Chapter 98 Clinical Manifestations of Diseases in the Newborn Period

Question 1

4 Major causes of central cyanosis in the newborn period

Answer 1

Cardiac
CNS
Hematologic
Metabolic

Question 2

Neonate with central cyanosis with rapid respirations accompanied by retraction of the thoracic cage. What could be the cause of central cyanosis?

Answer 2

Pulmonary

Question 3

Neonate with central cyanosis with irregular, weak, and slow respirations. What could be the cause of central cyanosis?

Answer 3

CNS depression

Question 4

Cyanosis unaccompanied by obvious signs of respiratory difficulty suggests

Answer 4

Cyanotic congenital heart disease or methemoglibinemia

Question 5

T/F Peripheral acrocyanosis is common in neonates and does not usually warrant concern unless poor perfusion is suspected

Answer 5

T

Question 6

Major considerations for newborn with pallor

Answer 6

anemia, acute hemorrhage

Question 7

What are the considerations in a VLBW neonate with sudden onset hypotension?

Answer 7

pneumothorax, IVH, subcapsular hepatic hematoma

Question 8

This type of movement may be stopped by holding the infant’s extremity. This depends on sensory stimuli and occurs when the infant is active. This is not associated with abnormal eye movements.

Answer 8

Jitteriness

Question 9

Rapid movements with small amplitude compared to tonic-clonic seizures.

Answer 9

Tremors

Question 10

Neonate with abnormal eye (fluttering, deviation, stare), or facial (chewing, tongue thrusting) movements; with tonic extension of the limbs, neck, and trunk may be having a ______

Answer 10

seizure

Question 11

Movements characterised by oral-buccal-lingual movements, rotary limb activities, tonic posturing or myoclonus, usually after severe birth aspyxia.

Answer 11

Motor automatisms

Question 12

Lethargy appearing after the 2nd day of life should in particular suggest _______

Answer 12

infection

Question 13

Give 3 considerations in an irritable nenonate.

Answer 13

Any of the following:
meningeal irritation
drug withdrawal
infections
congenital glaucoma
or any condition producing pain.

Question 14

Failure to feed in the newborn is most likely due to

Answer 14

infection, central or peripheral nervous system disorder, intestinal obstruction, etc.

Question 15

Unexplained hypothermia in the newborn may be due to

Answer 15

infection
circulatory system disturbance
CNS problem

Question 16

T/F Jaundice within the first 24 hours could be physiologic

Answer 16

F. Jaundice AFTER the 1st 24 hours could be physiologic. If jaundice was observed within the 1st 24 hours of life, is most likely due to HEMOLYSIS until proven otherwise

Question 17

What are the major considerations for a newborn with vomiting during the first day of life?

Answer 17

Upper GI obstruction

Increased intracranial pressure

Question 18

What is the character of vomitus suggesting obstruction below the ampulla of Vater?

Answer 18

Bile-stained

Question 19

Major considerations in a neonate with abdominal distension.

Answer 19

intestinal obstruction

intraabdominal mass

Question 20

Congenital anomaly characterized by respiratory distress in delivery room, nasograstric tube cannot be passed through nares.

Answer 20

Choanal atresia

Question 21

Congenital anomaly manifested as micrognathia, cleft palate, airway obstruction.

Answer 21

Pierre Robin Syndrome

Stickler Syndrome

Question 22

Congenital Anomaly manifested as polyhdramnios, aspiration pneumonia, excessive salivation, nasogastric tube cannot be placed in stomach.

Answer 22

Tracheoesophageal fistula

Question 23

What other anomalies should be suspected in a newborn with tracheoesophageal fistula?

Answer 23

Vertebral defects
Anus, imperforate
Tracheo
Esophageal fistula
Radial (and renal dysplasia) syndrome

Question 24

Congenital anomaly manifested as polyhdramnios, bile-stained emesis, abdominal distension.

Answer 24

Intestial obstruction:
Volvulus
Ileal Atresia
Duodenal Atresia

Question 25

Congenital anomaly manifested as oligohydramnios, anuria, pumonary hypoplasia, pneumothorax.

Answer 25

Renal agenesis, Potter Syndrome

Question 26

Congenital anomaly with polyhydramnios, elevated Alpha Fetoprotein, decreased fetal activity.

Answer 26

Neural tube defects

Question 27

Congenital anomaly manifested as cyanosis, hypotension and murmur

Answer 27

Ductus-dependent congenital heart disease