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Exam (elaborations)

STABLE Course Questions and Answers | Latest Update

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STABLE stands for: -:- Sugar and Safe care Temperature Airway Blood pressure Labs Emotion Fetal/infant hypoxemia and hypotension can result in... -:- Reduced intestinal blood flow, and ischemic injury --> withhold enteral feeds in sick infants!! Causes of Bowel Obstruction -:...

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  • September 13, 2024
  • 57
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • STABLE Course
  • STABLE Course
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2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




STABLE Course Questions and Answers |
Latest Update
STABLE stands for:

✓ -:- Sugar and Safe care

✓ Temperature

✓ Airway

✓ Blood pressure

✓ Labs

✓ Emotion




Fetal/infant hypoxemia and hypotension can result in...

✓ -:- Reduced intestinal blood flow, and ischemic injury

✓ --> withhold enteral feeds in sick infants!!




Causes of Bowel Obstruction

✓ -:- Congenital: Stenosis/Atresia, Malrotation + volvulus, imperforate anus




Functional: Hirschprung's, meconium plug (?CF), meconium ileus, hypothyroidism




Acquired: NEC, peritoneal adhesions (congenital = bands)

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,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




** Note: consider obstruction if polyhydramnios is present **




Name of surgery for malrotation?

✓ -:- Ladd's procedure - cutting obstructing bands, widening mesentery, to prevent

volvulus




Bilious emesis

✓ -:- = bowel obstruction

- work up: bloods, PFA, UGI series




Where is best site for IV in infants?

✓ -:- Hand, Foot, Scalp veins




Umbilical vein --> IV fluids, meds; can be cannulated for up to 1 week after birth




24 gauge IV cath or 23/25 gauge butterfly, usually




Insertion aided by transillumination under hand/foot




Maternal meds affecting neonatal glucose metabolism

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,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!


✓ -:- 1. Beta-sympathomimetics (terbutaline)

- maternal hyperglycaemia --> fetal hyperinsulinemia

- crosses placenta, breaks down glycogen stores




2. Sulfonylureas

- maternal hypergly, fetal hyperinsulin

- crosses placenta, promotes insulin secretion




3. Beta blockers

- blocks fetal adrenergic receptors, prevent stimulation of glycogenolysis (persists after

birth)




4. Thiazide diuretics, TCA

- maternal hypergly...




5. Maternal IV Dextrose during labour

- increased fetal insulin secretion




High risk groups for inadequate glycogen stores

✓ -:- 1. Preterm infants

2. Late preterm (34 - 36+6)

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, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!


3. SGA

- chronically stressed fetus may use all placental insulin --> not creating enough glycogen

stores




High risk groups for hyperinsulinemia

✓ -:- 1. Infant of diabetic mother

- can takes days or longer for insulin levels to down regulate --> regular feeding, +/- IV

dextrose

2. LGA

3. IEM, hypopituitarism, hypothyroidism




High risk groups for increased utilization of glucose

✓ -:- 1. Sick - including preterm, SGA

2. Also infection, shock, resp and cardiac disease, hypothermia, hypoxia




Late preterms are at risk of

✓ -:- - hypoglycaemia

- feeding problems

- temperature instability

- respiratory distress

- apnea


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