Question

1. Describe brown fat and describe the 4 mechanisms of heat loss of the neonate and give one example each.

2. Discuss the difference between physiologic and pathologic jaundice and describe 2 treatments used for jaundice.

3. What is GBS?  

   1. When is it tested?

   2. Why do we test for it?

   3. What is the treatment for a mom who is GBS + when laboring, what meds do we give, frequency, dosages, protocols?

   4. What labs do we draw on newborn to check for sepsis? What lab values are important?

   5. What is the treatment for a baby who is GBS +? Drugs, dosing, frequency, protocols?

   6. What assessment criteria are important to look for if you suspect GBS?

4. What are signs of hypoglycemia in the newborn?

5. Explain why these conditions put newborns at risk for hypoglycemia?

   1. Infant of a diabetic mother:

   2. Large for gestational age:

   3. Small for gestational age:

List the signs of Neonatal Abstinence Syndrome and summarize the Neonatal Effects of Commonly Abused Substances.

Answer 1

Brown adipose tissue or brown fat helps food to turn into body heat. Hence some time called as good fat . We can see these type of fat in newborns.

Brown fat contains small lipid particles and hign number of iron containing mitochondria which give it a dark red or tan. Brown fat also so contain more number of unmyelinated nerves and more number of capillaries. The major function of fat is generating heat by burning calories.

Methods of heat loss in babies.

Evaporation, example: keeping nacked baby on the cold tabletduring cheaking weight.

Radiation:

conduction,

convection: loss of body heat from body into environment.

Difference between physiological and pathological jaundice.

A. Physiological jaundice develop with in 1st week of life, maximum intensity of jaundice is on 4th day but and mostly subsides by 6th day . In pathological jaundice occurs with in 24 hours of birth and persist beyond 10 days.

B. Causes for physiological jaundice increased billirubin load on liver cells , defective hepatic uptake of bilirubin from plasma , defective bilirubin conjugation.

Causes for pathological jaundice ABO/Rh incapabilities, hemolytic diseases in new born , neobatal sepsis etc.

C. Treatment : phototherapy ( use of fluorescent light for the conversion of unconjugated bilirubin into conjugated bilirubin )

Exchange transfusion ( used only when serum bilirubin is more than 20mg/dl in term infants and more than 15mg/dl in preterm)

Pharmacological : phenobarbitone.

GBS in newborns: group B step is a group of bacteria which is found in digestive and lower reproductive tract. But in some cases GBS can cause miscarried stillborn, very sick new born or death after birth .