Management And Exam Of Neonate

Question 1

3 things for the routine care of a baby in the delivery room?

Answer 1

Warming, drying, and clearing of airways

Question 2

What are the 5 clinical components of the APGAR score and what score do most babies get?

Answer 2

HR, Respiratory effort, muscle tone, reflex irritability and color.
7-10

Question 3

Why do we give a vitamin K injection and topical erythromycin eye ointment to babies after birth?

Answer 3

Babies have low vitamin K so we give it to them to prevent vitamin K deficiency bleeding.
From baby getting pink eye from gonorrhea and less effective against chlamydia

Question 4

At what age do most newborns regain their birth weight? What is the expected daily weight gain in the first week? What is the maximal acceptable weight loss in the week following birth?

Answer 4

10-14 days
15-30 grams/day
Up to 10% of body weight is acceptable

Question 5

Explain acrocyanosis?

Answer 5

Blue discoloration around mouth, feet and hands associated with vasospasm of small vessels because of cold temp.
Normal for the first 24 hours.

Question 6

Explain central cyanosis?

Answer 6

Blue discoloration of tongue and mucus membranes. Lasting after the first 10 minutes of life is always abnormal. Cardiac or pulmonary problem.

Question 7

What color is good for babies and what color is really bad?

Answer 7

Pink is good and gray is bad.

Question 8

Why is the red reflex in newborns so important and what would indicate serious pathology when looking for the red reflex?

Answer 8

The red reflex ensures lack of opacity of the lends and cornea. When looking for the red reflex we can look for intraocular masses like a RB.
White reflex needs urgent attention.

Question 9

Micrognathia is part of what well known syndrome?

Answer 9

Pierre-Robin sequence

Question 10

Choanal atresia is associated with what syndrome?

Answer 10

Charge syndrome

Question 11

Bifid uvula can be indicative of what?

Answer 11

Soft palate cleft

Question 12

What are Epstein pearls?

Answer 12

Epithelial cysts in the mouth

Question 13

Explain what supernumery nipples are, what race most commonly do we find them in and what are they associated with in the white population?

Answer 13

Nipples inferior to true nipples
African American most common
In whites, they are associated with renal anomalies

Question 14

What is the difference between a gastroschisis and an omphalocele?

Answer 14

Gastro is no anterior abdominal wall so bowel is exposed

Omphalocele is persistent herniation of the bowel into umbilical cord

Question 15

What is the normal number of arteries and veins in an umbilical cord?

Answer 15

2 arteries and 1 vein

Question 16

What is the difference between a cephalohematoma and caput succedaneums?

Answer 16

Cephalos are subperiosteal bleeds, may be bilateral, do not cross suture lines and take weeks to months to resolve.
Caput are areas of edema or bruising that do cross suture lines and are gone in days.

Question 17

What is the least common but most dangerous extracranial injury in the baby?

Answer 17

Subgaleal hemorrhage.

Question 18

What do we mean when we say fetal head molding?

Answer 18

Because of the pressure on the head during delivery in the vaginal canal, the head can become more oblong than round. This usually resolves after 24 hours or so.

Question 19

What 5 things are we considering when examine the lumbosacral spine in an infant?

Answer 19

Hair tuft, lipoma, hemangioma, pit or dimple.

Question 20

What are the two maneuvers used to examine the hips in the newborn baby?

Answer 20

Ortolani and Barlow

Question 21

What is so important about re-examining the hips prior to discharge?

Answer 21

This is the only thing that has shown to pick up an abnormality not seen prior

Question 22

What is hypospadias?

Answer 22

Meatal opening on the ventral aspect of the penis

Question 23

What is vernix?

Answer 23

White cheesy stuff that babies have al over and appears at about 35 weeks gestation and may be gone at 41 weeks.

Question 24

Explain erythema toxicum?

Answer 24

Benign rash of the newborn that appears second or third day of life and goes away in a week or two.
1-2 mm sores with re base and it spares the palms and soles.
These vesicles/sores contain debri and eosinophils

Question 25

Describe milia?

Answer 25

1-2 mm white, firm papules on face and nose and resolve in a few months.

Question 26

Describe dermal Melanosis?

Answer 26

Benign slate blue/grey or black patch size spots. More common in blacks and Asians. Can take years for the ones on back and butt to resolve.