Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCOG Part 2 Clinical Skills, Teaching and Research > Neonatology from busy SpR > Flashcards

Neonatology from busy SpR Flashcards

1
Q

Breastfeeding + Aspirin

A

Risk Reye’s sydnrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

BF + Bromocriptine/carberfoline

A

Suppressess lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

BF + Caribmazole

A

Affect neonatal thyroid function, nodular goitre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

BF + Chlorampheniclol

A

Leucopenia, aplastic anaemia acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

BF + cyclophosphamide

A

Discotinune during BF and for 36hr after stopped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

BR + diazepam

A

Lethargy, drowiness, hyperbilirubimae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Erbs
- Nerve roots
- Cause
- Symptoms

A

C5/C6
Excessive displacement of head to the opposite side or depression of the shoulder on same side

Medially roasted and forearm pronated (waiters tip), sensory loss of lateral side of arm/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Klumpke’s
- Nerve roots
- Cause
- Symptoms

A

C8/T1

Small muscles of claw hand, sensory loss of medial side of arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 4 key adaptations of the fetal circulation?

A
  • Ductus venous
    (oxygenated blood coming from placenta umbilical vein, divides 1 to liver and ductus arterioles into inferior vena cava)
  • Forman ovale - semi oxygenated blood from IVC & SVC into R atrium shunts to L side of heart (low pressure) and into aorta
  • Ductus arteriosus - blood in pulmonary artery is connects to ductus arteriosus, placenta releases prostaglandin which keeps this open
  • Umbilical arteries - blood from aorta sends blood to body, common iliac which splits into internal. Umbilical arteries carrying deoxygenated blood back to placenta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the remnants of each fetal adaptation called after birth?

A

Foramen vale - fossa ovalis
Ductus arteriosus - ligament arteriosus
Umbilical arteries - proximal superior vesical arteries, distal medial umbilical arteries
Umbilical vein - round ligament of the liver
Ductus venous - ligament venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What proportion of adults have a patent foramen ovale?

A

25-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In what conditions is the foramen ovale less likely to close?

A

Born premature
Congenital rubella infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In what % of cases is a patent ductus arteriosus isolated?

A

90%
10% other congenital heart defects (tetralogy- necessary for survival)
Pink upper limbs, blue lower limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How common are cardiac congenital malformation

A

7-8/1000
6-10% all infant mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How often does neonatal examination fail to detect CHD?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is eisenmenger syndrome?

A

Left to right heart shunt that not corrected leading to pulmonary HTN, R ventricular becomes hypertrophied. R to L shunt.
Hypoxia - polycythemia, clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is combined pulse oximetry measured in neonate

A

Pre-ductal - Right hand
Post-ductal - any foot

Improves detect of CHD to 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is considered a normal combined pulse oximetry?

A

Both >95% and less to equal to 2% difference

At birth lower, in health term baby does not reach 90% in 1st 5 mins and gradient remains

Screening normally done 4-12 hours after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How to calculate APGARs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What scores of APGAR are considered normal?

A

> 7 are good
4-6 fairly low
<3 criticality low

Normally measured at 1 and 5 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Draw diagram showing location caput, cephalohaematoma, subgleal haemorrhage, extradural haemorrhage

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cephalohaematoma
- How common
- Location
- Association
- When does it present

A

1%
bleeding beneath periosteum, does not cross suture line
Associated with jaundice
May not appear until 2nd day of life, takes severeal weeks to disappear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Subglaleal hemorrhage
- How common
- Location
- Association
- RF

A
  • Rare
  • Bleeding beneath aponeurosis, crosses midline
  • Associated with shock, anaemia, neonatal death
  • Increased risk ventouse delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to sub-arachnoid haemorrhage occur? Progonsis>

A

Small vessels normally veins
Silent bleed, may present with fits
Good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Sub dural haemorrhage association, outcomes

A

Associated with excessive moulding forces or difficult delivery of head

Large infra-tentorial bleeds associated with poor outcome

26
Q

How common is intra-ventricular haemorrhage?
What is associated with poorer outcomes

A

2% normal babies at term, increased in preterm
Poorer prognosis if brain parenchyma involved
50% cerebral palsy if post haemorrhage hydrocephalus

27
Q

What is periventricular leukomalacia?

  • Biggest risk factor
  • Outcomes assocated
A

White-matter brain injury near lateral venticules

  • Most likely to affect preterm infants, <1500g
  • Can manifest as cerebral palsy >50%
28
Q

Rate of stillbirth in UK
Stillbirth risk at 39 weeks

A

1 in 200
39/40 1/1000

29
Q

Draw neonatal resuscitation flow diagram

A
30
Q

How many insufflation breaths?

A

5

31
Q

Acceptable pre ductal SPO2 at 2, 5 and 10 mins

A

2 65%
5 85%
10 90%

32
Q

Before what gestation should be wrapped in plastic bag?

