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Child Health 2020 > Year 4 Neonatology > Flashcards

Year 4 Neonatology Flashcards

(59 cards)

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1
Q

when is term?

A

37 - 41 +6 weeks

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2
Q

what is pre-term?

A

before 36 weeks

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3
Q

when is there foetal loss?

A

under 22 weeks

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4
Q

when is post-term?

A

beyond 43 weeks

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5
Q

what is LBW?

A

<2500g

SGA <10th centile

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6
Q

what are all neonates given at birth?

A

vitamin K

iron + multivitamins

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7
Q

what does the heel prick test screen for?

A

9 congenital conditions:

  • sickle cell disease
  • CF
  • congenital hypothyroidism
  • phenylketonuria
  • MCADD
  • maple syrup disease
  • IVA
  • GA1
  • homocystin
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8
Q

how long do the results for the heel prick test take to come back?

A

6-8 weeks

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9
Q

what can over-inflation of the lungs at birth lead to?

A

BPD

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10
Q

breathing support options

A 
low flow nasal/ high flow
CPAP
BiPAP
ventilation
oscillation
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11
Q

how long should cord clamping be delayed?

A

at least 1 minute

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12
Q

how long is the neonatal period?

A

first 28 days of life

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13
Q

when should steroids be given to the mother?

A

two doses prior to delivery <36 weeks (either dex or betamethasone?)

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14
Q

what do steroids reduce the risk of?

A

RDS
sepsis
IVH
NEC

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15
Q

when should magnesium sulphate be given?

A

to the mother for delivery <34 weeks

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16
Q

why is caffeine given to neonates?

A

given to pre-terms to prevent apnoeic epsiodes and for neuroprotection

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17
Q

what is NEC?

A

widespread necrosis of the small and large intestine

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18
Q

when does NEC typically occur?

A

in the neonatal period after recovering from RDS

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19
Q

presentation of NEC

A

neonate with lethargy, bloody stools, bilious vomit, abdominal distension, apnoea, bradycardia

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20
Q

management of NEC

A

parenteral nutrition stop feeding
antibiotics (vanc + cefotaxime)
surgery if severe or perforation (bowel resection +/- stoma)

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21
Q

diagnosis of RDS

A

CXR and airbronchogram (ground glass appearance)

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22
Q

management of RDS

A

low level oxygen

natural surfactant within 6 hours of birth (curosurf)

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23
Q

what sats should be aimed for in RDS?

A

85-93% to prevent the development of ROP

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24
Q

what is surfactant?

Study These Flashcards
A

phospholipid with apoproteins

25
what is interventricular haemorrhage?
bleeding into the germinal matrix
26
when do most IVHs occur?
first day of life
27
what is a RF for IVH?
RDS due to hypoxia, acidosis and hypotension making the cerebral circulation more unstable
28
management of IVH
steroids graded 1-4 vit K deficiency
29
who is screened for ROP?
<1500g or <32 weeks
30
management of ROP
diode laser therapy cryotherapy intravitreal VEGF
31
what can cause neonatal abstinence syndrome?
``` opiates methadone BZDs cocaine amphetamines alcohol nicotine cannabis SSRIs ```
32
when do most NAS occur?
within 3-72 hours
33
presentation of NAS
``` irritability increased tone, tremors, seizures sweating pyrexia poor feeding loose stools ```
34
management of NAS
monitored with NAS chart for 3 days | if severe give magnesium sulphate in opiate withdrawal or phenobarbitone in non-opiate withdrawal
35
appearance of foetal alcohol syndrome
``` microephaly thin upper lip smooth flat philtrum short palpable fissure LD behaviour hearing vision problems cerebral palsy ```
36
when is jaundice pathological?
first 24 hours of life | prolonged >2 weeks
37
when does physiological/ breast feeding jaundice occur?
2-5 days
38
causes of jaundice in the first 24 hours?
``` sepsis ABO incompatibility RhD incompatibility congenital spherocytosis G6PD deficiency ```
39
unconjugated prolonged jaundice causes
physiological/breast feeding hypothyroidism galactosaemia
40
conjugated prolonged jaundice causes
biliary atresia | neonatal hepatitis
41
management of jaundice
plot bilirubin levels of threshold charts phototherapy exchange transfusions
42
how does phototherapy work?
converts unconjugated bilirubin into isomers
43
what is kernicterus?
accumulation of unconjugated bilirubin in basal ganglia (acute bilirubin encephalopathy) choreoathetoid CP + SNHL
44
signs of BPD?
oxygen requirement beyond 36 weeks + evidence of pulmonary parenchymal disease on CXR
45
what is healing in BPD associated with?
continued lung growth over 2-3 years | often wheezy
46
what protection should babies with BPD be given?
monthly injections to protect against RSV
47
management of nappy rash
sudocream (+ clotrimazole if candida)
48
presentation of sepsis
``` resp distress apnoea jaundice temp poor feeding ```
49
management of febrile baby
``` cultures LP CXR urine microscopy septic screen ```
50
management of neonatal sepsis
gent + benzylpenicillin
51
what is a cephalohaemtoma?
subperiosteal bleed (collection of blood between the skull and periosteum)
52
does a cephalohaematoma cross suture lines?
no
53
management of cephalohaemtoma
resolves spontaneously | monitor for jaundice and anaemia
54
what is caput succedaenum?
oedema collection outside of the periosteum
55
does caput succedaneum cross suture lines?
yes
56
management of caput succedaneum
nothing | usually from traumatic delivery
57
what are milia?
white/cream papules on forehead, nose and cheeks | resolve spontaneously/ milk spots
58
CI to breastfeeding
HIV +ve mother amiodarone antithyroid (carbimazole) opiates
59
neonatal screening questions?
has the baby passed meconium? feeling okay? FH of heart, eye or hip problems

Child Health 2020 (22 decks)

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