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Neonatology Flashcards

(46 cards)

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1
Q

What is the pathology of hypoxic ischaemic encephalopathy?

A

Neonatal brain injury secondary to pre-natal, peri-natal or post-natal asphyxia

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2
Q

What are the signs of hypoxic-ischaemic encephalopathy (asphyxia)?

A

Mild - irritable, increased tone, staring eyes, poor feeding
Mod - lethargy, reduced tone, seizures
Severe - coma, proglonged seizures, multi-organ failure

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3
Q

What investigations would be done if hypoxic-ischaemic encephalopathy was suspected?

A 
Abnormal cardiotocograph (CTG)
Poor apgar score
Metabolic acidosis
EEG
MRI
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4
Q

How is hypoxic-ischaemic encephalopathy treated?

A

Fluid resuscitation
Respiratory and circulatory support
Anticonvulsants
Cooling

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5
Q

What are the complications of hypoxic-ischaemic encephalopathy?

A

Cerebral palsy
Learning difficulties
Epilepsy
Hearing and visual impairment

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6
Q

Apgar score

A 
Appearance
Pulse rate
Grimace
Activity
Respiration
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7
Q

What is the pathology of respiratory distress syndrome?

A

Lack of surfactant

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8
Q

What are the causes of respiratory distress syndrome?

A 
Pre-mature
Meconium aspiration
Congenital pneumonia
Heart failure
Pneumothorax
Diaphragmatic hernia
Transient tachypnoea of the newborn
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9
Q

What are the signs of respiratory distress syndrome?

A 
Tachypnoea - RR 60/min
Grunting
Intercostal/subcostal recession
Cyanosis
Hypercapnia
Respiratory distress
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10
Q

What investigations would be done if respiratory distress syndrome was suspected?

A

CXR

ECHO if cardiac cause

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11
Q

How is respiratory distress syndrome treated?

A

Endotracheal surfactant
Intubation and ventilation
Continuous positive airway pressure (CPAP)

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12
Q

What are the complications of respiratory distress syndrome?

A

Short-term - pneumothorax, infection, apnoea

Long-term - chronic lung disease of prematurity

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13
Q

How can respiratory distress syndrome be prevented?

A

Antenatal dexamethasone

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14
Q

What is the pathology of necrotising entero-colitis?

A

Ischaemic and inflammatory changes

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15
Q

What are the signs of necrotising entero-colitis?

A 
Abdominal distention
Shiny abdomen
Colour changes
Green bile
Absent bowel sounds
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16
Q

How is necrotising entero-colitis investigated?

A

X-ray

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17
Q

How is necrotising entero-colitis treated?

A

Nil by mouth
Antibiotics
Parental nutrition
Surgery

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18
Q

What are the complications of necrotising entero-colitis?

A

Peritonitis
Sepsis
Death
Abscess formation

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19
Q

What are the causes of neonatal sepsis?

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A 
Prolonged rupture of membranes (>24hrs)
Chorioamnionitis
Maternal pyrexia/sepsis
Maternal carriage of group B strep
Prematurity
20
Q

What pathogens are responsible for neonatal sepsis?

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A 
GBS - group B strep
E.coli
Chlamydia
Gonorrhoea
Listeria
HSV
21
Q

What are the signs of neonatal sepsis?

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A

Respiratory distress
Apnoea
Temperature instability
Poor feeding

22
Q

What investigations would be done if neonatal sepsis was suspected?

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A 
Bloods - CRP, WBC
Blood culture
Lumbar puncture
Urine MC&S
CXR
23
Q

How is neonatal sepsis treated?

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A

Maternal antibiotics when risk factors for sepsis are present
Strict infection control

24
Q

What are causes of hypoglycaemia?

Study These Flashcards
A 
Prematurity
Small for gestational age
Macrosomia
Infants of diabetic mothers
Sepsis
Polycythaemia
Metabolic
25
What are signs of neonatal hypoglycaemia?
``` Jitteriness Poor feeding Drowsiness Apnoea Seizures ```
26
How is hypoglycaemia investigated in the newborn?
BG <2.5mmol/L | Metabolic screen if persistent or severe hypoglycaemia
27
How is hypoglycaemia treated?
Early and frequent milk feeds | IV 10% dextrose
28
What are the complications of neonatal hypoglycaemia?
Seizures | Neurological disability
29
What is transient tachypnoea of the newborn?
Self-limiting, presents within 1st few hours of life
30
What are the signs of transient tachypnoea of the newborn?
Grunting Tachypnoea Oxygen requirement
31
How is transient tachypnoea of the newborn treated?
``` Supportive Antibiotics Fluids O2 Airway support ```
32
What are the risk factors for meconium aspiration?
Post-term Maternal diabetes Maternal hypertension Difficult labour
33
What are the signs of meconium aspiration?
``` Cyanosis Increased work of breathing Grunting Apnoea Floppiness ```
34
What investigations would be done if meconium aspiration was suspected?
Blood gas Septic screen CXR
35
How is a meconium aspiration managed?
``` Suction below cord Airway support Fluids IV antibiotics Surfactant ```
36
What are common complications of prematurity?
``` Respiratory distress syndrome Patent ductus arteriosus Necrotising enterocolitis Retinopathy of prematurity Intraventricular haemorrhage Hypothermia Hypoglycaemia Poor feeding Neonatal jaundice ```
37
What are common post-natal problems?
``` Jaundice Plethora Cyanosis Erythema toxicum Mongolian blue spots Naevus simples Naeverus flammeus Strawberry naevus Hypoglycaemia Cleft lip/palate Cataracts Retinoblastoma ```
38
Plethora
Redness | May be due to polycythaemia
39
Erythema toxicum
Maculo-papular rash Cause unknown Clears by the end of 1st 2nd week
40
Mongolian blue spots
Blue-grey pigmentations | Acculumation of melanocytes
41
Naevus simples
Light colour capillary dilatation Gradually fades within 1st/2nd years (Grey) - looks like stork lines
42
Narverus flammeus
Presents at birth | Caused by dilated mature capillaries in the superficial dermis
43
Strawberry naevus
(capillary haemangioma) Cluster of capillaries which appear within the first month after birth Raised and bright red
44
What is gastrochisis?
Abdominal wall defect - gut eviscerated and exposed, NOT COVERED Management - primary/delayed closure, TPN Survival - 90%, short gut
45
What is exomphalos?
Umbilical defect with covered viscera - typically encloses the bowel and liver Management - primary/delayed closure Post-natal mortality 25%
46
What are common congenital infections?
``` TORCH: Toxoplasmosis Other - HBV, syphilis, varicella zoster, HIV, parvovirus B19 (slapped cheek) Rubella CMV (cytomegalovirus) HSV Give aciclovir ```

Paediatrics (17 decks)

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