A

<32 weeks

33
Q

For inflamtion breaths what inflation pressures should be used <32 or >32

A

<32 25cm H20
>32 30 cm H20
Start in air

34
Q

What % of oxygen should be used
>32
28-32
< 28

A

> 32 21%
28-32 21-30%
<38 30%

35
Q

Ratio chest compressions to inflations

A

3:1

36
Q

What should the temperature of delivery room be in neonatal resuscitation?

A

26C

37
Q

How common is physiological neonatal jaundice?
When does is present in term and preterm infant?

A

30-50 term neonates, unconjugated
Term neonates - D3
Preterm neonate - D5
Does not present in 1st 24hrs

38
Q

What is jaundice considered pathological?

A

Conjugated
Marked jaundice >250-300 micro mol/L
Prolonged >10 days term/14 days preterm
Occurs 1st 24 hrs
Accosted with other illness

39
Q

Causes of haemolytic neonatal jaundice

A

Rhesus disease, ABO haemolytic disease of glucose-6-phosphate dehydrogenase deficiency, hereditary spherocytosis, pyruvate kinase deficiency, polycythaemia, TTTS, haemoglobinopathies

40
Q

What can high levels of unconjugated bilirubin cause in neonate?

A

Kericterus - crosses BBB
basal ganglia involved, athetoid cerebral palsy + deafness, seizures, neonatal death

More likely extreme preterm, sepsis, acidosis

41
Q

How is jaundice treated>

A

Phototherapy
Exchange transfusion - based on unconjugated bilirubin concerntaiton

42
Q

Inheritance of Glucose-6-phosphate dehydrogenase deficiency

A

X linked recessive

43
Q

Which clotting factors of vitamin K dependant?

A

2, 7, 9, 10

44
Q

What is haemorrhage disease of the newborn

A

Babies relative low vitamin K and can suffer harmorrhagic complications which can be fatal

45
Q

How is the risk of haemorrhage disease of the newborn minimised?

A

1mg vit K fine at birth
PO regime’s available 2mg

46
Q

Which babies required additional vitamin K?

A

If give oral vitamin K at birth and breast-fed
2mg at 1 week and 1 monthly until weaned

47
Q

Which babies at high risk of HDN?

A

Pre-term

  • Small for gestation age
  • Badly bruised
  • Breech deliveries
  • Operative delivery
  • Maternal anti-convulsant therapy
  • Maternal / neonatal liver disease
  • Admission to SCBU
  • Poor feeding
48
Q

How common is RDS before 32 weeks & term?

A

<32 40-50%
Term 2/1000

49
Q

NNT for AN steroid to prevent RDS/NND/IVH < 31 weeks and >34 weeks

A

<31 5
>34 94

50
Q

How common is TTN
- term
- CS before labour
- CS in labour
- VD

A
  • term 6/1000
  • CS before labour 35/1000
  • CS in labour 12/1000
  • VD 5/1000
51
Q

Complications of preterm

A

Resp
- RDS, TTN, chronic lung disease
- Apnoea of prematurity
Neuro
- ICH, IVH, HIE
Infection
NEC
Retinopathy
Anaemia
Patent ductus arteriosus

52
Q

Which tests included in health prink test

A

Sickle cell
CF
Congeitnal hypothyroid
PKU
MCADD
Mayple syrup urine disease
Isovaleric acidaemia
Glutaaric aciduria type 1
homocystinuria

53
Q

Which neonates at risk of neonatal hypoglycaemia

A

DM mothers
Mother taken BB
IUGR

54
Q

How to Dx neonatal hypoglycaemia?

A

A value <1.0mmol/l at any time

A single value <2.5mmol/l in a neonate with abnormal clinical signs

A value <2.0mmol/l and remaining <2.0mmol/l at next measurement in a baby with a risk factor for impaired metabolic adaptation and hypoglycaemia but without abnormal clinical signs.

55
Q

Treatment neonatal hypoglycaemia

A

Buccal dextrose + feeding plan if 1-1.9
<1 or persistent - medical R/V

56
Q

Fetal blood volume is what proportion of body weight?

A

10-12%

57
Q

Additional blood from delayed cord clamping if baby 3500g 1

A

166ml

58
Q

How common is neonatal hip dysplasia

A

0.5-1.5%

59
Q

Risk factors for neonatal hip dysplasia?

A

Female 8:1
Fix (6% sibiling, 12% parent)
Breech
Multiple preg
1st preg
LGA
Oligo
Postural and non portal abnormality - club foot, torticollis

60
Q

How common hip dysplasia bilateral? Which leg more likely to be effected

A

20-40% bilateral
L > R x 3

MRCOG Part 2 Clinical Skills, Teaching and Research (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions