Buzzwords: Neonatal

Question 1

Prune belly, absence of abdominal musculature

Answer 1

Renal abnormalities

Question 2

Severely scaphoid belly plus respiratory disease

Answer 2

Diaphragmatic hernia

Question 3

Prominent kidneys

Answer 3

hydronephrosis or cystic kidney disease

Question 4

Firm mass including bowel, liver, etc., protruding out of abdomen (typically central). Has covering sac.

Answer 4

Omphalocele

Question 5

Free intestinal loops protruding out of abdomen (typically right paraumbilical). No covering sac.

Answer 5

Gastroschisis

Question 6

Premature. Polyhydramnios. Abdominal distention and bilious vomiting in 1st hour of life. Dilated bowel loops.

Answer 6

Duodenal atresia

Question 7

Small pustules on erythematous base. 3-5 d of life.

Answer 7

Erythema toxicum

Question 8

Small, white papules concentrated on nose, cheeks, forehead, and chin.

Answer 8

Milia

Question 9

Flushed macular appearance involving neck, face, scalp, and diaper area.

Answer 9

Milaria, aka heat rash

Question 10

Symmetric mottling pattern of the skin.

Answer 10

Mottling

Question 11

Light red macules found on eyelids, nape of neck, and forehead.

Answer 11

Nevus simplex (stork bite if neck)

Question 12

Capillary venous malformation. Well demarcated, deep red to purple flat macular lesion seen at birth. Enlarges with child’s growth.

Answer 12

Nevus flammeus (port wine stain)

Question 13

Ipsilateral glaucoma and Sturge-Weber syndrome

Answer 13

Nevus flammeus (aka port wine stain) with ophthalmic V1 distribution.

Question 14

Bluish with clear borders on the abdomen or scalp. Absent for first few weeks of life, but then has rapid growth phase.

Answer 14

Infantile hemangioma

Question 15

Small to large, blue-black macules concentrated on the back and buttocks. Mistaken for bruising.

Answer 15

Slate gray nevus

Question 16

Skull bones floating → squished/overlap

Answer 16

Overriding sutures

Question 17

Premature fusion of sutures (usually sagittal)

Answer 17

Craniosynostosis

Question 18

Fluid accumulation under scalp (2ry to birth trauma). Can cross suture lines.

Answer 18

Caput succedaneum

Question 19

Fluctuant collection of blood under the periosteum of the skull. Well demarcated. Does not cross suture lines.

Answer 19

Cephalohematoma

Question 20

Accumulation of blood in the loose connective tissue of the subgaleal space (caused by vacuum/forceps delivery). Hypovolemia.

Answer 20

Subgaleal hematoma

Question 21

Low set ears, posteriorly rotated ears

Answer 21

Down or Turner syndrome

Question 22

Absent red reflex

Answer 22

Congenital cataracts, glaucoma, retinoblastoma.

Question 23

Congenital disorder. Back of the nasal passage is obstructed (unilateral or bilateral).

Answer 23

Choanal atresia or stenosis

Question 24

Excessive drooling

Answer 24

Esophageal atresia

Question 25

Small pearly nodules along the hard palate.

Answer 25

Epstein pearls

Question 26

Cyanotic on room air. Grunting, intercostal retractions, tachypnea. Nasal flaring. Tachycardia.

Answer 26

Respiratory distress syndrome.

Question 27

Unilateral decreased breath sounds. Mediastinal shift.

Answer 27

Pneumothorax _or_ a Congenital diaphragmatic hernia (CDH)

Question 28

Grunting, flaring nostrils. Retractions and tachypnea. Mild hypoxemia and **acidemia**.

Answer 28

Transient tachypnea of the newborn

Question 29

Meconium stained amniotic fluid. Respiratory distress symptoms.

Answer 29

Meconium aspiration syndrome (MAS)

Question 30

Cyanosis, congestive heart failure, diminished peripheral pulses.

Answer 30

Congenital heart disease (CHD)

Question 31

Abnormal placement of the urethra where the meatus is proximal and ventral to normal/anterior location.

Answer 31

Hypospadias

Question 32

Dorsal displacement of the penial urethral opening.

