risk factors for infection?

A

Mother received IV antibiotics in past 24h
Resp distress starting 4+ hours after birth
Multiple birth- other baby has suspected or confirmed infection

26
Q

Name 4 causes of neonatal abstinence syndrome

A

Illicit drugs
Alcohol
Prescribed medication
Caffeine

27
Q

What is the management for neonatal abstinence syndrome and when is it indicated?

A

Indicated if three consecutive scores averaging >8

Management: Oromorph, methadone, phenobarbitone

28
Q

What are the 3 reasons for bowel obstruction?

A

Intra-lumen
External compression
Something in the wall

29
Q

What is necrotising enterocolitis?

A

Inflammatory bowel necrosis when food is started too early and moved to a weakened area of intestinal tract

30
Q

What is meconium ileus?

A

Bowel obstruction that occurs when the meconium in the intestine is even thicker/sticker than normal creating a blockage in the ileus

31
Q

Most people with meconium ileus have which condition?

A

CF (this will be 1/3rd of patients 1st presentation)

32
Q

What do you get soap sign in?

A

Meconium ileus

33
Q

What is jejunal atresia?

A

A birth defect, partial/complete absence of the mesentery

The jejunum twists around the marginal artery resulting in intestinal blockage

34
Q

What is ladder bowel a sign of?

A

Small bowel obstruction

35
Q

What colour is the vomiting in malrotation?

A

Green vomiting

36
Q

Volvulus is a complication of malrotation TRUE/FALSE

A

true

37
Q

Treatment of hypoxic ischaemia encephalopathy

A

Cool them for 3 days on cooling mat, low temperature at 33 degrees, muscles become stiff

38
Q

Haemorrhage disease of the newborn is caused by a deficiency of what vitamin?

A

Vitamin K

39
Q

Symptoms of fetal alcohol syndrome

A 
Epicanthal folds
Small eye openings
Flat midface
Dysplastic kidneys
Ventricular septal defect
Micrognathia (undersized jaw)
Upturned nose
Smooth philtre
Thin upper lip
Microcephaly
40
Q

What is gastroschisis?

A

Birth defect of the abdominal wall

The baby’s intestines are found outside of the baby’s body, exiting through a hole beside the belly button

41
Q

How is gastroschesis treated?

A

Exposed intestines wrapped in “cling film” to reduce amount of fluids and heat loss, protects intestines from further damage

42
Q

What percentage of pregnancies deliver before 37wks?

A

6-7% of pregnancies

43
Q

Why is the number of preterm babies globally rising?

A

increasing maternal age
increasing rate of prig-related complications
greater use of infertility treatment
more c-sections than term

44
Q

Causes of preterm

A 
Infection
Vascular
Over distension --> Multiple, polyamnios
Cervical incompetence
Intercurrent illness --> UTI/Pyelonephritis, appendicitis and Pneumonia
Idiopathic
45
Q

If you are going to have an early pregnancy to induce you need what?

A

Steroids
OR
Magnesium sulphate

46
Q

Death of babies before which age are not officially registered?

A

24wks

47
Q

RF for infant death

A 
Higher risk for twins
Complications during delivery
Preterm
Black/asian
Tennage mothers and mothers >40
Mothers living in poverty
48
Q

Why are there so many more problems with premature babies?

A

Need more help to stay warm
more fragile lungs
Fewer reserves
Don’t breathe effectively

49
Q

TRUE/FALSE

Low admission temperature is an independent risk factor for neonatal death

A

true

50
Q

What bacterial are implicated in early onset sepsis?

A

Gp B Streptococcus

Gram negatives

51
Q

What bacteria are implicated in lat onset sepsis?

A

Coagulase negative staphylococci
Gram negatives
Steph aureas

52
Q

What is the primary pathology of respiratory distress syndrome?

A

Surfactant deficiency, structural immaturity

53
Q

Respiratory distress syndrome occurs in what percentage of infants <29 weeks?

A

75%

54
Q

Signs of respiratory distress syndrome

A

Tachypnoea
GruntingIntercostal recession
Nasal flaring
Cyanosis

55
Q

PDA is more common in male neonates TRUE/FALSE

A

FALSE

More common in female neonates

56
Q

When is retinopathy of prematurity most common?

A

6-8wks after delivery

ADELE-Repro Ramblings (21 decks)

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