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ADELE-Repro Ramblings > Neonatology > Flashcards

Neonatology Flashcards

(56 cards)

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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?

Study These Flashcards
A 
Sepsis
Withdrawl
Meconium aspiration
TTN
PDA
24
Q

How is NRDS reduced?

Study These Flashcards
A

Use of steroids to mothers during premature labour

25
What are the red flag risk factors for infection?
Mother received IV antibiotics in past 24h Resp distress starting 4+ hours after birth Multiple birth- other baby has suspected or confirmed infection
26
Name 4 causes of neonatal abstinence syndrome
Illicit drugs Alcohol Prescribed medication Caffeine
27
What is the management for neonatal abstinence syndrome and when is it indicated?
Indicated if three consecutive scores averaging >8 | Management: Oromorph, methadone, phenobarbitone
28
What are the 3 reasons for bowel obstruction?
Intra-lumen External compression Something in the wall
29
What is necrotising enterocolitis?
Inflammatory bowel necrosis when food is started too early and moved to a weakened area of intestinal tract
30
What is meconium ileus?
Bowel obstruction that occurs when the meconium in the intestine is even thicker/sticker than normal creating a blockage in the ileus
31
Most people with meconium ileus have which condition?
CF (this will be 1/3rd of patients 1st presentation)
32
What do you get soap sign in?
Meconium ileus
33
What is jejunal atresia?
A birth defect, partial/complete absence of the mesentery | The jejunum twists around the marginal artery resulting in intestinal blockage
34
What is ladder bowel a sign of?
Small bowel obstruction
35
What colour is the vomiting in malrotation?
Green vomiting
36
Volvulus is a complication of malrotation TRUE/FALSE
true
37
Treatment of hypoxic ischaemia encephalopathy
Cool them for 3 days on cooling mat, low temperature at 33 degrees, muscles become stiff
38
Haemorrhage disease of the newborn is caused by a deficiency of what vitamin?
Vitamin K
39
Symptoms of fetal alcohol syndrome
``` Epicanthal folds Small eye openings Flat midface Dysplastic kidneys Ventricular septal defect Micrognathia (undersized jaw) Upturned nose Smooth philtre Thin upper lip Microcephaly ```
40
What is gastroschisis?
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
How is gastroschesis treated?
Exposed intestines wrapped in "cling film" to reduce amount of fluids and heat loss, protects intestines from further damage
42
What percentage of pregnancies deliver before 37wks?
6-7% of pregnancies
43
Why is the number of preterm babies globally rising?
increasing maternal age increasing rate of prig-related complications greater use of infertility treatment more c-sections than term
44
Causes of preterm
``` Infection Vascular Over distension --> Multiple, polyamnios Cervical incompetence Intercurrent illness --> UTI/Pyelonephritis, appendicitis and Pneumonia Idiopathic ```
45
If you are going to have an early pregnancy to induce you need what?
Steroids OR Magnesium sulphate
46
Death of babies before which age are not officially registered?
24wks
47
RF for infant death
``` Higher risk for twins Complications during delivery Preterm Black/asian Tennage mothers and mothers >40 Mothers living in poverty ```
48
Why are there so many more problems with premature babies?
Need more help to stay warm more fragile lungs Fewer reserves Don't breathe effectively
49
TRUE/FALSE | Low admission temperature is an independent risk factor for neonatal death
true
50
What bacterial are implicated in early onset sepsis?
Gp B Streptococcus | Gram negatives
51
What bacteria are implicated in lat onset sepsis?
Coagulase negative staphylococci Gram negatives Steph aureas
52
What is the primary pathology of respiratory distress syndrome?
Surfactant deficiency, structural immaturity
53
Respiratory distress syndrome occurs in what percentage of infants <29 weeks?
75%
54
Signs of respiratory distress syndrome
Tachypnoea GruntingIntercostal recession Nasal flaring Cyanosis
55
PDA is more common in male neonates TRUE/FALSE
FALSE | More common in female neonates
56
When is retinopathy of prematurity most common?
6-8wks after delivery

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