Neonatology Flashcards
Name five components of a baby check
Top to toe
Head, face, mouth palate, eyes, colour and skin, arms, chest, heart, abdomen, genitalia, muscle tone and reflexes, back and spine, hips, feet, count toes
What should be palpated for in the head of a baby?
Fontanelle
What are fontanelle?
(colloquially, soft spot) is an anatomical feature of the infant human skull comprising soft membranous gaps (sutures) between the cranial bones that make up the calvaria of a fetus or an infant.
What are Epstein’s pearls?
Gingival cyst, also known as Epstein’s pearl, is a type of cysts of the jaws that originates from the dental lamina and is found in the mouth parts. Completely benign and commonly found in newborns
What should be assessed in the eyes?
opthalmoscope- red reflex
Why is a red reflex performed?
to exclude cataracts
Name three abnormalities in the skin of a newborn?
Pale, jaundiced
Cyanosis
Skin rash
Discolouration e.g. port wine stains
What is the name of a skin lesion in babies that can be found near the eye and may obstruct vision
Cavernous hemangioma (see in paediatric dermatology clinic SSC)
Black baby with blue skin marks along the base of spine. What is the likely cause?
Mongolian blue spots= congenital dermal melanocytosis
Name one aspect to examine in the arms?
abnormal posturing- nerve palsies if difficult delivery
Name one aspect of hand exam in baby check
palmar crease (down’s)
What should you examine during the heart assessment of baby check?
thrill/heave
listen over precordium and back
brachial and femoral pulses
Name one condition in which femoral pulses is reduced
coarctation
Name three normal reflexes found in babies
grasp
suck (place finger in mouth)
moro= infant suddenly splaying their arms and moving their legs before bringing their arms in front of their body, this is normal. If absent then worry
What is Galeazzi sign?
used to assess for hip dislocation, primarily in order to test for developmental dysplasia of the hip. It is performed by flexing an infant’s knees when they are lying down so that the feet touch the surface and the ankles touch the buttocks to assess for leg length.
Which two maneuvers are employed to determine whether the hip is disloctable?
Barlow’s- initial test
Ortolani
What does the newborn blood spot test screen for?
cystic fibrosis, sickle cell disease, congenital hypothyroidism, inherited metabolic diseases, PKU
Name one cause of conjugated hyperbilirubinaemia in neonates?
biliary atresia
What is a typical presentation of biliary atresia?
pale stool and dark urine
Why do you get dark urine dark and pale stools?
Biliary blockage causes bile to leak into systemic circulation. Since conjugated bilirubin is soluble it is excreted in the urine (making it dark). The faeces are deprived of their stercobilinogen and are pale.
What is biliary atresia?
Biliary atresia is a blockage in the tubes (ducts) that carry bile from the liver to the gallbladder. This congenital condition occurs when the bile ducts inside or outside the liver do not develop normally.
Name three causes of unconjugated hyperbilirubinaemia in neonates?
- Physiological
- Breast milk jaundice
- Haemolytic disease (Rhesus, ABO or other antibodies)
- Infection (UTI, sepsis)
- Congenital hypothyroidism (prolonged jaundice)
What is the definition of prolonged jaundice?
Prolonged jaundice is defined as visible jaundice persisting >14 days in a term
infant and >21 days in a preterm infant.
What is the most common cause of prolonged jaundice?
breast feeding
Treatment for hyperbilirubinaemia is determine by which two factors?
gestational age and bilirubin level
Name two treatment options for hyperbilirubinaemia
Phototherapy and exchange transfusion