Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Final exam > Nb Exam > Flashcards

Nb Exam Flashcards

1
Q

What is objective of red eye reflex exam
What referral for abnormal Rer?

A

Obj
Confirm clarity of len
Confirm presence of retina

Referral- consult

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

when is surfactant produced

A

~32 wks

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

embryology
state what each layer of embryonic cells becomes

endoderm
mesoderm
ectoderm
trophoblast
epiderus

A

endoderm- epithelium
mesoderm- muscle
ectoderm - nervous system
trophoblast- placenta
epiderus- nuchal crest

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

When do fetal structures change during extra uterine transition?

A
  1. 1st breath reduces pulmonary resistance. Lung expansion opens lungs. Deoxygenated blood goes to lungs
  2. Oxygenated blood returns to left atrium- increases pressure = foramen ovale closes
    (note closure may be incomplete in first 24-48 hrs- and heart murmurs maybe heard. Anatomically closes1yr

3 ductus arteriosis- triggered to close by increase in oxygen + prostaglandins Functionally closed by 8-10hrs but may not anatomically close for several mths

4) ductus venosus- First to close - closes relative to umbilical blood flow

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

what are 4 ways to lose heat

A

conduction (heat loss when having direct contact)
evaporation (when water evaporates from skin)
convection (fan - move air or water molecules across skin
radiation (e.g.heat loss to surrounding colder solid object not directly in contact with skin)

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

what are urates - what is normal

A

pink / brick red staining on nappy
common / normal in first few days, but after few days, it may indicate dehydration

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

What could (unexpectedly) low or raised temp signal?
What is referral

A

GBS infection
Consult (temperature instability)

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

Jaundice
What are indicators it may be pathological

A

Jaundice develops <48hrs old
Baby is sleepy, feeding poorly, reduced urine output
Jaundice persisting 7-10 days (should decline over this period)
Sclera/ blanched gums indicate yellow

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

What are referrals for jaundice

A

<24 hrs- transfer
SBR >250 in 48hrs- consult
sBR >300 any time- consult
Prolonged / >150 in first 2 wks - consult
Significant jaundice previous baby- consult

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

Vitamin k deficiency bleeding

Cause
timing
Risks
Signs

A

Baby needs vitamin k to produce clotting factors
Vit k synthesised In intestine by bacteria- requires feeding to be established

Types
Early <48hrs
Classic 2-7
Late 1wk- 6mths

Risk factors
Premature
Birth trauma/ asphyxia/ cephaehaematoma/ known hepatic disease
Mum is on anticoagulants, anticonvulsant/ antibiotics / anti turbuculosis

Signs
Bleeding, bruising
Not feeding
Prolonged jaundice

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

brown fat

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

describe glucose regulation for nb

A

NORMAL for BGL’s to fall in first 2-6hrs ( transient period of hypoglycaemia + active ketogeneisis)
then rise slowly / steadily over next 24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Signs of neonatal hypoglycaemia

A

often vague / non-specific
jitteriness
cyanosis
apnoea
weak cry
lethargy
floppy
refusal to feed

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

neonatal response to SSRI’s

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

normal weight loss in nb

A

<10% normal.
@ 7%, assess feeding
@10-12.5% consult
>12.5% Transfer

regain birth weight by 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Signs that baby is full term

A
  • flexed limbs (preterm are extended)
  • ear returns to normal when folded
  • cartilage / curves of pinna are complete
  • there are creases over whole of sole of foot in first 12hrs
  • genitalia well developed (testes descended)
  • scarf sign (crossing arm across midline)- elbow doesn’t reach midline
  • plantar creaes
    *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe normal neonatal breathing patterns

rate
rhythm
chest/abdo movement
nose
sound
colour

A

rate- 30-60 rpm
rhythm- regular + irregular periods, apnoea <20 sec
chest/abdo movement- SYNCHRONISED diaphram + abdo movements (NOT in-drawing)
nose- breathing through nose - no nasal flaring
sound- silent (no grunting)
colour- pink (not pale / cyanosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are rales + rhonchi ?
what causes these
what do you do?

