Neonatology

Question 1

what is the definition of a neonate

Answer 1

neonate is an infant int he first 28 days after birth

Question 2

when does the development of CVS occur

Answer 2

begins toward the end of the third week
heart starts to beat at the beginning of 4th week
critical days 20-25 days after fertilisations

Question 3

where does oxygenated blood come from

Answer 3

umbilical vein

Question 4

what is the function os ductus venous

Answer 4

takes blood from oxygenated umbilical vein to IVC

Question 5

what is ductus arteriosos

Answer 5

protects the lungs against circulatory overload

connects trunk of pul artery to descending aorta

Question 6

what is the BP of 1 hour child

Answer 6

70/44

Question 7

what is bp after 1 day

Answer 7

70+-9/42+-12

Question 8

what is bp after 3 days

Answer 8

77+-12/49+-10

Question 9

what is the resp rate

Answer 9

30-60/ min

Question 10

what is the HR

Answer 10

120-160

Question 11

what is tachycardia

Answer 11

> 160

Question 12

what is bradycardia

Answer 12

<100

Question 13

how to neonates thermoregulate

Answer 13

lack shivering

brown fat used to make heat

Question 14

how is heat lost

Answer 14

radiation
convection
evaporation
conduction

Question 15

describe jaundice in neonates

Answer 15

appears day 2-3 
up to 21 days in premature infants 
most come from haemoglobin 
metabolised in the liver 
can cause irreversible changes in the brain

Question 16

how do you treat jaundice

Answer 16

exchange transfusion and phototherapy

Question 17

how is fluid balanced in new borns

Answer 17

weight loss up to 10% is normal

Question 18

how if fluid balanced jn premature infants

Answer 18

less fat 
increased loss through kidney 
slower GFR
reduced na absorption 
decreased ability to concentrate or dilute urine 
insensible water loss

Question 19

what is anaemia in a new-born

Answer 19

born with hb 15-20g/l
week 10 hb 11.4g/l
anaemia caused by reduced erythropoiesis 
infection
blood letting

Question 20

what are the maternal causes of SGA

Answer 20

pre-eclampsia

Question 21

what are the foetal causes of SGA

Answer 21

chromosomal

infection

Question 22

what are the placental causes of SGA

Answer 22

placental abruption

Question 23

what are other causes of SGA

Answer 23

twin pregnancy

blood is shunted from one twin to another

Question 24

what are common problems of SGA

Answer 24

peritonea hypoxia
hypoglycaemia 
hypothermia
polycythaemia
thrombocytopenia 
GI and feeding problems

Question 25

what is the management of a preterm baby

Answer 25

NUTRITION enormous nutrition patients triple their size building new function tissue

Question 26

what are long term problems with being preterm

Answer 26

hypertension reduced growth ismchaemic heart disease

Question 27

what is respiratory distress syndrome

Answer 27

when the lungs aren't fully developed and cannot provide organs with 02 treat with surfactant prevent with steroids for the mum

Question 28

what is broncho-pulmonary dysplasia BPD

Answer 28

``` caused by the over stretch of lungs happens when use of a respirator can be caused by infection inflammatory changes and scarring treat with nutrition and steroids ```

Question 29

how do you treat apnoea

Answer 29

double espresso

Question 30

what is intravenricular haemorrhage IVH

Answer 30

bleeding into the ventricles of the brain | treat with steroids and drainage

Question 31

what is persistent ductus arteriosis

Answer 31

``` leads to pressure from aorta going to pul artery additional blood to pulmonary circulation over perfusion of legs leg oedema steals from systemic circulation retention of fluid GI problems right sided heart failure ```

Question 32

what is necrotising entero-colitis NEC

Answer 32

inflammatory and ischeamic changes | necrosis of the bowel

Question 33

what are the outcomes of extreme prematuirty

Answer 33

``` unpredictable deterioration between 2 and 6 some die some have mild disability some have severe disability ```

Question 34

what are benign conditions or ones that revolve themselves

Answer 34

``` plethora cyansis erythema toxicum Mongolian blue spot stork marks port wine stain strawberry navus ```

Question 35

what is the useful triad

Answer 35

``` pink sweet warm hypoxia hypoglycaemia hypothermia ```

Question 36

what are symptoms of hypoglycaemia

Answer 36

``` jitteriness temperature instabulity lethargy vomitng poor suck seizures ```

Question 37

what is the cause of a cleft lip

Answer 37

failure of formation from medial and axially nasal process

Question 38

what is the pathology of jaudice

Answer 38

uncongugated bilirubin in the blood | liver enyzyme pathways are immature

Question 39

what are the causes

Answer 39

haemolysis congenital infection sepsis hypothyroidism pyloric stenosis

Question 40

what are the symptoms of sepsi

Answer 40

``` pyrexia poor feeding lethargy early jaundice floppy ```

Question 41

what is the treatment for sepsis

Answer 41

iv penicillin and gentamicin | iv vneocymin and gentamicin

Question 42

what are casuses of sepsis

Answer 42

toxiplasmosis CMV herpes