healthy term infant

Question 1

what is a normal weight for a baby at birth?

Answer 1

2.5-4kg

Question 2

how many weeks is considered a term baby?

Answer 2

37-41

Question 3

what happens in perinatal adaptation?

Answer 3

First breath/cry
Alveolar expansion
Change from foetal to newborn circulation
Decreased pulmonary arterial pressure
Increased PaO2
Early/immediate skin to skin and suckling

Question 4

what is the apgar score?

Answer 4

Objective measure of perinatal adaptation
Score out of 10
0, 1 or 2 per component
Heart rate, Respiratory rate, Responsiveness, Tone, Colour
“Normal” > 8

Question 5

what screening tests are done on newborns?

Answer 5

examination
universal hearing screening
hip screening
CF, haemoglobinopathies, metabolic disease (PKU, MCADD, MSUD etc.)

Question 6

what head abnormalities are looked for in newborn examination?

Answer 6

OFC
Overlapping sutures
Fontanelles (skull hasn’t fused)
Ventouse/forceps marks
Moulding
Cephalhaematoma
Caput succedaneum (cone shaped head)

Question 7

what do you look for in the eyes in newborn examination?

Answer 7

Size
Red reflex
Conjunctival haemorrhage
Squints (frequent)
Iris abnormality

Question 8

what do you look for in the ears in newborn examination?

Answer 8

Position
External auditory canal
Tags/pits
Folding
Family history of hearing loss

Question 9

what do you look for in the mouth in newborn examination?

Answer 9

Shape
Philtrum
Tongue tie
Palate
Neonatal teeth
Ebsteins pearls
Sucking/rooting reflex

Question 10

what do you look for in the face in newborn examination?

Answer 10

facial palsy
dysmorphism

Question 11

what do you look for in respiratory examination of the newborn?

Answer 11

Chest shape
Nasal flaring
Grunting
Tachypnoea
In-drawing
Breath sounds

Question 12

what do you look for in cardio examination of the newborn?

Answer 12

Colour/Saturation (SaO2)
CHD screening
Pulses: femoral
Apex
Thrills/heaves
Heart sounds

Question 13

what do you look for in abdominal examination of the newborn?

Answer 13

Moves with respiration
Distension
Hernia
Umbilicus
Bile stained vomiting
Passage of meconuim (should occur in first 24hrs - if not red flag)
Anus

Question 14

what do you look for in genitourinary examination of the newborn?

Answer 14

normal passage of urine
normal genitalia
undescended testes
hypospadius (opening of urethra is not at the tip of the penis)

Question 15

what do you look for in msk examination of the newborn?

Answer 15

Movement & posture
Limbs and digits
Spine
Hip examination

Question 16

what do you look for in neurological examination of the newborn?

Answer 16

Alert, responsive
Cry
Tone
Posture
Movement
Primitive reflexes

Question 17

what skin abnormalities can be seen on newborns?

Answer 17

erythema toxicum (typical looking red rash)
strawberry haemangioma
congenital dermal melanocytosis
naevus flammeus (port wine stain)

Question 18

when do you do a hip ultrasound on a newborn?

Answer 18

if they have any degree of dysplasia on examination, or if they were breach at any point during pregnancy, or family history of hip dysplasia

Question 19

what are the differences in types of neonatal head swelling?

Answer 19

Caput: can cross suture, oedematous, max size at birth
Cephalhaematoma: doesn’t cross suture, distinct margin, max size 12-24 hours
Subgaleal (rare): extends, ill-defined, progressive