management and exam of the healthy neonate

Question 1

90% of apgar scores are between

Answer 1

7-10 and require no further assistance

Question 2

normal respiratory rate

Answer 2

40-60 if above then troublesome

Question 3

feeding and early weight loss of neonate

Answer 3

early and often no more than 3 hours apart bc can’t keep BG up on their own

up to 10% weight loss is acceptable in most situations
weight usually regained within 2 weeks

Question 4

what is the best way to do an initial assessment of the baby

Answer 4

wactch it and listen to it

Question 5

what kind of breathing does baby do

Answer 5

diaphragmatic see saw respirations

if baby looks okay then probably normal

Question 6

what would be an abnormal respiratory finding

Answer 6

retractions or singing

Question 7

what color is good of baby and which are the worst

Answer 7

pink = good

blue
mottling/pallor
and grayish hue

• these 3 bad

Question 8

acrocyanosis

Answer 8

blue discolor of perioral area, feet and hands

normal within first 24 hours

Question 9

central cyanosis

when abnormal

Answer 9

blue tongue/mucus membranes

if persists after the first 10 mintues of life then this is abnormal

think cardiac or pulmonary disease

Question 10

does cyanosis or bruises blanch

Answer 10

cyanosis, turns white when pushed on

Question 11

jaundice in the first _____ is of concern

Answer 11

24 hours

Question 12

what does grayish hue/color mean

Answer 12

severe acidosis
poor outcome
seen in infections and cardiac disease

Question 13

what does a high pitched cry mean

Answer 13

cns head trauma and or substance withdrawal

Question 14

finding a white red reflex means what

Answer 14

tumor, trauma, rop, need urgent referral

Question 15

red reflex in darker skinned infants

Answer 15

may be more pearly gray, vessels still present

Question 16

disconjugate gaze should be gone by why

Answer 16

age 4 months

Question 17

what do you look for in ears

Answer 17

if they are low set

Question 18

choanal atresia mnemonic

when can they become cyanotic?

Answer 18

CHARGE

coloboma, heart defect, atresia choanne, retarded growth/development, genital abnormalities, ear abnormalities

may be cyanotic when not crying

Question 19

micrognathia is part of

Answer 19

pierre-robin sequence

Question 20

natal/neonatal teeth signifigance

Answer 20

if they are loose then they need to come out

Question 21

what is an epstein peral

Answer 21

epithelial cysts, collagen in the mouth

Question 22

excess skin at the base of the neck is common in

Answer 22

down syndrome

Question 23

normal hr in newbork

Answer 23

100-160

Question 24

checking pulses

Answer 24

check femoral and branchial simultaneously to see if they are equal

Question 25

what does absence of murmur during ausculataion mean?

Answer 25

nothing, still can have pathological structural problems

Question 26

babies and murmors

Answer 26

most have murmurs which is usually innocent | if loud murmur then further investigation

Question 27

scaphoid abdomen seen with

Answer 27

diaphragmatic hernia

Question 28

full upper abdomen with a flattened lower abdomen means

Answer 28

proximal obstruction or atretic lesion

Question 29

which is covered gastroschisis or omphalocele?

Answer 29

gastroschisis oh shit that is not covered (omphalocele)

Question 30

extreme distension of the abdomen at birth or shortly after think what? ____ abdomen = bad

Answer 30

pathology, taut meconium ileus ascites volvulus bowel sounds not there is bad

Question 31

when palpating baby abdomen what position do you want them in?

Answer 31

legs flexed

Question 32

umbilical vessels and abnormality

Answer 32

usually 2 arteries and 1 vein single artery is normal varient but if also have any other abnormal (not really sure bc she didn't say in lecture) is of concern

Question 33

cephalohematoma what is it where does it spread how long till goes away? what can mask it?

Answer 33

subperiosteal blood do not cross suture lines weeks to months for resolution can be hidden under caput succedaneum

Question 34

caput succedaneum what is it location resolution

Answer 34

boggy area of edema or bruising that crosses suture lines, gone in days, present at birth

Question 35

what is the least common but most dangerous extracranial injury lots of blood loss enlarges after birth crosses suture lines fluid wave can cover entire scalp and extend in to the neck

Answer 35

subgaleal hemorrhage

Question 36

dimples separate from the gluteal crease think what and do what

Answer 36

``` spinal dysraphism (tethered cord) US by 3 months ```

Question 37

extremity important fact what test done

Answer 37

re examine the hips before discharge bc can pick up new abnormality that was not seen before barlow and ortolani test

Question 38

genitalia emergency

Answer 38

if ambiguous genitalia then endocrinologic emergency CAH

Question 39

femal with mucous (ocassionally bloody) discharge

Answer 39

common and a parental concern

Question 40

labial mass or mass in the groin maybe

Answer 40

a hernia | consider ectopic gonad

Question 41

hymenal tags are rare or common

Answer 41

common

Question 42

the average penis is about ____

Answer 42

2.5 cm, (hung AF)

Question 43

epispadias | what and location

Answer 43

dorsal meatal opening

Question 44

hypospadias | what and location

Answer 44

ventral meatal opening

Question 45

2% of newborn males are cryptorchid and what usually happens

Answer 45

most resolve by 3 months | if not down by 9-12 months then surgeon eval

Question 46

absence (imperforate) anus is often associated with what

Answer 46

VATER verterbral defects, VSD anal atresia T-E fistual/esophageal atresia Radial dysplasia

Question 47

what is vernix

Answer 47

white cheesy stuff that babies have all over, appears 35 weeks and gone by 41 usually

Question 48

flea bite syndrome

Answer 48

benign rash of newborn | patches or pustules that move around = normal

Question 49

1-2 mm white firm papules on face and bridge of nose | what happens

Answer 49

milia | go away on own

Question 50

benign dermal melanosis look like bruises mainly on dark skin individuals? what must you always do with these?

Answer 50

slate gray spots document them