PEDIATRICS

Winter semester 2018/2019

III Year

NEONATOLOGY

Lecture – 15 hours

1. Introduction into the pediatrics. General terms related to the child care. Ethical issues in the pediatrics. Diagnostics guidelines and therapeutic standards in the modern pediatrics [1 hour].
2. Puberty – physiology. Disorders of puberty development [1 hour].
3. Child abuse and neglect. Fetal Alcohol Syndrome. Diagnostics of neuro-developmental disorders: autism and autism spectrum disorders, hyperkinetic/attention deficit disorders (ADHD) [2 hours].
4. Most common metabolic disorders in children. Screening of the inborn errors of metabolism
   [1 hour].
5. General principles of nutrition in healthy children. Breast-feeding, formula feeding [2 hours].
6. Malnutrition, obesity. Eating disorders: anorexia nervosa, bulimia nervosa [2 hours].
7. Immunization – general principles, schedule. Mandatory and obligatory vaccinations. Overview of adverse events following immunization [2 hours].
8. History-taking and physical examinations in pediatrics [1 hour].
9. Signs and symptoms in pediatrics. General semiotics in pediatrics and significance of clinical signs and symptoms in children [2 hours].
10. Vitamin D – metabolism and clinical significance. Disturbances of calcium and phosphorus homeostasis (rickets, osteoporosis) [1 hour].

Seminar – 10 hours

1. Classification of newborn infants by birth weight and gestational age. Prematurity [2 hours].
2. Medical assessment of the newborn infant. Adaptation to the extra-uterine life. Physiological and pathological jaundice [2 hours].
3. Physiology and pathology of the respiratory system and cardiovascular system [2 hours].
4. Neonatal screening, inborn errors of the metabolism [2 hours].
5. Skin and subcutaneous tissue of the newborn infant: physiology, most common disorders
   [2 hours].

Exercises – 20 hours

ATTENTION!!!

The sequence of topics may change during the semester according to the schedule for Pediatrics. Due to the wide range of material we recommend earlier preparation.

A test, which covers the subject from basic literature, seminars and  lectures, will be taken before every practical exercises.

Teachers conducting exercises:

Ewa Szwałkiewicz – Warowicka MD, PhD – The Regional Children’s Specialized Hospital, Clinical Department of Pathology Congenital Malformations of Newborns and Infants.

Maria Kozak MD – The Regional Specialist Hospital, Department of  Neonatology and Intensive Care of the Newborn.

Subject 1: Medical history & physical examination of the term newborn – physiological and morphological features of the term babies. Adaptation to extra uterine life. Physiological jaundice. Breast feeding, importance of  colostrum, jaundice connected to  breast feeding, basic differences with pathological jaundice.

1. Taking history (past medical history of the mother, previous pregnancies, current pregnancy, delivery, family history – siblings, prenatal tests).
2. Physical examination of the newborn (general state, neurological state, skin, examination of the respiratory and cardiovascular system, assessment of the abdomen and genito-urinary tract, assessment of the congenital defects).
3. Description of the physiology and morphology of term newborns.
4. Basic knowledge of the day care of the newborn (care of the navel, bathing, vitamins D and K supplementation).
5. Knowledge about the benefits from breast –feeding, assessment of the physiological weight loss, assessment of the jaundice – Kramer scale, basic mechanism of the heat loss, transient states (Erthema neonatorum, Ebstein’s pearls, Caput succedaneum).
6. Starting of the feeding, basic technique of the breast – feeding.
7. Physiological jaundice vs pathological, Kramer scale.

Subject 2: The initial medical evaluation of the newborn infant. Resuscitation of the newborn (term and premature). Maternal diseases and medications influencing condition of the newborn. Feeding of term and pre-term babies.

1. APGAR scale assessment.
2. Ballard scale assessment.
3. Indication for instrumental delivery.
4. Management of the newborn directly after the birth (drying, warming, umbilical cord clamping, Crede procedure, Vit. K injection or oral administration).
5. Resuscitation of the newborn – general principles (head position, ventilation, chest compressions, drug administration).
6. Management of stable vs unstable newborns.
7. Maternal diseases and disorders affecting the newborn.
8. General management of the hypoglycemia, hypocalcemia, thermoregulation of newborns.

Subject 3: The preterm infant.

1. Prematurity – basic information.
2. The differences between a pre-term born child and a child born on time.
3. Definition of the SGA, IUGR – causes, differences.
4. LGA – causes.
5. The most common pathology related to the prematurity (ROP, respiratory problems, metabolic problems, IVH, NEC, infections) – basic information.
6. Feeding of the premature babies – the role of colostrum.
7. The medical transport of a sick newborn.

Subject 4: Development of the cardiovascular system, fetal circulation – changes after birth.  Development of the respiratory system. The most common respiratory disorders in the newborn. Apnea.

1. Characteristics of the respiratory system of the newborn.
2. The most common pathologies of the respiratory system in the newborns – apnea, congenital pneumonia, Respiratory Distress Syndrome, pneumothorax, Meconium Aspiration Syndrome) – clinical assessment.
3. Fetal circulation, changes after the birth, neonatal circulation.
4. The most common pathologies of the cardiovascular system in the newborns – signs and symptoms of the congenital heart defects, in neonatal period, basic  diagnostic procedures in neonatal cardiology). Patent ductus arteriosus. Clinical assessment.