A

rales- discontinous clicking / rattling
ronchi- continous rattling (“snoring”)

caused by lung fluid not yet absorbed. Shoud clear after 1 hr.

mgt
if baby is full term / healthy + alert, with normal resp+ HR–> recheck in 15mins, and monitor every 15mins until they go.
CONSULT IF these persist, or other signs of respiratory distress
(pale/ cyanosis, tachycardia, - tachyapnoea, lethargy, poor tone)

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

What are the 4 listening positions

A

ALL - aortic
PRACTITIONERS- pulmonic
TAKE -tricuspid
MONEY- mitral

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

what are heart murmurs?

what is mgmt? (Incl. referrals)

are they a reliable measure of cardiac anomalies

A

heart murmurs- Sounds that may be heard due to abnormal valves/ defects

most NB’s have soft murmurs that are transient and not associated with anomalies
if you hear a heart murmur at initial exam but no symptoms (colour, poor feeding, resp rate), CONSULT
usually you reassess at 24hrs and it passes within 1st week

if you hear heart murmor WIth Symptoms- TRANSFER

many serious cardiac malformations are silent - observe for general symptoms (colour, resp, feeding behaviour, muscle tone)

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

what is referral for persistent / recurrent cyanosis

A

transfer

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

what is referral for persistent tachycardia

A

consult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is referral for absent femoral pulse

A

consult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is hypoxaemia?
what is referral