Answer 32

Epispadias

Question 33

Failure of testes to descend after birth.

Answer 33

Cryptorchidism

Question 34

Inconsolable infant. Extra full scrotal sac. Does **not** transilluminate.

Answer 34

Inguinal hernia

Question 35

Extra full scrotal sac. Does **transilluminate.**

Answer 35

Hydrocele

Question 36

Respiratory distress, cyanosis, diffuse edema. Poor muscular tone of the abdomen. Abdominal distention. Urinary obstruction symptoms.

Answer 36

Posterior urethral valve (PUV)

Question 37

Neonate with vaginal bloody discharge and edematous labia.

Answer 37

Vaginal leukorrhea

Question 38

Fused vaginal introitus

Answer 38

Vaginal adhesions

Question 39

Neonate with apparent female genitalia with clitoromegaly, inguinal or labial mass, or posterior labial fusion.

Answer 39

Ambiguous genitalia.

Question 40

Micropenia with bilateral non palpable testes. Hypospadias with undescened testes. Isolated penoscrotal or perineoscrotal hypospadias.

Answer 40

Ambiguous genitalia

Question 41

Neonate with history of breech delivery. "Clunk" during hip exam. Gluteal fold asymmetry.

Answer 41

Developmental dysplasia of the hip (DDH)

Question 42

Adducts the fully flexed hip while applying posterior force to the femur → hip dislocation

Answer 42

Barlow maneuver

Question 43

Abducts the hip while applying anterior force to the femur → reduction of the hip

Answer 43

Ortolani maneuver

Question 44

Fixed, severe eversion of the plantar surface of the foot.

Answer 44

Talipes equinovarus aka "Clubfoot"

Question 45

Tufts of hair. Hemangiomas that cross midline. Deep sinus tracts in gluteal cleft.

Answer 45

Signs of spinal deformities: spina bifida or tethered spinal cord

Question 46

Adducted and internally rotated upper arm and extended forearm. Preserved hand and wrist movement. Hx of shoulder dystocia.

Answer 46

Erb's palsy (C5-C6)

Question 47

Isolated claw hand (hand paralysis) and Horner's syndrome. Hx of shoulder distocia.

Answer 47

Klumpke's palsy (C8-T1)

Question 48

Miosis (pupillary constriction), ptosis (drooping eyelid), anhidrosis (no sweating in the face).

Answer 48

Horner's syndrome

Question 49

Abnormal tuft of hair, birthmark, protruding spinal cord tissue. Sacral dimple.

Answer 49

Myelomeningocele

Question 50

Bulging fontanelle. Splayed sutures. Prominent scalp veins. Irritability, poor feeding, recurrent vomiting, high-pitched cry, seizures, and sunsetting eyes.

Answer 50

Hydrocephalus

Question 51

TORCH

Answer 51

**T**oxoplasmosis **O**ther - syphilis, varicella, mumps parvovirus B19, HIV **R**ubella **C**ytomegalovirus **H**erpes simplex \*Causes of hydrocephalus

Question 52

Neonate with impaired visual tracking, hypotonia, and reduced spontaneous movement. Seizures, anemia, and change in consciousness. Rapid deterioration and sudden hypotension. Increased oxygen needs. Full feeling fontanelles.

Answer 52

Intraventricular hemorrhage (IVH) \*may also be asymptomatic\*

Question 53

Scleral icterus and splenomegaly.

Answer 53

Neonatal jaundice ## Footnote **\*also jaundice of skin and oral mucosa\***

Question 54

1-2d: Poor suck, stupor, hypotonia, seizures. 3-7d: hypertonia of extensor muscles, opisthotonos, retrocollis, fever. \>7d: hypertonia

Answer 54

kernicterus

Question 55

Hyper- or hypothermia. Apnea or tachypnea, grunting, cyanosis. Lethargy, irritability, hyper- or hypoglycemia. Vomiting and feeding intolerance. Abdominal distention.

Answer 55

Early onset sepsis

Question 56

APGAR

Answer 56

**A**ppearance **P**ulse **G**rimace **A**ctivity **R**espiration