Fetus And Neonatal Infant Flashcards by Venessa Marie Pagalilauan

Which of the following best describes the neonatal period?
A. 28th week of pregnancy to the 7th postpartum day
B. First year after birth
C. First 28 days of life
D. >42 weeks gestation

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Classification of preterm birth that corresponds to gestational age of less than 32 weeks?

Early preterm

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Extreme preterm is how many weeks?

<28 weeks

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Moderate preterm

32-34 weeks

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Late preterm

35-36 weeks

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Post term

> 42 weeks

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Screening of newborns iof diabetic mothers should be done when?

Within first 24 hours of life

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Initial examination is performed

A. After the APGAR score becomes 8
B. After breastfeeding
C. As soon as possible after delivery

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When do we repeat the APGAR scoring?

If score is <7; repeat scoring for every 5 mins up to 20 mins

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Examination for high risk deliveries are performed in the

A. NICU
B. Delivery Room

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What is the minimum accepted score for APGAR?

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Normal neonatal pulse

120-160 bpm

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Normal RR

30-60 bpm

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Evaluate APGAR score:

Heart rate over 200
Respiratory effort: slow, irregular
Muscle tone: some flexion of extremities
Response to catheter in nostril: cough or sneeze
Color: body pink, extremities blue

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An edema confined to one or more extremities of a female infant is an initial sign for what syndrome?

Turner syndrome

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A general circulatory instability associated with serious illness or related to transient fluctuation in skin temperature

Mottling

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Division of the body from forehead to the pubis into red and pale halves; Transient and harmless

Harlequin color change

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Momentarry blanching pallor that occurs after pressure

Cyanosis (localized)

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Ruddy appearance of the plethora

Polycythemia

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May be stained brownish yellow if the amniotic fluid has been colored by the passage of meconium during or before birth

Vernix, skin, and cord

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Deeper blue masses; If large, may trap platelets and produce disseminated intravascular coagulation or interfere with local organ function

A. Cavernous hemangiomas
B. Mongolian spots
C. Petechiae
D. Polycythemia

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Usually seen on scalp or face after a difficult delivery

A. Mottling
B. Petechiae
C. Mongolian spots

Petechiae

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Slate-blue, well demarcated areas of pigmentation seen over the buttocks and back; Common in more than 50% black, native American and Asian infants;

Mongolian spots

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Mongolian spots usually disappear

A. Within 6 months
B. Within a month
C. Within a year

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True or False. Post-term infants have thin and delicate skin which is usually deep red

False. ##FOOTNOTE The skin appearance should be peeling, parchment-like

True or False. Extremely premature infant’s skin is thin and delicate which tends to be deep red

False ##FOOTNOTE Skin should be gelatinous and transluscent

Fine, soft immature hair covering the scalp, brown and face of premature infants

Lanugo hair

When the lanugo hair is lost, it is replaced by

Vellus hair

Tufts of hair over the lumbosacral spine suggests

Spina bifida, sinus tract or a tumor

Benign, small, white papules in an erythematous base which developed 1-3 days after birth and may persist for as long as 1 week

Erythema toxicum

Erythema toxicum contains A. Eosinophils B. Neutrophils

These are benign lesions seen predominantly in black neonates lasting 2-3 days

Pustular melanosis

Pustular melanosis contains A. Eosinophils B. Neutrophils

Deformity caused by scalp pressure from the uterus, cervix or pelvis. The baby’s head appear as circular boggy area of edema with indistinct borders and often overlying ecchymosis A. Caput succadaneum B. Cephalohematoma C. Subgaleal hemorrhage D. Microcephaly

Caput succedaneum

Presents as a well-circumscribed fluid-filled mass that does not cross suture lines and often not present at delivery but develops over the first few hour of life A. Caput succadaneum B. Cephalohematoma C. Subgaleal hemorrhage D. Microcephaly

Cephalohematoma

Larger and more diffuse and not restricted by the boundarries of the sutures A. Caput succadaneum B. Cephalohematoma C. Subgaleal hemorrhage D. Microcephaly

C ## FOOTNOTE Requires prompt recognition because extensive bleeding may result in hypovolemic shock

