Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Lecture 3: Newborn Exam > Flashcards

Lecture 3: Newborn Exam Flashcards

1
Q

What is the purpose of the prenatal visit?

A

Finding the right pediatrician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 general aspects of newborn history?

A
  1. Prenatal visits
  2. Review of Prenatal history
  3. Review of Delivery history
  4. Newborn history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 3 things make up newborn history?

A
  • Maternal and paternal medical Hx
  • Maternal past OB Hx
  • Current antepartum and intrapartum Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define antepartum, intrapartum, and post-partum.

A
  • Antepartum: occurring prior to delivery
  • Intrapartum: occurring during delivery
  • Postpartum: occurring up to 6 weeks post delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is the Hep B vaccine indicated for newborns?

A

All newborns, starting in 1st month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the newborn treatment if the mother is HBsAg+?

A

Baby: HBIG + HBV (opposite legs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the recommendation regarding breastfeeding for HIV+ mothers?

A

Do not breastfeed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is APGAR measured?

A

1 minute and 5 minutes post birth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does APGAR stand for?

A
  • Appearance
  • Pulse
  • Grimace (reflex irritability)
  • Activity
  • Respiration

0-10, exact same scales as HEART

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the Dubowitz/Ballard Exam?

A

Evaluation of newborn physical and neurological characteristics.

6 signs of each, estimating gestational age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is generally the best indicator of gestational age?

A

LMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is the Ballard postnatal assessment performed and what does it look at physically?

A
  1. Performed 30-42 hours of age.
  2. Testable on any infant from 20-44 weeks.
  3. Looks at plantar creases.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When might a newborn/pediatric assessment be performed without any parent present?

A

Suspicion of abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What qualifies as sudden infant death syndrome? (SIDS)

A

Sudden death of a previously healthy baby prior to age 1, MC during sleep.

Thought to be due to an immature brain forgetting to breathe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors for SIDS?

A
  • Born with hydrocephalus
  • Low birth weight
  • Respiratory infections
  • Sleeping on stomach/side
  • Sleeping on soft surface
  • Co-sleeping
  • Overheating (term babies have normal temp regulation)
  • Males between 2-4m
  • Pre-term
  • Secondhand smoke
  • Sibling who died of SIDS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the ideal sleeping situation for a newborn?

A
  • On their back with a firm mattress
  • Only a simple blanket, no pillows or blankets or stuffed animals.
  • In parent’s room but in crib for the first 6m
  • Pacifier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 3 things are measured for every infant exam for a growth curve?

A
  • Ht
  • Wt
  • Head circumference
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is normal skin for a newborn?

A

Pink and uniform

Yellowness = abnormal in first 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What parts of an infant are commonly blue?

A

Extremities. Acrocyanosis is NORMAL, but central cyanosis is ABNORMAL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is cutis marmorata/marbled skin commonly seen?

A

Seen in about half of infants.

More common in Down syndrome.

Rewarming should eliminate it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is vernix caseosa?

A

Waxy/cheesy film present on newborn to protect from infection.

Left on for 24 hours to help!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is lanugo?

A
  • Light fine hair covering baby.
  • Earlier it appears, the hairier they are.
  • Disappears over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 4 normal skin “rashes” in newborns?

A
  • Erythema toxicum
  • Newborn acne
  • Milia
  • Sebaceous gland hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is erythema toxicum?

A
  • Small vesicular rash commonly due to eosinophils that resolves within weeks.
  • First appears 2-5 days postbirth.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is acne neonatorium?

A
  • Newborn acne around 2-4 weeks age
  • Closed comedones that resolve on their own.
  • Probable etiology: maternal hormones.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is milia?

A
  • Tiny, white, epidermal cysts made of keratin.
  • MC on face, resolving in 2-4 weeks.
  • Epstein’s pearl is milia on the roof of the mouth.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are hemangiomas?

A
  • Large vascular birth marks
  • Grow rapidly, but tend to resolve by age 9.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What might prompt us to treat a hemangioma?

A
  • Visual/hearing/rectal/vaginal/nasal/airway obstruction
  • If very large, could cause cardiac decompensation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is a nevus simplex?

A
  • “Stork bite”
  • Light red macule
  • MC on neck, upper eyelid, between eyebrows.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is nevus flammeus/port wine stain?

