Key Surgical Conditions- Undescended testes
- Inguinal hernia
- Hydrocoele
- Circumcision
- Umbilical hernia
- Tongue tie
- Pyloric stenosis
- Intususception
- Causes of bowel obstruction
- Malrotation volvulus
- Intestinal atresia
- Meconium ileus
- Hirschprung's
Acid-base Tutorial - SBE vs BE
- Base excess is the quantity required to return the plasma in-vitro to a normal pH
- Standard base excess is the quantity required to fix the whole ECF
- In practice they're quite similar, since the plasma does most of the buffering
- Anion gap
- = Na - (HCO3- + Cl-)
- Should be around 12
- Good measure of ketones, lactate
- Not used much now, as lactate is measured directly
- Chloride rise
- Chloride "displaces" HCO3- and so causes a metabolic acidosis
- This is "hyperchloraemic acidosis" and doesn't change the anion gap
- Other causes of metabolic acidosis cause an isolated HCO3- fall and thus a fall in the anion gap
- TPN contains acetate which is converted to HCO3- and causes a metabolic alkalosis
Retinopathy of prematurity (ROP)
- Previously known as retrolental fibroplasia (RLF)
- Caused by disorganized growth of retinal blood vessels
- May result in scarring and retinal detachment
- All preterm babies are at risk for ROP
- Very low birth weight is an additional risk factor
- Both oxygen toxicity and relative hypoxia can contribute to the development of ROP
VACTERL
- Vertebral anomalies
- Ano-rectal malformation
- Cardiac anomalies
- Tracheo-oesophageal fistulae
- Most have NO patant oesophagus
- End of oesophagus joins into trachea
- Causes mucousy-bubbly-frothy mouth
- Renal anomalies
- Limb anomalies
Notes
- Paediatric history
- Developmental history
- Birth history
- Neonatal history
- Allergies
- Pets, carpets, cigarettes
- Babies breathe through their NOSE
- Babies need FLUIDS and GLUCOSE but can survive without other stuff for quite a while
- Umbilical arteries and vein remain patent for weeks
- Can be used for venous/arterial access
- Threshold for admission to NNU = 1.8 kg
- ROP
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