Newborn Assessment

Question 1

What is gestation

Answer 1

Using the method of adding 280 days to the first day of the last menstrual period and giving this as the ‘due date’

Question 2

Centile chart

Answer 2

• Plot weight (in kgs), length (in cm) and head circumference (in cm) against age

• Below 2nd centile

Question 3

Neonatal largest organ

Answer 3

Skin

Question 4

Baby skin

Answer 4

Less melanin
Thinner epidermis
Faster rate of water loss
Less moisture

Question 5

Baby skin

Answer 5

Less melanin
Thinner epidermis
Faster rate of water loss
Less moisture

Question 6

Vernix caseosa

Answer 6

Develops from mid term, decreases as gestation increases

composed of sebaceous gland secretions (sebum) and skin cells and is rich in lipids, cholesterol and protein

Question 7

Lanugo

Answer 7

Downy body hair – fine and unpigmented (from 12 weeks and mostly shed by birth)

Question 8

Acrocyanosis

Answer 8

Increased blood to extremities seen within 48hrs

Question 9

Milia/milk spots

Answer 9

small hard white pearly keratin vesicles (1-2mm in size)

Occurs in around 50% of newborn babies

Question 10

Erythemia toxicum (rash of the newborn)

Answer 10

Rash of yellow papules surrounded by reddened areas

Question 11

Port Wine Stain (naevus flammeus

Answer 11

Shape/colour, depression of the skin (colour stays the same)
Refer if on head

Question 12

Blue Spot (Dermal Melanocytes

Answer 12

Present in 90% ethnic babies
Lasts 5-6years

Question 13

Strawberry haemangioma

Answer 13

Overgrowth of blood vessels – benign tumour
Can be very faint colour at birth, then develops over time to become red, like a strawberry colour
Will disappear on own

Question 14

Café au lait

Answer 14

Brown areas <3cm diameter
Refer if more than 5

Question 15

Naevus Simplex (salmon patch - stock mark / angel kiss)

Answer 15

ink, location, goes when gently press skin
Most common birthmark present at birth – 40% of neonates
Fades within a year
Refer if on spine or not on head/neck

Question 16

Sucking blisters

Answer 16

Resolves in day/two
Document as looks like cigarette burn

Question 17

Linea nigra

Answer 17

Y

Question 18

Head

Answer 18

Almost 25% of body mass
33-38cm OFC
Microcephaly <10th centile (fetal alcohol syndrome)
Macrocephaly >90th centile

Question 19

Caput succedaneum

Answer 19

Seen at birth - crosses suture lines, involves scalp only (soft tissue swelling), resolves spontaneously within 24-48 hours, common cause of jaundice

Question 20

Cephalhaematoma

Answer 20

Not seen at birth, but can increase in size over the first few days – does NOT cross suture lines, involves bone (subperiosteal hemorrhage)

Question 21

Pre-auricular sinus/pits

Answer 21

Common congenital malformation

Question 22

Edwards dyndrome

Answer 22

Low set hypoplastic ears

Question 23

Red reflex

Answer 23

Absence of red when lights is passed in newborn eye could mean cataract

Question 24

Epstein pearls in mouth

Answer 24

Small white cysts

Question 25

Receding mandible/chin

Answer 25

Pierre syndrome

Question 26

Webbed neck

Answer 26

Webbed neck – folds that extend digitally or taut skin areas. Tend to be linked to syndromes e,g, Turner’s syndrome​

Question 27

Cystic hygroma​

Answer 27

v rare 1;12000 worldwide. Watery tumour - re benign but can be disfiguring. It may compress and distort the trachea, causing breathing issues and require aspiration

Question 28

Anterior fontanelle (bregma)

Question 29

Posterior fontanelle (lambda)

Question 30

Sutures

Answer 30

Coronal, lambdoial and frontal

Question 31

Fetal alcohol syndrome

Answer 31

-short palpebral fissure (small eyes)​
•thin upper lip​
•smooth philtrum (area between the mouth and nose

Question 32

Down’s syndromr

Answer 32

Epicanthal folds​
Brushfield’s spots (eyes)​
Small white or greyish brown spots on periphery of iris​
Cardiac-ASD, AVD

Question 33

Stomach capacity

Answer 33

15-30mls

Question 34

Gut development

Answer 34

By 24 weeks