EINC II & Physical Examination of the Newborn

Question 1

3 Things to do upon arrival of Mother in the ER

Answer 1

CET

Antenatal counseling
Equipment check
Room temperature check (25-28 deg Celsius)

Question 2

What does the STABLE program stand for?

Answer 2

blood Sugar
Temperature
Airway
Blood pressure
Labs
Emotional support

Question 3

What should the newborn’s blood sugar be prior to rooming-in?

Answer 3

> 50 mg/dL

Question 4

How much water should be given to the newborn to achieve appropritate blood sugar level?

Answer 4

80cc/kg/day

Question 5

What is the allowable range of temperature for newborns?

Answer 5

36.5 to 37.5 deg Celsius

Question 6

True or False:

Infant must not be wearing any clothing during the exam

Answer 6

True

Question 7

What are the three factors to determine infant size?

Answer 7

Weight, Length, Head circumference

Question 8

This is the most important factor to determine infant size

Answer 8

Weight

Question 9

Normal weight of a Filipino baby

Answer 9

2500 to 4000g

Question 10

Normal length of a newborn

Answer 10

50 cm

Question 11

What is the normal head circumference of a newborn?

Answer 11

35 cm

Question 12

What is the normal head and chest circumferential difference in newborn?

Answer 12

±2

Question 13

A newborn is said to be small for gestational age if he’s weight is:

Answer 13

less than the 10th percentile for infant’s gestational age

Question 14

True or False:

A newborn that is small for gestational age is at high risk of hypoglycemia due to less glucose stores since glucose
storage happens during the 3rd trimester

Answer 14

True

Question 15

What are the 2 types of Intrauterine Growth Restriction?

Answer 15

Symmetric and Asymmetric

Question 16

This type of intrauterine growth restriction happens at the beginning of pregnancy (1st or 2nd trimester)

Answer 16

Symmetric

• head of infant is proportional to its body

Question 17

This type of intrauterine growth restriction still allows the infant to have a head circumference larger than the body

Answer 17

Asymmetric

Question 18

The brain becomes fully developed at which trimester of pregnancy?

Answer 18

Second trimester

Question 19

Infants who are large for gesational age weigh:

Answer 19

greater than the 90th percentile for gestational age

Question 20

Which of the following is not characteristic of an infant that is Large for Gestational age?
A. usually seen in infants of a diabetic mother
B. from those with family that is genetically bigger than most average people]
C. observed in infants with hypertensive mothers
D. High risk for hypoglycemia due to increased ulitization and demand for glucose
E. NOTA

Answer 20

C. is characteristic of small for gestational age babies

Question 21

These are twins with one bigger than the other due to twin-to-twin transfusion

Answer 21

Discordant twins

> 20% weight difference and >20% hemtocrit difference

Question 22

An infant should be presumed to be at high risk for mortality or morbidity if a discrepancy exists between the estimation of gestational age by:
A. PE
B. Mother’s LMP
C. fetal US evaluation
D. Both A and C
E. All of the above

Answer 22

E. All of the above

Question 23

This is the most comonly used to in assessing the gestational age at birth

Answer 23

Ballard scoring system

Question 24

The New Ballard Score is used to determine the gestational age at birth through _____________________ and ____________________ of a newborn infant

Answer 24

Neuromuscular and Physical assessment

Question 25

The New Ballard Scoring system is most reliable when performed before the ______________ hour of life, although the test can still be done after.

Answer 25

before the 12th hour of life

Question 26

What are the Physical components under the Physical Maturity of the Ballard Exam?

Answer 26

"So Long, Pork & BEEF Meat" Skin Lanugo Plantar surface Breast Ears Eyes Female genitals Male genitals

Question 27

This protective covering of newborns normally thickens, dries, and becomes wrinkled and/or peels, and may develop rashes as featl maturation progress

Answer 27

vernix caseosa

Question 28

Lanugo begins to appear at ________ week of gestation?

Answer 28

24-25th week

Question 29

The first appearance of a crease appears on the _______ sole at the ________ of the foot

Answer 29

anterior sole at the ball of the foot

Question 30

How to measure the heel-toe distance?

Answer 30

Place the infant’s foot on a metric tape measure and note the distance from the back of the heel to the tip of the great toe.

Question 31

What is the Ballard score for a heel-toe distance of less than 40 mm?

Answer 31

-2

Question 32

What is the score for thinning lanugo?

Answer 32

2

Question 33

What is the score for plantar surface with anterior transverse crease

Answer 33

2 *32 weeks; crease at anterior 1/3

Question 34

Breast tissue is stimulated to grow by which hormones?

Answer 34

maternal estrogens

Question 35

Fatty tissue of the breast is dependent upon fetal __________ status

Answer 35

nutritional status

Question 36

This condition of enlarged breast in neonates presenting on the 2md to 4th day of extrauterine life due to maternal estrogen effect

Answer 36

Neonatal Gynecomastia

Question 37

What is the score for Flat areola with no bud?

Answer 37

1

Question 38

In addition to the cartilage and stiffness of the ear pinnae, the state of ______ development is also an indicator of fetal maturation

Answer 38

eyelid

Question 39

Score for loosely fused eyelids

Answer 39

-1

Question 40

Score for a formed and firm pinnae with instant recoil

Answer 40

3

Question 41

Which parts of the female genitalia are noted for the Ballard scoring?

Answer 41

Clitoris Labia minor Labia majora

Question 42

Degree of hip abduction when checking for the appearance and size of female genitalia

Answer 42

45 degrees

Question 43

Ballard score for Major covering clitoris and minora

Answer 43

4

Question 44

When does the fetal testicles begin to descend from the peritoneal cavity into the scrotal sac?

Answer 44

30th week of gestation

Question 45

The left testicle precedes the right and usually enters the scrotum during the _____ week of gestation

Answer 45

32nd

Question 46

Testicles found inside the ______________ zone are considered descended

Answer 46

rugated zone

Question 47

This is the most common genital problem encountered in pediatrics

Answer 47

cryptorchidism

Question 48

Total Body Muscle Tone is reflected in: A. the infant's preferred posture at rest B. resistance to stretch of individual muscle group C. resistance to force onto gross muscle groups D. A and B E. All of the above

Answer 48

D. A and B