A
  • Dark red macules on body with thick, dilated vessels.
  • If found on ophthalmic branch of Trigeminal, 25% have sturge weber syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is sturge weber syndrome associated with?

A
  • Vision problems (glaucoma)
  • Brain angiomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is congenital dermal melanocytosis?

A
  • “Mongolian spot”
  • Darkish blue birthmark on lower back/butt
  • Found on darker skinned babies
  • Lasts for years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What might make cafe au lait spots suspicious?

A

More than 6 that are > 0.5cm = diagnostic criteria for NF1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What happens to heads in vaginal births vs breech births?

A
  • Vaginal: Elongation of head
  • Breech: Narrow face and head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is hydrocephalus?

A

Enlargement of ventricles due to increasing ICP.

36
Q

What are the possible underlying mechanisms for hydrocephalus?

A
  • Malformations
  • Dandy walker malformation
  • Arnold chiari malformations
  • Overproduction of CSF
37
Q

What might suggest hydrocephalus upon exam?

A
  • Sunsetting eyes
  • Enlarged head measurements
38
Q

What is the tx for hydrocephalus?

A

VP shunt

39
Q

Where are the two fontanelles located?

A

Anterior and posterior

Anterior closes at 9-24m
Posterior closes first at 2-3 months

40
Q

What does a bulging fontanelle suggest? Depressed?

A
  • Bulging: ICP
  • Depressed: Dehydration
41
Q

What is caput succedaneum?

A
  • Swelling of scalp due to mechanical pressure on head during vaginal birth
  • Resolves 2-3 days after usually with a cap.
  • Extends past suture lines, presenting as squishy edema
42
Q

What is cephalohematoma?

A
  • Subperiosteal hemmorhage
  • Soft like a cyst, but DOES NOT CROSS SUTURE LINES
  • Takes weeks to resolve
43
Q

Caput vs cephalohematoma

A
44
Q

What are craniotabes?

A
  • Abnormal thinning of parietal bones in preterm babies
  • MC seen along parietal bones
  • Should disappear in a few weeks.
45
Q

What is a subgaleal hematoma/hemorrhage?

A

Complication during vacuum assisted delivery that is due to rupture of emissary veins and accumulation of blood in the epicranial aponeurosis.

46
Q

What is pierre robin syndrome and how is it treated?

A
  • Life-threatening congenital abnormality
  • Short jaw, cleft palate, airway obstruction
  • Failure of mandible growth
  • Treated by lower jaw surgery.
47
Q

What might suggest facial nerve palsy at birth?

A

Crying with an asymmetric face

Just observation

48
Q

What is a common eye finding in newborns that requires no treatment?

A

Subconjunctival hemorrhage

49
Q

What is given to all newborns in their eyes and what does it prevent?

A

Erythromycin ointment in all eyes to prevent chlamydia infection.

Prevent blindness.

50
Q

What might cataracts at birth suggest?

A
  • Metabolic disease
  • Congenital infection
  • Thyroid issues
51
Q

How does glaucoma present in a newborn?

A
  • Tearing
  • Tight eyelids
  • Photophobia
52
Q

What is the proper way to check red reflex in a newborn?

A
  1. 6 inches away
  2. every visit for first 3 years
  3. Lack thereof = immediate referral to oph.
  4. White reflex = leukoria = referral
53
Q

What is a retinoblastoma?

A
  • Rapidly developing eye tumor due to immature retinal cells.
  • Highly curable if caught early.
  • Presence of leukoria = refer to oph IMMEDIATELY.
54
Q

What is dacryostenosis and management?

A
  • Blocked tear duct
  • MCC of tearing and discharge from eye
  • Should not cause redness.
  • Self-resolving within 6 months.

Redness would suggest dacryocystitis

55
Q

What is acute dacryocystitis and management?

A
  • Infection of tear duct
  • Redness, warmth, swelling of area
  • Staph A MCC.
  • Can lead to orbital cellulitis!
  • Consult oph and probe.
56
Q

What is choanal atresia and treatment?

A
  • Back of nose is not connected to pharynx, so they can only breathe through their mouth.
  • Newborn will suffocate when fed.
  • Need surgery to open area.
57
Q

What are natal teeth and the management?

A
  • Weak teeth with poor rotos that present on birth
  • Removable but associated with multiple syndromes.
58
Q

What is oral thrush and the management?