An excessively large head which may suggest hydrocephalus, storage disease, achondroplasia, cerebral gigantism, neurocutaneous syndromes, or inborn errors of metabolism or familial

Megalencephhaly

Presence of a third fontanel is suggestive of a. Turner syndrome b. Down syndrome C. Kleinfelter syndrome

A hard, non-movable ridge over the suture and abnormally shaped skull. This is due to premature fusion of the sutures A. Craniotabes B. Cranial synostosis C. Microcephaly

Soft areas occasionally found in the parietal bone at the vertex near the **sagittal suture**. This is common among preterm infants who have been exposed to uterine compression A. Microcephaly B. Cranial synostosis C. Craniotabes

C. Craniotabes

A result of prolonged focal pressure by the maternal pelvic bone usually of prenatal onset A. Megalencephaly B. Depressed skull C. Microcephaly

B. Depressed skull

Descriptions below refer to **dysmorphic features** except E. Epicanthal folds B. Widely or narrowly spaced eyes C. Micropthalmos D. Long philtrum E. NOTA

E. NOTA ## FOODNOTE To add: low set of ears

A result of a 7th nerve palsy, hypoplasia of the depressor muscle at the angle of the mouth or an abnormal fetal pressure A. Symmetrical facial palsy B. Mobius syndrome C. Assysmetrical face

C. Assysmetrical face

Baby’s eyes often open spontaneously if the infant is A. Lying and tipped side by side B. Held up and tipped forward and backward C. Held up and tipped side by side

Benign; common with vacuum-forceps-assisted deliveries; usually bilateral intraretinal and in the posterior pole of the eyes which resolve in most infants by 2 weeks A. Colobomas B. Heterochromia C. Conjunctival hemorrhage and Retinal hemorrhages

Pupillary reflexes are present during A. 18-20 weeks AOG B. 26-27 weeks AOG C. 28-30 weeks AOG

A condition where some tissue is missing in a part of the eye

Colobomas

Inspection for colobomas or heterochromia usually involves which part of the eye?

Iris

Baby with a differently colored eyes

Heterochromia

Size of cornea which suggests congenital glaucoma in babies? A. 2 cm B. < 0.5 cm C. >1 cm

>1 cm

Tympanic membrane normally appers A. Dull gray B. Red C. Blue

Presence of bilateral red reflex is suggestive of

Cataracts and intraocular pathology

The tympanic membrane is easily seen otoscopically through the short and straight A. External auditory canal B. Internal auditory canal

This reflex is suggestive of the following: Cataracts, tumor, chorioretinitis, retinopathy or prematurity, or persistent hyperplasic primary vitreous A. White puppilary reflex B. Bilateral red reflex

Teeth in the lower incisor position that should be shed befre decidous teeth erupt

Natal and neonatal teeth ## FOOTNOTE Occurs in ELlis-van Creveld and Hallerman-Streiff

Temporary accumulation of epithelial cells on either side of the hard palate

Epstein pearls

Seen on the gums; benign with similar appearance with epstein pearls. Disappear spontaneously within few weeks of birth

Retention cysts

unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth;

Tongue-tie or ankyloglossia ## FOONOTE Evaluation for 2-3 weeks before frenotomy

Fullness on both the buccal and external aspects of the baby’s cheeks is attributed to the accumulation of?

Fat in the sucking pads

Lesions of SCM caused presumably by trauma

Hematoma of SCM

Lesion of SCM causedd by fixed positioning in utero

Fibrosis

Causes the head to turn toward and the face to turn away from affected side

Congenital Torticollis

Redundant skin and webbing in a female infant is suggestive of A. Intrauterine lymphedema B. Turner Syndrome C. Both D. NOTA

Intrauterine lymphedema and Turner synndrome

True or False. Breast hypertrophy is common among newborns.

True. ## FOOTNOTE caused by maternal hormones

Asymmetry, erythema, induration and tenderness of the breasts

Mastitis or breast abscess

Respiratory rate should be counted for A. 30 seconds B. 1 minute

B ## FOOTNOTE Count when baby is asleep or at rest

Breath sounds of a newborn is normaly

Bronchovesicular