Healthy Newborn

Question 1

What is the weight of a healthy newborn ?

Answer 1

2.5-4kg

Question 2

What is the weight of a SFD and LFD newborn?

Answer 2

<2.5 and >4

Question 3

What is the daily weight and fat gain in the 3rd trimester?

Answer 3

24g of weight per day and for the last 4 weeks fat gain is averaging about 7g/day - when born are 15% fat

Question 4

What does APGAR stand for?

Answer 4

Appearance (colour)
Pulse (>100 is normal)
Grimace (should cry when provoked)
Activity (muscle tone - should be in a flexed position and resist movement)
Respirtation (no abnormal sounds, strong cry)

Question 5

What does an APGAR score of >8 mean?

Answer 5

normal

Question 6

What does an APGAR score <8 mean

Answer 6

requires appropriate investigation/management as this baby is potentially unwell

Question 7

What is haemorrhagic disease of the newborn?

Answer 7

also termed vitamin K deficiency so there is reduced synthesis of factors 2, 7, 9, 10 and protein C/S. this results in increased bleeding

Question 8

What infections is a newborn at risk of?

Answer 8

HIV, Hep B/C, chlamydia, syphilis, TB, group b strep

Question 9

What screening tests are carried out?

Answer 9

Top to toe = immediately after birth
hearing
hips
heel prick test for haemaglobinopathy and specific diseases (PKU, MSUD etc)
CF
Formal neonatal screen

Question 10

What are checked for in the head examination?

Answer 10

Occipital frontal circumference, moulding, fontanelles, overlapping sutures, caput, cephahaematoma, forcep/ventouse marks

Question 11

What is checked for in the eye examination?

Answer 11

Size, red reflex, conjunctival haemorrhage, iris abnormalities, squint

Question 12

What is checked for in the ear examination?

Answer 12

size, placement, folding, extra external meatus, FHx of hearing loss

Question 13

What is checked for in the examination of the mouth?

Answer 13

shape, philum, tongue tie, neonatal teeth, epstein’s pearls (mucus filled cysts in gum), palate, sucking and rooting reflex

Question 14

What is checked for in the examination of the face?

Answer 14

dysmorphia and facial palsy

Question 15

What is checked for in the resp examination?

Answer 15

nasal flaring, chest shape and size, grunting, tachy, indrawing, breath sounds

Question 16

What is checked for in the CV examination?

Answer 16

colour and perfusion, CHD, peripheral pulses (femoral), added heart sounds, apex, heaves and thrills

Question 17

What is teralogy of fallot?

Answer 17

this is chracterised by an overriding aorta, ventricular septal defect, right ventricular hypertrophy and pulmonary stenosis

Question 18

What is looked for in the abdominal exam?

Answer 18

moves with breathing, distension, hernia, umbillicus, bile in vomit, meconium, anus

Question 19

What is looked for in the GU exam?

Answer 19

Passing urine, normal genitalia, undescended testes and hypospadias

Question 20

What is looked for in the MSK exam?

Answer 20

normal muscle and tone, digits and limbs, spine (spina bifida) and hips (hip dysplasia)

Question 21

What is looked for in the neuro exam?

Answer 21

alert, cry, tone, posture, movement and reflexes present

Question 22

What are the reflexes that are examined?

Answer 22

rooting/suckling reflex
Moro relfex (falling)
ANTR (fencing posture when sleeping)
Grasping (holds onto object)
Stepping (attempting to walk when help above solid surface)

Question 23

How should a baby sleep?

Answer 23

on BACK to avoid SIDS