CLIPP 1

Question 1

Adverse Effects of Prenatal Substance Use:

Tobacco

Answer 1

risk for low birth weight

Question 2

Adverse Effects of Prenatal Substance Use:

Alcohol

Answer 2

fetal alcohol syndrome

There is no “safe” amount of alcohol that can be consumed during pregnancy to ensure that fetal alcohol syndrome does not occur

Question 3

Adverse Effects of Prenatal Substance Use:

Marijuana

Answer 3

Distinctive effects of marijuana have not been identified

Question 4

Adverse Effects of Prenatal Substance Use:

Heroin and other opiate medications

Answer 4

increased risk of fetal growth restriction, placental abruption, fetal death, preterm labor and intrauterine passage of meconium.

Question 5

Adverse Effects of Prenatal Substance Use:

Cocaine and Other Stimulants

Answer 5

vasoconstriction leading to placental insufficiency and low birth weight.

Question 6

What type of labs could be ordered for a prenatal screen? (10)

Answer 6

Maternal blood type, Rh and antibody screen

Rubella IgG

Hepatitis B Surface Antigen (HBSAg)

HIV antibody

RPR or VDRL

Urinalysis

Urine nucleic acid amplification testing (NAAT) for chlamydia and gonococcus

Urine or vaginal culture for group B streptococcus

Hepatitis C antibody (in women with a history of IV drug use)

Tuberculosis skin test (e.g. Mantoux) or TB blood test (e.g. Quantiferon) (in women with HIV or who live in a household with someone with active TB)

Question 7

APGAR components

Answer 7

Appearance (color)
Pulse
Grimace
Activity (tone)
Respiration

Question 8

Rooting

Answer 8

Newborn turns his head toward your finger when you touch his cheek.

Question 9

Sucking

Answer 9

Newborn sucks on your finger when you touch the roof of his mouth.

Question 10

Startle (Moro)

Answer 10

Support the newborn’s head with one hand and buttocks with the other. With the head in a midline position, the hand supporting it is quickly dropped to a position approximately 10 cm below its original supporting position, and the head is caught in its new position. In response, the newborn will flex his thighs and knees, fan and then clench his fingers, with arms first thrown outward and then brought together as though embracing something.

Question 11

Palmar and Plantar Grasps

Answer 11

Newborn grasps your finger when you stroke it against the palm of his hand or plantar surface of his foot.

Question 12

Asymmetrical Tonic Neck Response

Answer 12

Turning the newborn’s head to one side causes gradual extension of arm toward direction of infant’s gaze with contralateral arm flexion–like a fencer.

Question 13

Stepping Response

Answer 13

Newborn’s legs make a stepping motion when you hold him vertically above the table and stroke the dorsum of his foot against the table edge.

Question 14

absent red reflex ddx (5)

Answer 14

• A cataract
• An opacified cornea (such as in mucopolysaccharidosis)
• Inflammation of the anterior chamber
• Developmental anomalies of the eye
• Retinoblastoma, a potentially lethal malignancy (careful examination of the eye of an infant with retinoblastoma often identifies a white, irregular mass within the globe).

Question 15

What do you give a newborn for prophylaxis?

Answer 15

Vit K IM shot
Hep B vaccine
Erythromycin eye ointment

Question 16

define small gestational age (SGA)

Answer 16

Weight below the 10th percentile for gestational age

Question 17

difference between symmetric and asymmetric IUGR?

Answer 17

Symmetric IUGR refers to a growth pattern in which head, length, and weight are decreased proportionately

Asymmetric IUGR refers to a greater decrease in the size of the length and/or weight without affecting head circumference (“head-sparing phenomenon”)

Question 18

Risk factors for SGA?

Answer 18

hypoglycemia
hypothermia
polycythemia