First examination of a healthy newborn

Question 1

Neonatal Period (Full-Term Newborn)

Answer 1

Birth to 28 days

Question 2

The gestational age of a full-term newborn

Answer 2

37 weeks - 41 weeks + 6 days

Question 3

What is a Plesse scale?

Answer 3

A scale for assessing newborn morphological maturity

Question 4

What is an APGAR score?

Answer 4

A score used to assess the vital functions of a newborn at 1 and 5 minutes after birth.

Question 5

What is assessed using the APGAR scale?

Answer 5

Heart rate, breathing, muscle tone, reflexes, skin color

Question 6

Normal neonatal respiratory rate

Answer 6

30 - 60 breaths per minute

Question 7

Signs of respiratory distress

Answer 7

Tachypnea, respiratory muscle retractions, grunting, nasal flaring

Question 8

Normal heart rate

Answer 8

120-160 beats per minute

Question 9

Signs of cardiac disfunction

Answer 9

Murmurs, diminished heart sounds, heart rate <100 beats per minute or >180 beats per minute

Question 10

Meconium

Answer 10

The first stool (particles and substances that the fetus ingested while in the uterus) is usually passed only after 1-2 days, and less commonly after 3 days.

Question 11

The newborn’s first urination

Answer 11

During the first 24 hours after birth, only 2, 3 of full-term newborns urinate. About 10% of newborns do not urinate until the second day.

Question 12

Umbilical blood vessels

Answer 12

Two arteries and one vein

Question 13

Neonate’s skin looks cyanotic, greyish. What would you do?

Answer 13

You should evaluate the baby for congenital heart disease, infection, respiratory distress, circulatory disfunction (evaluate capillary refill time (normal - <3 seconds), femoral pulses), polycythemia

Question 14

On the first days after birth, when the newborn urinates, orange deposits are observed in the diaper. What is this?

Answer 14

The orange deposits in the diaper are likely urates, which are a normal byproduct of concentrated urine in newborns during the first days of life.

Question 15

Neonatal mastopathy

Answer 15

Neonatal mastopathy refers to the swelling of the breast tissue (one or both sides) in newborns, without the surrounding tissue redness, which can occur in both male and female infants.

Question 16

When would you take neonate’s blood for bilirubin concentration?

Answer 16

When jaundice appears before 24 hours of age, or there is clinically severe jaundice, or transcutaneous monitoring shows a bilirubin level higher than the permissible threshold (usually tested if >250 μmol, l)

Question 17

What changes occur in the blood composition on the 4th-5th day after birth?

Answer 17

Neutrophils cross over with lymphocytes, and lymphocytes dominate until 4-5 months.

Question 18

Neonatal milia

Answer 18

Keratin plugs in the stratum corneum due to fat retention in the glands

Question 19

Erythema toxicum neonatorum

Answer 19

Small, firm, yellow pustules with redness on the face, body, and limbs

Question 20

Mongolian spots

Answer 20

Grayish-blue spots on the buttocks, which may also appear on the trunk or limbs. This is an uneven distribution of pigment caused by melanocyte migration.

Question 21

Cephalohematoma

Answer 21

A collection of blood beneath the periosteum that does not cross suture lines and may take days or weeks to resolve.

Question 22

Barlow symptom

Answer 22

When the hip is flexed and the thigh is adducted, if the femoral head is felt slipping out of the acetabulum during adduction, this sign is positive.

Question 23

Ortolani symptom

Answer 23

When the hip is flexed and the thigh is abducted, the femoral head is felt slipping back into the acetabulum.