Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHASE 3A > PAEDS - neonatology > Flashcards

PAEDS - neonatology Flashcards

(82 cards)

Start Studying
1
Q

healthy newborns should have a…
a) RR
b) pulse
c) temperature

A

a) 30-60 breaths per min
b) regular between 100-160 beats per min
c) around 37 celsius

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

most common congenital infection

A

cytomegalovirus

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

key signs of congenital rubella syndrome in a newborn (4)

A
  1. sensorineural deafness
  2. congenital cataracts
  3. glaucoma
  4. CHD e.g. PDA

think eyes and ears!

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

key signs of congenital cytomegalovirus infection in a newborn (4)

A
  1. LBW
  2. purpuric skin lesions
  3. microcephaly
  4. sensorineural deafness

think small, skin lesions

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

key signs of congenital toxoplasmosis infection in a newborn (3)

A
  1. cerebral calcification (intracranial)
  2. chorioretinitis (inflammation of choroid and retina of eye)
  3. hydrocephalus

think big, calcium

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

tx for baby with congenital toxoplasmosis

A

pyrimethamine and sulfadiazine

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

key signs of congenital varicella syndrome in a newborn (4)

A
  1. skin scarring
  2. microphthalmia (small eyes)
  3. limb hypoplasia
  4. microcephaly (small head/brain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is an epstein’s pearl?

A

congenital cyst found in mouth - common on hard palate but may be seen on gums (mistaken for erupting tooth)

not harmful, will resolve by itself

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

presentation of caput succadeneum

A
  • commonly seen in newborns immediately after birth
  • generalised superficial scalp oedema which Crosses Suture lines
  • associated with prolonged labour
  • will rapidly resolve over a couple of days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

presentation of cephalohematoma

A
  • associated with instrumental deliveries
  • appears 2-3 days following delivery
  • swelling in parietal region
  • gradually resolves over weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

stepwise principles of neonatal resus

A
  1. warm baby - rigorous drying
  2. calculate APGAR score
  3. stimulate breathing e.g. by rigorous drying
  4. inflation breaths
  5. chest compressions
  6. if severe > IV drugs and intubation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how are babies <28 kept warm during resus?

A

place in plastic bag while still wet, manage under heat lamp

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

when are inflation breaths given in neonatal resus?

how are they given if
a) term/near term
b) preterm

A

when gasping/not breathing despite adequate initial stimulation

a) air
b) mix of air and O2

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

stepwise principles of inflation breaths in neonatal resus

A
  1. two cycles of five inflation breaths (lasting 3 secs each)
  2. if no response and HR still low, 30 seconds of ventilation breaths
  3. if STILL no response, add chest compressions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when are chest compressions performed in neonatal resus?

how are they performed?

A

if HR remains <60bpm despite resus and inflation breaths

performed at 3:1 ratio with vent breaths

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

delayed cord clamping in
a) uncompromised neonates
b) neonates that require resus

A

a) delay of at least 1 minute before clamping
b) cord clamped sooner - prevents delays getting to resus team

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

what is necrotising enterocolitis?

A

intestinal inflammation and death in premature babies

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

which babies are most at risk of necrotising enterocolitis?

A

premature babies

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

presentation of necrotising enterocolitis

A

neonate with:
- bilious vomiting
- reduced feeding
- abdo distension
- bloody stools

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

key investigation and results for necrotising enterocolitis

A

X-RAY (chest and abdo)
- dilated bowel loops
- portal venous gas
- intramural gas
- Rigler’s sign (air both inside and outside the bowel wall)

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

management of necrotising enterocolitis

A

STAIN:
S - surgical emergency
T - total parenteral nutrition
A - abx (vancomycin + cefotaxime)
I - IV fluids
N - nil by mouth

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

complications of necrotising enterocolitis

A

perforation, peritonitis

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

RFs for gastroschisis/exomphalos (6)

A
  1. maternal smoking
  2. alcohol
  3. illicit drug use
  4. young (gastrochisis)/old (exomphalos) maternal age
  5. SES
  6. opioid prescription in pregnancy
  7. DS (exom)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when is gastrochisis/exomphalos normally diagnosed? with what? what will the result be?

