Normal Term + Pre-Term Infant

Question 1

Definition of extremely preterm

Answer 1

23-27 weeks

Question 2

Definition of very preterm

Answer 2

28-31 weeks

Question 3

Definition of preterm

Answer 3

32-36 weeks

ie. anything before 37 weeks gestation

Question 4

Definition of term

Answer 4

37-42 weeks

Question 5

Definition of post-term

Answer 5

anything after 42 weeks

Question 6

Why is the 3rd trimester important

Answer 6

Daily weight gain of 7g fat

3.5% fat at 28 weeks, 15% fat at term

Question 7

what is transferred via the placenta in the 3rd trimester

Answer 7

iron, vitamins, calcium, phosphate, antibodies

Question 8

normal weight of term baby

Answer 8

2.5kg-4.0kg
>4kg = large for gestational age
<2.5kg = small for gestational age

Question 9

what type of environment occurs during labour? How does baby cope with this?

Answer 9

Hypoxic environment

Foetal Hb helps release oxygen

Question 10

what is perinatal adaptation

Answer 10

the response of the baby to the post partum environment

Question 11

what happens has part of perinatal adaptation

Answer 11

First breath/cry
Alveolar expansion 
Change from foetal to newborn circulation
Decreased pulmonary arterial pressure
Increased PaO2

Question 12

What are the 5 categories of an APGAR score

Answer 12

HR
RR
Responsiveness
Tone 
Colour

Question 13

Normal APGAR score

Answer 13

8 or more out of 10

Question 14

what is haemorrhagic disease of the newborn

Answer 14

Autoimmune condition
The IgG antibodies passed from mother to foetus attack the red blood cells causing haemolytic
Can cause anaemia + reticulocytosis (increase in immature RBC’s)

Question 15

what is given to prevent haemorrhagic disease of the newborn

Answer 15

IM vitamin K

Question 16

what is moulding

Answer 16

the shape of the infants head changes to fit the shape of the mothers birth canal

Question 17

what is caput succedaneum

Answer 17

Oedema of the newborns scalp soon after delivery

Appears as a lump- should disappear after a few days

Question 18

characteristics of fetal alcohol syndrome

Answer 18

Epicanthal folds (skin of upper eye lid covers inner eye)
Small eye openings
Upturned nose
Smooth philtrum
Thin upper lip

Question 19

hip examinations performed on a new baby

Answer 19

barlow- tries to dislocate the hip

Ortolani- tries to relocate the hip

Question 20

causes of pre-term birth

Answer 20

spontaneous
multiple pregnancy
Rupture of membranes
IUGR
Antepartum haemorrhage
Cervical incompetence 
IVF

Question 21

Differences between term + preterm infant

Answer 21

Get cold faster
More fragile lungs
Don’t breathe as effectively

Question 22

Examples of conditions caused by system immaturity in pre-term infants

Answer 22

Respiratory distress syndrome
Patent ductus arteriosus
Intraventricular haemorrhage
Nectrotising enterocolitis

Question 23

why do preterm infants have trouble keeping warm

Answer 23

low BMR
Minimal muscular activity
Low levels of fat
High ratio of surface area to body mass

Question 24

two types of neonatal sepsis

Answer 24

Early onset- due to bacteria acquired before + during delivery
Late onset- acquired after delivery

Question 25

Organisms that cause early onset neonatal sepsis

Answer 25

Group B strep | Gram -ve: klebsiella, E.Coli, Pseudomonas, Salmonella

Question 26

Organisms that cause late onset neonatal sepsis

Answer 26

Gram +ve: Staph.Aureus, Strep Pneumoniae, Strep. Pyogenes

Question 27

what is important to remember about the use of incubators

Answer 27

they increase infection

Question 28

Respiratory complications of preterm

Answer 28

RDS apnoea of prematurity Bronchopulmonary dysplasia

Question 29

pathology behind RDS

Answer 29

Surfactant deficiency + structural immaturity | Leads to alveolar damage, inflammation + exudate formation from leaky capillaries

Question 30

Features of RDS

Answer 30

``` Tachypnoea Grunting Nasal flaring Intercostal recessions Cyanosis ```

Question 31

Management of RDS

Answer 31

Maternal steroid | Ventilation

Question 32

Cardiac concerns with preterm delivery

Answer 32

Patent ductus arteriosis | Systemic hypotension

Question 33

what type of murmur is heard in PDA

Answer 33

machine like murmur | connection between aorta and pulmonary artery remains open

Question 34

what is an intraventricular haemorrhage

Answer 34

A form of intracranial haemorrhage that begins with bleeding into germinal matrix

Question 35

How does an intraventricular haemorrhage present

Answer 35

``` within first 72 hours Diminished/absent moro reflex Poor muscle tone sleepiness lethargy apnoea ```

Question 36

management of intraventricular haemorrhage

Answer 36

Preventative measures (antenatal steroids)

Question 37

what is necrotising enterocolitis (NEC)

Answer 37

Widespread necrosis in the small and large intestine

Question 38

Symptoms of NEC

Answer 38

``` lethargy bloody stool temperature instability apnoea bradycardia Abdominal distension ```

Question 39

Long term complication of prematurity

Answer 39

cerebral palsy

Question 40

Normal HR for a newborn

Answer 40

120-140 BPM

Question 41

Expected RR for a newborn

Answer 41

40-60 breaths/min

Question 42

What is transient tachypnoea of the newborn

Answer 42

presents as tachypnoea for first few hours of life, lasts up to 1 day and resolved by day 2

Question 43

Most common bacterial cause of septicaemia in neonates

Answer 43

Group B strep