A

<90% oxygen sat
Consult (may indicate congenital heart defect, or other respiratory / infections that may be causing hypoxaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
25
What are neonatal reasons for emergency
CNS * convulsions * unresponsive * limpness / hypotonic (with abnormal vital signs/ other abnormality) * severe infant depression at birth (1min Apgar ≤6 and litte improvement at 10mins) HAEMATOLOGY * neonatal subgaleal haemorrhage- with concerns about babys vitals/ongoing bleeding/ head circumferance Increasing RESPIRATORY * apnoea (stop breathing for >20secs and needs resus)
26
what is purpose of pulse oximetry what are referrals
to detect hypoxaemia (low oxygen saturation levels) caused by congenital heart disease in NB before onset of symptoms note- congenital heart disease is most common group of congenital malformations ≥95% = "PASS" 90-94% = "inconclusive"- repeat 3 times then consult <90% oxygen sat- CONSULT
27
what is definition / referral for microcephaly
HC <3rd percentile CONSULT
28
What is difference between -caput -cephaehaematoma -subgaleal haemorrhage
Caput present at birth oedema sitting above periosteum (crosses sutures) generally doesn't require treatment cephaehaematoma develops after birth bleeding UNDER periosteum does not cross sutures subgaleal haemorrhage bleeding into epicranial space and periosteum boggy swelling increases in size, head circumference, signs of shock risk- vacuum delivery - TRANSFER- if vital signs normal and HC stable / no ongoing bleeding - EMERGENCY- if concern about baby's vitals / bleeding/ HC increasing
29
what may a bulging fontanelle indicate
hydrocephalus (build up of CSF) Intracranial haemorrhage
30
what is ankyloglossia when is treatment warranted
tongue tie when lingual frenulum is abnormally short or tight = restricted movement of tongue "not very BF difficulty is due to tongue tie, and not every tongue tie causes a BF issue" NOT recommended unless there is clear association with breastfeeding difficulty MCNZ * expects MW's assess BF and make appropriate/timely referral for ankyloglossia * allows MW 's that have competed training to carry out frenotomy
31
what happens to skin ph after birth
falls (becomes more acidic)
32
what is lanugo what does it indicate
fine soft downy hair more likely to be present if baby is preterm
33
what is vernix what are it's benefits
waxy cheese like substance on baby antimicrobial + thermoregulation- leave in situ
34
what is acrocyanosis
transitory bluish hands / feet first 2-6hrs post birth cause- delay for peripheral perfusion to be fully established
35
superficial capillary naevi when do they go
stork bites mainly go in 1st year
36
hyperpigmented macules
mongolian blue spots usually fade over 1st year of life- some persist into adulthood
37
what are strawberry naevus
develop after birth - grow fast in first few months, then stop. caused by overgrowth of cells usually shrink over few years
38
what is erythema toxicum
small red lesions with white centre rash can be extensive 1st week of life NOT an infection -clears by itself
39
milia
exposed sebaceous glands on face - disappear after 4-6wks
40
# p petechiae
small pinpoint skin lesions- looks a bit bruised disappear 48-72hrs
41
how/ when does the cord separate what is best way to care for cord
cord separation process of 'dry gangrene' Saprophytic action can become quite sticky around hte base- should gently remove sticy material. VERY small amount of dark blood may be seen Any further discharge- blood / serous/ purpulent may indicate infection redness at base usually infeciton 3-7days clamp can come off 2-3 days
42
what is treatment for umbilical hernia
unless very large, closes spontaneously by 2-3yrs
43
when can you palpate kidneys
1st 24-48hrs
44
what is polydactyly
extra digits
45
what is single palmar crease associated with
Downsyndrome T21
46
What is inguinal hernia / mgmt
rx - consult
47
when do you consult for no pasage of mec
36hrs post partum
48
what is rx for undescended testes
primary
49
what is expected nappy output in 1st wk
day 1: 1 wet nappy / 1+ mec 2: 2 wet nappies / 3+ mec 3: 3 wet nappies /3+ transitional 5-7: 6-8 wet nappies / 3-5 yellow stools
50
what is traction response when does baby have this
lifting baby up by hands, head lags behind >37wks
51
asymmetric tonic neck reflex
when baby lies on their side- limbs on same side relax, limbs on other side flex strong / present 30-36wks
52
moro reflex
(startle reflex)- responding to loud noise/ sudden lowering of head
53
stepping response
simulated walking indicates mature extension/flexion mechanisms
54
Developmental dysplasia of hips describe barlow and ortalani test
**barlow** * test to see joint laxity / capability for joint to dislocate with ease * procedure- lift leg and ADDUCT - testing whether head of femur slides over rim) - "PALPABLE clunk *** ortalani ***examines for presence of dislocated hip" procedure- ABDUCT testing whether dislocated head can be slid back into acetabulum palpable and audible CLUNK
55
what is general attitude to early signs baby is not well
* babies can become unwell very quickly * they don't show signs of illness the way adults do * signs are often subtle- baby that has been feeding well, then stops feeding / persistent low grade jaundice * LISTEN to mum if she is worried
56
metabolic screen -can you use alcohol swab?
no -alcohol can affect accuracy of results don't warm foot with warm water/ warmed cloth
57
when is bed sharing associated with increased SUDI risk
evidence indicates it is the circumstances of bedsharing that lead to SUDI risk, not bed sharing itself vulnerable baby (not breastfed, maternal smoking, premature, young age <3mths) impaired mum (refent maternal alcohol / drug consumption / overtired) physical environment (excess bedding, crowding)
58
what is management if baby has 'sticky eyes' in first week of life
most commonly related to inflamed tear duct recommend -regular cleansing of eye gentle massage few drops of breastmilk if infection is suspected - take swab for cultures + sensitivities BEFORE starting treatment consider chlamydia if eye is red + inflamed, or infection doesn't resolve quickly
59
Persistent pulmonary hypertension of newborn what is it signs risk factors
Fetal circulation persists at birth signs- cyanosis Risk factors- antidepressants asssssment- monitor colour + breathing mgmt give oxygen, check pulse oximetry, call NICU
60
how do we assess risk of breastfeeding if mum is taking maternal psychotrophic meds
'relative infant dose' <10% % baby receives s mum's weight
61
what is 'poor neonatal adaptation'
collection of symptoms seen in some babies exposed to (AD's and antipsychotics) poor feeding, vomiting diarrhoea tremors, irritability, lethargy hyper/hypotonia instable body temp tachyapnoea hypoglycaemia usually mild / self resolve in <72hrs
62
what are signs of baby exposed to benzodiazepines / opiates in trimester 3
hypotonia hypothermia respiratory depression neonatal abstinence (tremors, feeding difficulty, irritability) BUT NEVER ASSUME these signs are solely due to maternal medicine, they may also indicate baby is seriously unwell, so you need to investigate
63
what is FASD what are signs
Fetal alcohol syndrome disorder umbrella term for range of lifelong physical, cognitive and beavhiour impairments including Fetal alcohol syndrome) signs: - small eye openings - thin upper lip - flat midface - absent/ elongated groover between upper lip and nose - low birthweight
64
what is neonatal abstinance syndrome
sudden withdrawal of opiates symptoms- irritability, hypertonia, tremores, feeding intolerance, respiratory distress
65
66
what is plantar reflex
press index under toes and toes curl inwards
67
what is babinski reflex
place finger on outer edge- toes splay outwards
68
69
How do we support baby born to drug dependent mother
expect baby to be normal, except likely SGA Don't necessarily need NICU DON'T GIVE NALOXONE TO BABY AT RISK OF DRUG WITHDRAWAL (MUM HAS BEEN TALKING OPIOIDS) Assessments vital obs wrap snugly signs of withdrawal tremors, irritability, hypertonicity + hyperactivity, vomiting, high pitched cry, maybe Resp distress
70
71

Final exam (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions