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Paediatrics > Neonatology > Flashcards

Neonatology Flashcards

1
Q

What is neonatology?

A

Medical care of newborn infants, especially the ill or premature newborn

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2
Q

When does the CVS develop?

A

Towards the end of the 3rd week
Heart beats at the beginning of the 4th week
Critical period is day 20-50

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3
Q

What happens in foetal circulation?

A 
Oxygenated = umbilical vein
Deoxygenated = umbilical arteries

Blood from umbilical vein to IVC by ductus venosus

Blood from RA to LA by foramen ovale

Blood from pulmonary A to aorta via ductus arteriosus

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4
Q

What is the saturation of foetal blood?

A

60-70% O2

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5
Q

What happens when a baby takes its first breath?

A

Umbilical veins and arteries become ligaments

Ductus arteriosus and venosus become ligaments

Foramen ovale closes

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6
Q

What does the umbilical vein do?

A

oxygenated blood from placenta to IVC via ductus venosus

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7
Q

What does the umbilical artery do?

A

Carries deoxygenated blood to the placental from descending aorta

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8
Q

What does the Ductus arteriosus do?

A

Shunts blood from the PA to the aorta to bypass the lungs

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9
Q

What are the normal vial signs of a newborn?

A 
BP = 70/44
RR = 30-60
HR = 120-160
Tachy = >160
Brady = <100
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10
Q

How is thermoregulation done?

A

Maternal in the womb

Newborn = lipolysis and heat production

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11
Q

Where is newborn heat lost

A

Radiation = to other colder objects
Convection = moving air
Evaporation
Conduction = heat loss to surface the baby is on

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12
Q

What is the PaCO2 of a newborn?

A

5-6kPa

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13
Q

What is the PaO2 of a newborn?

A

8-12kPa

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14
Q

What is the tidal volume of a newborn?

A

4-6ml/kg

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15
Q

How do you calculated minute ventilation?

A

Tidal volume ml/kg X RR

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16
Q

When does physiological jaundice appear?

A

DOL 2-3 and disappears within 7-10 days

17
Q

What percentage of newborns develop jaundice?

A

60% of term

80% of premature

18
Q

What percentage of babies develop breast fed jaundice?

A

10% at 30 DOL

19
Q

What is the physiology of jaundice?

A

75% bilirubin from Hb
Metabolised in liver

Is lipid soluble and crosses BBB
High conc = irreversible changes = kernicterus

20
Q

How much weight loss to newborns loose due to water?

A

10%

Shift of interstitial fluid to intravascular and diuresis

21
Q

What happens in a newborns kidney?

A

Slower GFR
Reduced Na reabsorption
Decreased ability to concentrate or dilute urine

22
Q

What is the physiology of anaemia in a newborn?

A

RBC production is 10% of in uterus
Hb of 15-20g/l
20 week Hb = 12g/l

23
Q

What is a small birth weight?

A

<2500g

Born under the 10th weight centile

24
Q

What are the causes of a small for date?

A

Maternal (smoking, maternal pre-eclamptic toxemia)

Foetal (chromosomal and infection)

Placental - abruption

Other - twins

25
Q

What are problems with being small for dates?

A 
Hypoxia
Hypolygaemic
Hypothermic
Polycythaemia
Thrombocytopenia
GI problems
RDS and infection
26
Q

What are long term problems with being small for dates?

A

Hypertension
Reduced growth
Obesity
Ischaemic heart disease

27
Q

What is a preterm baby?

A

<37 weeks

28
Q

What is an extremely preterm baby?

A

<28 weeks

29
Q

What is an extremely low birth weight?

A

<1000g

30
Q

What is the incidence of prematurity?

A

5-12%

Extreme = <0.5%

31
Q

How to prevent respiratory distress syndrome?

A 
Antenatal steroids
Surfactant
Early extubation
N-CPAP
Minimal ventilation
32
Q

What is broncho-pulmonary dysplasia?

A

Damage to lungs by ventilation leading to scarring

  • Overstretched
  • Infection
  • Atelectasis
  • O2 toxicity
33
Q

What is the treatment for broncho-pulmonary dysplasia?

A

Patience
Nutrition and growth
Steroids

34
Q

What are minor lung problems in preterm babies?

A

Apnoea
Irregular breathing
Desaturations

Treatment = caffeine and N-CPAP

35
Q

How do you prevent and treat intraventricular haemorrhage?

A

Prevention = steroids

Treatment = symptomatic and drainage

36
Q

What are other conditions that affect the preterm brain?

A

Peri-ventricular haemorrhage

Post-haemorrhagic hydrocephalus

37
Q

What happens in a patent ductus arteriosus?

A

As pressure is greater in Aorta = blood from left to right

=Over perfusion of lungs
Lung oedema
Systemic ischemia

38
Q

What is necrotising entero-colitis?

A

Ischaemic and inflammatory changes and necrosis of the bowel

Surgery is often required + AB’s and nutrition

Paediatrics (15 decks)

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