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31 Cards in this Set
- Front
- Back
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What are the common congenital heart lesions associated with Down Syndrome and Turner Syndrome? |
Down syndrome= VSD and AVSD Turner syndrome= aortic valve stenosis and coarctation of the aorta |
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How will an infant with GBS infection present and what is the treatment? If cultures return positive, what else should be done? |
Apnoea, respiratory distress and temperature instability Broad spectrum amoxicillin or benzylpenicillin Check for neurological signs and examine and culture CSF |
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When an infant is infected with CMV what are the outcomes? |
90% normal 5% have hepatosplenomegaly and petechiae and neurodevelopmental disability- sensorineural hearing loss, CP, epilepsy 5% have problems later in life (mainly sensorineural hearing loss) |
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When an infant is infected with rubella what are the outcomes (at specific weeks!)? |
<8 wks: cataracts, CHD, deafness in 80% 13-16 wks: impaired hearing in 30% >18wks: risk minimal |
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What are the effects of toxoplasmosis? |
Retinopathy- an acute fundal chorioretinitis Cerebral calcification Hydrocephalus Long term neuro disabilities |
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What drugs should infants with HIV be given? |
PCP prophylaxis- co-trimoxazole Hep A, B, VZV and influenza immunisations |
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What is congenital syphilis treated with? |
Penicillin |
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What are the effects of chlamydia? How is it treated? |
Purulent discharge + swollen eyelids Oral erythromycin for 2 weeks |
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What are the effects of gonococcal infection? How is it treated? |
Purulent discharge + conjunctival infection + swelling of the eyelids 3rd gen cephalosporin + culture discharge |
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What is the treatment for hep B/C? |
Passive immunisation within 24 hours of birth |
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How can HSV infection present? How is it treated? |
Localised herpetic lesions on the skin or eye or with encephalitis and disseminated disease
If mother has primary disease or develops genital herpetic lesions at the time of delivery, elective c-section and aciclovir prophylaxis |
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Ddx for bilious vomiting?
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Intussusception Obstruction Volvulus Malrotation Tumours Hirschsprung's disease Constipation/meconium ileus |
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What is included in a septic screen? |
FBC U&Es Glucose Blood culture CXR Lumbar puncture Urine culture and dip CRP CT or MRI (if suspected meningitis) |
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What is transient tachypnoea of the newborn? |
Caused by a delay in the reabsorption of lung fluid CXR --> fluid in horizontal fissure Usually settles within 1 day, may take several days to resolve completely |
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What is respiratory distress syndrome? Who does it often affect? |
Much more common in immaturity (<28 weeks), genetic cause, meconium aspiration or maternal DM if term Caused by a deficiency in surfactant and an immature respiratory centre in the brain |
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What is surfactant? |
Produced by type 2 alveolar cells and lowers the surface tension of the alveolar air sacs |
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What is the treatment for RDS? |
Antenatal steroids in 2 doses within 48 hours before delivery when the labour is under 34 weeks gestation Artificial surfactant |
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What are the RFs to congenital pneumonia? How is it treated? |
Prolonged rupture of the membranes, chorioamnionitis and low birth weight Infection screen and start broad spec abx |
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How does an infant with RDS present? |
Respiratory distress within 4 hours postpartum Characterised by grunting (breathing out against a closed epiglottis to maintain positive pressure in the airways) |
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What are the ddx for neonatal respiratory distress? |
TTN RDS Congenital pneumonia Congenital abnormalities e.g. heart disease, diaphragmatic hernia Septicaemia Meconium aspiration |
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What is meconium aspiration? |
- Meconium passed in response to fetal hypoxia - At birth inhale thick meconium - Asphyxiated infant, gasping, aspirate meconium - Meconium is a lung irritant and result in both mechanical obstruction and chemical pneumonitis (destroys surfactant) - Predisposes to infection - Lungs overinflated + patches of collapse and consolidation - Pneumothorax and pneumomediastinum - May develop persistent pulmonary HTN of the newborn |
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How does nec. enterocolitis present? |
Stops tolerating feeds Milk aspirated Vomiting --> may be bile stained Distended abdo Stool may contain fresh blood Infant rapidly shocked |
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How is nec. ent. tx? |
Stop oral feeding Give broad spec abx Parenteral nutrition |
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Which newborns are particularly likely to get hypoglycaemia in the first 24 hours of life? |
IUGR (low glycogen stores) Preterm (low glycogen stores) Born to DM mothers (high insulin) Large for date Hypothermic Polycythaemic Ill for any reason |
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How is hypoglycaemia managed? |
Frequent feeding and regular monitoring If 2 levels <2.6 or one <1.6, IV infusion given. If difficulty or delay in starting or no satisfactory response, can give glucagon or hydrocortisone |
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Why are preterm infants particularly vulnerable to hypothermia? |
Large SA:V Skin is thin and more heat permeable Little subcut fat Often nursed naked, can't curl up or shiver |
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How is apnoea of prematurity tx? |
Gentle physical stimulation Caffeine CPAP |
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What is ROP? What increases the risk? |
When vascular proliferation occurs leading to retinal detachment, fibrosis and blindness. Risk increased by high concentration oxygen. |
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How is ROP treated? |
Laser therapy and opthalmologist screen every week |
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How does IVH present? |
Apnoea Lethargy Poor mm tone Sleepiness Coma Increased ICP with bulging fontanelle |
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How is IVH treated? |
VP shunt may be required Symptomatic relief by removal of CSF by lumbar puncture or ventricular tap |
