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Nelson - Exam 2 (Neonat) > Nelson - The Newborn Infant > Flashcards

Nelson - The Newborn Infant Flashcards

1
Q

Initial examination of a newborn infant should be performed when

A

As soon as possible after delivery

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2
Q

After a stable DR course, a 2nd and more detailed examination should be performed within

A

24h of birth

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3
Q

Normal pulse in the neonate

A

120-160bpm

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4
Q

Normal RR in the neonate

A

30-60bpm

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5
Q

T/F Pulse oximetry is part of the routine screening for newborn infants

A

T

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6
Q

T/F An O2 sat more than or equal to 95% after 24h of birth in otherwise healthy appearing term infants has >99% sensitivity and specificity to rule out CHD

A

T

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7
Q

Which part of the PE should be done first in a relaxed quiet infant?

A

Palpation of the abdomen or auscultation of the heart

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8
Q

T/F Coarse, tremulous movements with ankle or jaw myoclonus is significant in newborns and should be worked up

A

F, More common and less significant in newborns than at any other age

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9
Q

T/F Convulsive twitching is normal in neonates usually occurring in a quiet state

A

T

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10
Q

When confined to 1 or more extremities of a female infant, edema may be the initial sign of

A

Turner syndrome

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11
Q

T/F Acrocyanosis is harmless cyanosis of the hands and feet especially when they are cool

A

T

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12
Q

Localized cyanosis is differentiated from ecchymosis by

A

Momentary BLANCHING pallor with cyanosis that occurs after pressure

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13
Q

T/F Postmature infants tend to have paler skin than premature infants

A

T

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14
Q

Skin finding in neonates that if large may trap platelets and produce DIC or interfere with local organ function

A

Cavernous hemangiomas

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15
Q

Slate-blue, well-demarcated areas of pigmentation called Mongolian spots are benign and tend to disappear within

A

1st year of life

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16
Q

T/F Tufts of hair over the lumbosacral spine suggest an underlying abnormality including tumors

A

T

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17
Q

What is erythema toxicum

A

Benign white papules on an erythematous base that develop 1-3 days after birth

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18
Q

Erythema toxicum persists for as long as

A

1 week

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19
Q

Erythema toxicum contain what cells

A

Eosinophils

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20
Q

A benign lesion predominantly seen in black neonates that contain neutrophils

A

Pustular melanosis

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21
Q

Pustular melanosis is present when and lasts until when

A

At birth until 2-3 days

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22
Q

T/F Pustular melanosis and erythema toxicum need to be distinguished from more dangerous vesicular eruptions

A

T

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23
Q

Normal size of the anterior fontanelle

A

20±10mm

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24
Q

A third fontanel suggests what chromosomal abnormality

A

Trisomy 21

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25
Q

T/F A third fontanel may be seen in premature infants

A

T

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26
Q

T/F Megalencephaly (excessively large head) may be familial

A

T

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27
Q

T/F Depression of the skull (indentation, fracture, ping pong ball deformity) is usually of prenatal onset

A

T

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28
Q

Atrophic or alopecia scalp may represent what congenital abnormality

A

Aplasia cutis congenita

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29
Q

T/F Möbius syndrome is associated with SYMMETRIC facial palsy

A

T

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30
Q

Absence or hypoplasia of the 7th nerve nucleus

A

Möbius syndrome

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31
Q

T/F Conjunctival and retinal haemorrhages in neonates are usually benign

A

T

32
Q

T/F Retinal haemorrhages are more common in SVD than vacuum- or forceps-assisted deliveries

A

F, less common in SVD

33
Q

T/F Retinal haemorrhages are usually bilateral, intraretinal, and in the posterior pole

A

T

34
Q

Retinal haemorrhages resolve in most infants by

A

2 weeks of age

35
Q

Retinal haemorrhages resolve in all infants by

A

4 weeks of age

36
Q

A cornea >___cm in diameter in a term infant (with photophobia and tearing) suggests congenital glaucoma and requires prompt ophthalmologic consultation

A

1

37
Q

T/F The presence of bilateral red reflexes warrants an immediate ophthalmologic consultation