A

antenatally diagnosed at 20 weeks
1. USS scan - bowel free-floating in amniotic fluid
2. maternal bloods - raised AFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how does gastroschisis present in neonates?
- lateral (right-side) of umbilical cord - abdominal contents exposed to air
26
management of gastroschisis including type of delivery (5)
1. vaginal delivery can be attempted - 37/40 2. immediate fluid resus 3. sterile, clear covering of abdo contents 4. immediate surgery (if large may need staged repair) 5. then NG tube and parenteral feeding
27
how does exomphalos present in neonates?
- abdominal contents protrude through abdo wall via umbilical cord - covered in amniotic sac
28
conditions associated with exomphalos (4)
1. Beckwith-Wiedemann syndrome 2. DS 3. cardiac/kidney malformations 4. edwards
29
management of exomphalos including type of birth
1. c-section preferred (prevents sac rupture) 2. OG tube to decompress stomach 3. IV fluid resus 4. staged repair surgery
30
management of exomphalos if sac ruptures
immediate surgical intervention
31
causes of hypoxic ischaemic encephalopathy (HIE) (6)
1. maternal shock e.g. placental abruption, uterine rupture 2. intrapartum haemorrhage 3. prolapsed cord 4. nuchal cord (wrapped around neck of baby) 5. prolonged labour 6. shoulder dystocia
32
general signs and symptoms of HIE
- highly alert/v low energy - trouble breathing - not eating - trouble hearing - seizures/other neuro - slow HR - organ failure
33
what system is used to stage HIE? how many stages are there?
Sarnat staging 3 stages - mild, moderate, severe
34
mild HIE features (signs, resolves when, prognosis)
1. poor feeding, generally irritable and hyper-alert 2. resolves within 24h 3. normal prognosis
35
moderate HIE features (signs, resolves when, prognosis)
1. poor feeding, lethargy, hypotonic, seizures 2. can take weeks to resolve 3. up to 40% develop cerebral palsy
36
severe HIE features (signs, mortality)
1. reduced consciousness, apnoeas, flaccid, reduced/absent reflexes 2. up to 50% mortality 3. up to 90% develop cerebral palsy
37
what is the diagnosis of HIE often based off of?
child's symptoms and problems that took place during labour/delivery
38
investigations to confirm HIE diagnosis (4)
1. bloods - check O2 2. test blood in umbilical cord/examine placenta (identify cause) 3. USS of head 4. brain MRI (only at 4-7 days old!)
39
initial management of HIE
therapeutic hypothermia/cooling
40
therapeutic cooling for HIE a) which babies b) target temp c) how long for d) what is done after
a) near/at term with HIE b) 33-34 degrees c) continued for 72h d) baby gradually warmed to normal temp over 6h
41
supportive management for HIE
- neonatal resus - ongoing optimal ventilation - circ support - nutrition - acid base balance - tx of seizures
42
complications of HIE (3)
1. permanent damage to brain - CP 2. death 3. delays in growth/development
43
features of congenital syphilis (8)
1. blunted upper incisor teeth (Hutchinson's teeth) 2. saddle nose 3. saber shins (tibial malformation) 4. rhagades (linear scars around mouth) 5. deafness 6. lymphadenopathy 7. hepatosplenomegaly 8. rash
44
jaundice in the first 24 hours of life is always...
pathological
45
causes of jaundice in first 24h (4)
1. rhesus haemolytic disease 2. ABO haemolytic disease 3. hereditary spherocytosis 4. glucose-6-phosphodehydrogenase deficiency (G6PD)
46
causes of jaundice in days 2-14
normally physiological!
47
causes of prolonged jaundice (>21 days in term infant, >14 in preterm infant) (5)
1. biliary atresia 2. breastmilk jaundice 3. hypothyroidism 4. congenital infection e.g. CMV, toxoplasmosis 5. prematurity (immature liver function)
48
when is a transcutaneous bilirubinometer used first line for jaundice?
- baby >35w - prolonged (not within 24hr)
49
what ix is first line for jaundice if baby is <35w or it is within the first 24hr?
serum bilirubin
50
2nd line investigation for jaundice if transcutaneous bilirubinometer is >250