A
  • White coating inside mouth/tongue that is not scrapable
  • Due to yeast infection and requires antifungal
  • Boil all nipples and pacifiers while treating.
59
Q

How is appropriate ear placement determined in a newborn?

A

Inner canthus to eye perpendicular to vertial axis of head.

canthus = where upper and lower eyelids meet

60
Q

What are preauricular pits and management?

A
  • Little hole in the front of ear
  • Common, but more likely to have permanent hearing loss
  • Rarely needs fixing.
  • Newborns all get hearing tests.
  • Perform a renal US if found with other craniofacial abnormalities
61
Q

What is normal respiratory rate for a newborn?

A

30-60 BPM

62
Q

If a baby has poor LE pulses, what congenital heart defect might this be?

A

Coarctation of the aorta

63
Q

If an abdominal mass is felt in a newborn, what is the most probable etiology?

A

Kidney anomaly

64
Q

What might an imperforate anus suggest for a newborn?

A

Missing or blocked.

65
Q

What abdominal organs can be felt in a newborn easily?

A
  • Liver
  • Spleen
  • Kidneys
66
Q

What are the S/S of a diaphragmatic hernia?

A
  • Tachypnea
  • Tachycardia
  • Cyanosis

Often diagnosed prenatally and fixed surgically.

MC: left side

67
Q

What is an infected umbilical area called?

A

Omphalitis

68
Q

Who is an umbilical hernia MC in?

A

African Americans

69
Q

How do we manage an umbilical hernia?

A
  • Self-resolving usually within 3-4 months
  • Surgery consult if not resolved by 3 years
70
Q

What is an umbilical granuloma?

A
  • Friable granulation tissue commonly seen at belly button.
  • Silver nitrate used to cauterize area.
71
Q

What is leukorrhea?

A

Vaginal discharge in female infants

72
Q

What is the main thing to check for in male infants?

A

Presence of both testicles in scrotum.

Cannot retract foreskin so penis cant be checked well.

73
Q

What is congenital hip dysplasia?

A
  • Head of femur not fitting into hip socket well.
  • Due to socket being shallow
  • MC in left hip, girls, firstborns, FHx, breech, multiples

Untreated will cause limp and osteoarthritis of hip

Check via US due to lack of bone density

74
Q

What two maneuvers to check for hip socket fit?

A
  • Barlow: Adduct hip and push
  • Ortolani: Abduct hip and pull
75
Q

What is the management for congenital hip dysplasia?

A

Pavlick harness

76
Q

What is the most common fracture in a newborn?

A

Clavicular fracture

77
Q

How does a clavicular fx present in a newborn and what is the management?

A
  • Difficult vaginal delivery
  • Crepitus, swelling, crying, abnormal bone contour
  • Immobilize with a sling if desired.
  • No surgery to fix.
78
Q

What are the risk factors for clavicular fracture in a newborn?

A
  • Shoulder dystocia
  • Post-term
  • Induced birth
  • High birth weight
79
Q

What are the primitive reflexes?

A
  • Sucking reflex: nipple or pacifier in mouth
  • Rooting reflex: turn to side of facial stimulation
  • Palmar grasp (by 28 wks)
  • Babinski: outward fanning normal under 2yo
  • Moro/startle: Head drop will cause baby to abduct arms and extend, then adduct and flex.
80
Q

What is a tonic neck reflex?

A
  • Turning of head will cause extension of ipsilateral leg and arm.
  • Contralateral flexion of leg
  • “Fencing position”
  • GONE BY 8 MONTHS
81
Q

What is a traction reflex?

A
  • Pulling a baby from sitting position by the hands will cause it to have lag when moving its head, which goes midline and then flex forward.
  • Infant will eventually help.
82
Q

What nerve plexus is the most commonly injured during delivery?

A

Brachial plexus

83
Q

What kind of maneuvers cause brachial plexus injury?

A
  • Pulling on shoulders during head first delivery
  • Pressure on baby’s raised arms during feet first delivery
84
Q

How is brachial plexus injury managed?

A
  • Massage + ROM exercises
  • Surgery is rarely needed
  • 3-6 months of obs.
85
Q

What is a sacral dimple?

A
  • Small hole/dimple in the gluteal folds near tailbone.
  • Only considered abnormal if large or hair or lumpy
  • Associated with spina bifida occulta or tethered cord

Pediatrics (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions