Module 16 common concerns for the newborn

Question 1

Candidiasis presentation

Answer 1

erythematous rash with well demarcated borders
satellite papules and pustules
commonly in skin folds
can also be oropharyngeal

Question 2

Candidiasis caused by

Answer 2

excess moisture

Question 3

Candidiasis tx

Answer 3

topical eruptions: nystatin, imidazoles

Oral: oral nystatin

Question 4

hemangioma presentation

Answer 4

early telangiectasia or red macules

- later are partially compressible red vascular tumors

Question 5

Cause of hemangioma

Answer 5

prematurity is a risk factor

Question 6

Hemangioma tx

Answer 6

many regress over time
if large and threaten organ fxn
- high dose steroids, propranolol, laser therapy, surgery

Question 7

cradle cap (seborrhea) presentation

Answer 7

salmon-colored patches with thick yellow scale on scalp

Question 8

cradle cap tx

Answer 8

removal of crusts with warm olive oil compress followed by baby shampoo or

• 2% ketoconazole
• 1-2.5% hydrocortisone cream
• 1% pimecrolimus cream

Question 9

umbilical granuloma presentation

Answer 9

polypoid mass at umbilicus evident after stump falls off

Question 10

cause of umbilical granuloma

Answer 10

low-grade infection

excessive moisture at umbilicus

Question 11

Umbilical granuloma tx

Answer 11

silver nitrate cauterization

topical isopropyl ETOH

Question 12

Milia presentation

Answer 12

pearl-yellow 1-3mm pustules on face

Question 13

Cause of milia

Answer 13

miniature epidermal inclusion cysts

Question 14

milia tx

Answer 14

spontaneous resolution in 4-6 weeks

Question 15

Spit up

Answer 15

some considered nml d/t weak LES

• peaks at 4 months
• 2/3 of infants spit up at least 1/day

Question 16

benign reflux

Answer 16

the happy spitter

• normal wt gain
• easy feedings
• no irritability with feeds
• no resp or neuro s/s

Question 17

parent education with spit up

Answer 17

positioning
smaller feeding volumes if overfed
small/frequent feeds
thickened feeds

Question 18

Colic presentation

Answer 18

3+ hours of crying per day for
3+ days per week in infant
< 3 months

Question 19

hydrocele presentation

Answer 19

elnargement of one testis that transilluminates with light

Question 20

cause of hydrocele

Answer 20

failure of processus vaginalis to close allowing fluid to pass

Question 21

hydrocele tx

Answer 21

resolves in first 1-2 years of life

Question 22

labial adhesion presentation

Answer 22

parental report of rash
dysuria
local irritation
overt concern about anatomy

Question 23

cause of labial adhesion

Answer 23

hypo-estrogen state resulting in denuded skin -> adhesion formation
- often follows vulvovaginitis

Question 24

Labial adhesion tx

Answer 24

resolve spontaneously by 18mo. 
observe if no s/s
- A&D, vaseline ointment
impaired function
- premarin 1% cream bid x 3wk then nightly x 2-3 wks 
DO NOT manually release

Question 25

fever

Answer 25

temp > 100.4

< 3mo old require a work up