serum bilirubin
51
investigations in a jaundice screen
- serum conjugated and unconjugated bilirubin - direct antiglobulin test (Coomb's) - TFTs - FBC and blood film - urine - U&Es, LFTs
52
prolonged jaundice and a raised conjugated bilirubin indicates...
biliary atresia
53
investigations for baby presenting w jaundice in first 24h
1. serum bilirubin 2. FBC 3. blood groups 4. direct Coomb's test 5. blood film 6. TORCH screen 7. urine dip/microscopy
54
management of prolonged jaundice
- treat cause - phototherapy (on/above blue line) - exchange transfusion (on/above red line)
55
what is kernicterus? what is its pathophys?
neurological complication of neonatal jaundice bilirubin crosses BBB and deposits in basal ganglia
56
presentation of kernicterus
history of jaundice then... - floppy, drowsy baby - poor feeding
57
complications of kernicterus (3)
1. CP 2. learning disability 3. deafness
58
when is the blood spot screening test performed?
5-9 days of life
59
innocent murmurs - 5 Ss
soft, systolic, short, symptomless, standing/sitting (vary w position)
60
what is biliary atresia
congenital condition - extrahepatic bile duct is either narrowed or obliterated. progressive necro inflammatory process
61
pathophys of biliary atresia
1. inflammation/absence of tree 2. discontinuous/obliterated bile ducts 3. obstruction in bile flow (cholestasis) > bile cannot be transported from LIVER to bowel 4. CONJUGATED bilirubin cannot be excreted 5. OBSTRUCTIVE JAUNDICE
62
presentation of biliary atresia
- first few weeks of life - prolonged jaundice - dark urine, pale stools - failure to thrive
63
investigations and results for biliary atresia (3)
1. BLOODS - raised serum conjugated bilirubin - deranged LFTs 2. NEWBORN SCREEN - rule out CF - usually normal 3. ABDO USS - triangular cord sign - liver may be enlarged
64
1st line tx for biliary atresia
Kasai procedure - portoenterostomy (2nd line is liver transplant if end-stage)
65
what is oesophageal atresia? what other conditions may it occur with?
congenital abnormality of the oesophagus where the upper and lower parts aren't connected may occur with tracheo-oesophageal fistula and polyhydramnios
66
what is a tracheo-oesophageal fistula?
abnormal connection between oesophagus and trachea
67
when is oesophageal atresia normally diagnosed?
antenatally
68
presentation of oesophageal atresia if not diagnosed antenatally (6)
1. resp distress 2. cyanosis 3. choking + cyanotic spells following aspiration 4. frothy white bubbles in mouth 5. coughing 6. pneumonia from aspirating stomach contents
69
management of oesophageal atresia
surgery within 12-24h
70
what is duodenal atresia?
congenital malformation of the duodenum - doesn't join with rest of small intestine, causing complete bowel obstruction
71
what is the duodenum?
first part of the small intestine, connects to the stomach
72
RF for duodenal atresia
down's syndrome
73
presentation of duodenal atresia
FIRST FEW DAYS OF LIFE... 1. projectile vomiting 2. abdo distension 3. absent bowel movements
74
main investigation and result for duodenal atresia
abdo x-ray - double bubble sign
75
management of duodenal atresia (2)
1. decompress stomach with NG 2. surgery= duodenoduodenostomy
76
complications of duodenal atresia (2)
1. polyhydramnios > preterm labour/rupture 2. malnutrition/weight loss
77
what is transient tachypnoea of the newborn (TTN)?
commonest cause of resp distress in the newborn period
78
what causes TNN? what is a RF?
- caused by delayed resorption of fluid in the lungs - c-sections > lung fluid not 'squeezed out' during passage through birth canal
79
what will be seen on CXR in TNN?
hyperinflation of lungs fluid in horizontal fissure
80
management of TTN
- observation, supportive care - supplementary O2 potench
81
group B strep organism
streptococcus agalactiae
82
tx for baby with neonatal abstinence syndrome
IV phenobarbital

PHASE 3A (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions