The Sick Term Baby

Question 1

When is the neonatal period?

Answer 1

from the birth to the first 28 days of life

Question 2

What appearance would give an apgar score of 0?

Answer 2

blue or pale

Question 3

What appearance would give an apgar of 1?

Answer 3

blue in extremities/pink body

Question 4

What appearance would give an apgar of 2?

Answer 4

no cyanosis

Question 5

What pulse rate would give an apgar of 0?

Answer 5

absent pulse

Question 6

What pulse would give an apgar of 1?

Answer 6

<100

Question 7

What pulse would give an apgar score of 2?

Answer 7

> 100

Question 8

What grimace/refelx irritability would give apgar of 0?

Answer 8

no response

Question 9

What grimace would give apgar of 1?

Answer 9

grimace/feeble cry when stimulated

Question 10

What grimace would give an apgar of 2?

Answer 10

cry of pull away when stimulated

Question 11

What tone would give an apgar of 0?

Answer 11

no tone

Question 12

What tone would give an apgar of 1?

Answer 12

some flexion

Question 13

What tone would give an apgar of 2?

Answer 13

flexed arms and legs that resist extension

Question 14

What respiration would give a score of 0?

Answer 14

absent

Question 15

What respiration would give an apgar score of 1?

Answer 15

weak, irregular, gasping

Question 16

What respiration would give an apgar of 2?

Answer 16

strong cry

Question 17

What are the common general causes of a sick term baby?

Answer 17

pregnnacy/birth related; metabolic; congential anomalies; infection

Question 18

Which sex is more likley to get UTIs in the neonatal period?

Answer 18

males

Question 19

What are the common bacteria that cause problems in neonates?

Answer 19

group B strep; e.coli; listeria monocytogenes; staph. aureus; staph. epi

Question 20

What happens in the hypoxic-ischaemic encephalopathy?

Answer 20

multi-organ damage due to tissue hypoxia

Question 21

What are the causes of hypoxic ischaemic encephalopathy?

Answer 21

failure of gas exchange across the placenta; interruption of umbilical blood flow; inadequate maternal placental perfusion; compromised fetus; feailure of cardiorespiratory adaptation at birth

Question 22

Which babies is transient tachypnoea of hte newborn most common in?

Answer 22

those delivered by elective C/S

Question 23

Why are babies delivered by C/S more at risk of TTN?

Answer 23

have not had time to prepare; hormones during labour have not reduced lung fluid production

Question 24

What are the causes of hydrops foetalis?

Answer 24

rhesus disease; chromosomal

Question 25

What is seen on CXR with transient tachpnoea of the newborn?

Answer 25

hazy lungs; fluid in the horizontal fissure- can be difficult to tell from NRDS

Question 26

What is seen with tetralogy of fallot?

Answer 26

ventricular septal defect; pulmonary stenosis; right ventricular hypertrophy and overriding aorta

Question 27

What happens in TAPVD?

Answer 27

total anomalous pulmonary venous drainage- pulmonary veins do not drain into the left atrium but into veins that drain back into the rigt atrium

Question 28

What is erythema toxicum?

Answer 28

common benign transient lesion found 1-3 days usually after birth; moves to different sites in hours

Question 29

What are the antenatal risk factors for hypoglycaemia?

Answer 29

maternal DM; maternal obesity; largeo r rapid infusions of glucose immediately after delivery; maternal beta-adrenergic agonist/antagonist

Question 30

What are hte neonatal risk factors for metabolic disease?

Answer 30

IUGR; LGA; preterm; ill infant; iatrgogenic; polycythaemia; hypoxic-ischaemic encephalopathy; hypothermia; rhesus disease