Neonatology

Question 1

When does the CVS begin to develop?

Answer 1

The end of the third week of gestation

Question 2

When does the heart begin to beat ?

Answer 2

Fourth week of gestation

Question 3

When is the critical development of heart development?

Answer 3

Day 20-50 after fertilisation

Question 4

What provides oxygenated blood to a fetus?

Answer 4

Umbilical vein

Question 5

How does blood get to the aorta in a fetus?

Answer 5

Foramen ovale –> left atrium –> left ventricle –> aorta

Question 6

Where foes blood travel to from the right ventricle?

Answer 6

Pulmonary artery to the patent ductus arteriosus to aorta

Question 7

What is the function of the ductus arteriosus?

Answer 7

Protects lungs against circulatory overload

Allows RV to strengthen

Carries low oxygen saturated blood

Question 8

What is the function of the ductus venosus?

Answer 8

Foetal blood vessel connecting the umbilical vein to the IVC

Blood flow is regulated by a sphincter and carries mostly oxygenated blood

Question 9

What is the normal RR for a neonate?

Answer 9

30-60 resps/min

Question 10

What is the normal HR for a neonate ?

Answer 10

120-160 bpm

Question 11

What is the normal blood pressure for a 1 hour old baby?

Answer 11

70/44

Question 12

What is the blood pressure for a one day old?

Answer 12

~70/42

Question 13

What is the blood pressure for a three day old baby?

Answer 13

~77/49

Question 14

What kind of fat insulates babies?

Answer 14

Brown fat

- cold fat leads to lipolysis and heat production

Question 15

Define radiation?

Answer 15

Heat dissipated to colder objects

Question 16

Define convection?

Answer 16

Heat loss by moving air

Question 17

Define conduction?

Answer 17

Heat loss to surface on which baby lies

Question 18

What is physiological jaundice?

Answer 18

Jaundice that appears on day of life and dissapears within 7-10 days in term infants/21 days in premature infants

Can be prolonged till 30 days if baby is experiencing breast fed jaundice

Question 19

How can jaundice be treated?

Answer 19

Biliblanket

Phototherapy

Question 20

What are Milia?

Answer 20

white papules on nose caused by hyerplastic sebaceous glands

Question 21

What are miliaria?

Answer 21

Immature sweat glands

Question 22

What are the causes of jaundice in children?

Answer 22

24 hours old = Haemolytic anaemia, TORCH

2nd day - 3rd week

• physiological
• breast milk
• sepsis
• polycythaemia
• cephalhaematoma
• craiger-najar syndrome
• haemolytic disorders

3rd week onwards

• breast milk
• hypothyroidism
• pyloric stenosis
• cholestasis

Question 23

What are the symptoms of hypoglycaemia in neonates?

Answer 23

Jitteriness, hypothermia, temperature instability, lethargy, hypotonia, apnoea, poor suck, vomiting, high pitched or weak cry, seizures

Question 24

Define hypoglycaemia?

Answer 24

Blood sugar <2.6mmol/l

Question 25

How is heat lost ?

Answer 25

Conduction Convection Evaporation Radiation

Question 26

How does one resuscitate baby under cold stress?

Answer 26

``` Dry quickly Remove wet linnens Use warm towels/blankets Provide radiant warmer heat Use heated/humidified oxygen ```

Question 27

Tongue Ties are characterised by | ?

Answer 27

Short +/- thickened frenulum | Attached anteriorly to base of tongue

Question 28

What areas are assessed for retractions if baby is admitted to NNU?

Answer 28

Substernal Subcostal Intercostal Supreasternal

Question 29

What are the main symptoms of airway obstruction?

Answer 29

Stridor and retractions

Question 30

What are the causes of airway obstruciton?

Answer 30

Laryngomalacia - worse at 2-4 months, gets better without treatment Tracheomalacia - improves by 2 years old Bronchomalacia - need CPAP +/- tracheostomy

Question 31

What should be considered immediately if cyanosis is present?

Answer 31

SEPSIS

Question 32

What may spinal dimples indicate?

Answer 32

Spina bifida | Kidney problems

Question 33

When should spinal dimples be investigated?

Answer 33

If dimple is - Large - Red - Swollen - Pigmented - Tender - accompanied by fluid