A

F, WHITE reflex warrants an immediate ophthalmologic consultation

38
Q

T/F the tympanic membrane in the neonate normally appears pearly white

A

F, dull gray

39
Q

T/F Precocious dentition usually indicates extraction

A

F, not usually indicated

40
Q

Temporary accumulations of epithelial cells on the hard palate on either side of the raphe

A

Epstein pearls

41
Q

T/F Clusters of small white or yellow follicles or ulcers on erythematous bases found on the anterior tonsillar pillars warrant empiric treatment

A

F, clear without treatment in 2-4 days

42
Q

T/F Neonates do not have active salivation

A

T

43
Q

T/F Ankyloglossia is usually an indication for frenulotomy

A

F, rarely a reason for cutting

44
Q

T/F Frenotomy may reduce maternal nipple pain and improve breastfeeding scores more rapidly than no treatment but over time neonates not treated with frenotomy also had successful feeding

A

T

45
Q

T/F Suckling callus disappear when suckling ceases

A

T

46
Q

T/F Throat of a newborn infant is hard to see

A

T, because of the low arch of the palate

47
Q

T/F Neonatal tonsils are small

A

T

48
Q

Shield-shped chest may be seen in what chromosomal abnormality

A

Turner syndrome

49
Q

T/F RR should be counted for a full minute with the infant in the resting state, preferably asleep

A

T

50
Q

T/F In premature infants, the RR is higher and fluctuates more widely

A

T

51
Q

T/F An RR consistently greater than 60bpm that persists for more than 30 minutes is an indication to rule out pulmonary, cardiac, or metabolic disease etiologies

A

F, 60 minutes or 1 hour

52
Q

T/F The breathing of newborn infants at rest is almost entirely nasal

A

F, diaphragmatic (during inspiration, the soft front of the thorax is usually drawn inward while the abdomen protrudes, producing a paradoxic movement)

53
Q

T/F Paradoxic/diaphragmatic breathing always signifies insufficient ventilation and should be investigated

A

F

54
Q

Expiratory grunting is benign if it resolves between ___ mins after birth

A

30 and 60 mins

55
Q

Normally, breath sounds of neonates are vesicular

A

F, bronchovesicular

56
Q

T/F Suspicion of pulmonary pathology in neonates should always be verified with a chest radiograph

A

T

57
Q

Neonatal pulse is usually ___ bpm at rest, but may vary normally from ___bpm in relaxed sleep to ___bpm during activity

A

110-140, 90, 180

58
Q

Pulse rate of SVT

A

> 220

59
Q

Preterm infants usually have a higher resting HR up to ___

A

160bpm

60
Q

The easiest and most accurate noninvasive method available for BP measurements

A

Oscillometric method

61
Q

The normal liver is palpable as much as ___cm below the rib margin

A

2

62
Q

T/F At no other period than the neonatal period does the amount of air in the GIT cry so much, nor is it usually so great under normal circumstances

A

T

63
Q

T/F The intestinal tract is gases at birth

A

T

64
Q

Gas is swallowed soon after birth, and gas should normal be present in the rectum on roentgenogram by

A

24 hr of age

65
Q

The cause of most neonatal abdominal masses

A

Renal pathology

66
Q

A solid flank mass clinically associated with hematuria, hypertension, and thrombocytopenia

A

Renal vein thrombosis

67
Q

Abdominal distension at birth or shortly afterward suggests

A

Obstruction or perforation of the GIT often as a result of meconium ileus

68
Q

Abdominal distension later after birth suggests

A

1) Lower bowel obstruction 2) Sepsis 3) Peritonitis

69
Q

Abdominal wall defect that occur THROUGH the umbilicus

A

Omphalocele

70
Q

Abdominal wall defect that occur lateral to the midline

A

Gastroschisis

71
Q

Abdominal defect usually associated with other congenital anomalies and syndromes

A

Omphalocele

72
Q

Anomaly of the umbilical cord associated with an increased risk for occult renal anomaly

A

Single umbilical artery

73
Q

T/F A normal scrotum at birth is relatively large

A

T

74
Q

Most neonates void by

A

12hr

75
Q

Approximately 95% of preterm and term infants void within

A

24hr

76
Q

99% of term infants and 95% of preterm infants pass meconium within

A

48hr

77
Q

T/F Passage of meconium does not rule out an imperforate anus

A

T, a rectal-vaginal fistula may be present

Nelson - Exam 2 (Neonat) (8 decks)

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