Most commons: Jaundice & Neurology

Question 1

Physiologic jaundice Neuro exam components Level of alertness, posture & muscle tone, spontaneous mvmt, muscle strength, cranial nerves, DTR [check masseter reflex, moro/startle reflex, sucking reflex, tonic neck reflex, grasp reflex], sensory, behavior [habituation, consolability]

Answer 1

Not visible until after 24 hrs of age East Asian newborns bilirubin peaks higher and later than others

Question 2

When newborn jaundice requires tx

Answer 2

Direct hyperbilirubinemia always! - no phototherapy! → bronze baby! lolol & when total bilirubin is at or w/in 3 pts of phototherapy threshold

Question 3

How long O2 takes to reach nml lvls

Answer 3

10 min to get to 95% O2 *don’t give 100% O2 to newborn

Question 4

The ___ Estimates gestational age based on 6 physical and 6 neuro criteria

Answer 4

New Ballard Score

Question 5

New Ballard Score: the higher the score, the (closer/further) the baby is to full term?

Answer 5

The higher the score, the CLOSER to full term the baby is

Question 6

What are the Neuro criteria of the New Ballard Score?

Answer 6

posture square window arm recoil popliteal angle scarf sign heel to ear

Question 7

With increasing gestational age, there is: (↓/↑) translucency and (↓/↑) wrinkling of the skin (↓/↑) lanugo hair (More/less) creases on the sole of the foot (Larger/Smaller) and more well-defined breast tissue (Loss/gain) of eyelid fusion, (firming/smoothing) of pinna of the ear (↓/↑) rugae and pendulousness of the scrotum (as the testes descend) Formation of labia (Majora/Minora), then labia (Majora/Minora)

Answer 7

↓ translucency and ↑ wrinkling of the skin ↓ lanugo hair MORE creases on the sole of the foot LARGER and more well-defined breast tissue LOSS of eyelid fusion FIRMING of pinna of the ear ↑ rugae and pendulousness of the scrotum (as the testes descend) Formation of labia Minora, then labia Majora

Question 8

When hemolysis presents in pathologic jaundice

Answer 8

< 24 hrs

Question 9

Risk factors for hemolysis in pathological jaundice

Answer 9

newborns who weigh > 9 lbs often have polycythemia or ineffective erythropoiesis

Question 10

What are the componenets of the APGAR score

Answer 10

Appearance, Pulse, Grimace, Activity, Respirations

Question 11

The APGAR score doesnt predict ____, _____, or make _____

Answer 11

Doesn’t predict morbidity/mortality or make dx

Question 12

What is a good APGAR score

Answer 12

7-10

Question 13

When do you perform the APGAR score?

Answer 13

1 min and 5 min of life And every 5 min if CPR is occurring.

Question 14

Small for gestational age - SGA is considered at ___ percentile weight

Answer 14

< 10th percentile weight

Question 15

large for gestational age: LGA ] is considered at ___ percentile weight What predisposes a child to this?

Answer 15

> 90th percentile weight Gestational diabetes

Question 16

____ is defined as; < 10th percentile in head circumference and can signal a problem with _____

Answer 16

microcephaly problem w/ brain growth

Question 17

___ is defined as; > 90th percentile in head circumference

Answer 17

macrocephaly

Question 18

____ is defined as; birth weight < 10% but everything else is normal

Answer 18

asymmetric IUGR (intra-uterine growth restriction)

Question 19

___ is described as; < 10% percentile in all 3 growth parameters - could be genetic syndrome, not good prognosis

Answer 19

Symmetric IUGR (intra-uterine growth restriction)

Question 20

Cranial nerves needed for successful feeding (5)

Answer 20

5 [trigeminal] 7 [facial] 9 [glossopharyngeal] 10 [vagus] 12 [hypoglossal]