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Pediatrics Exam 1 > Newborn Evaluation > Flashcards

Newborn Evaluation Flashcards

1
Q

presents day 2 or 3 of life and is mainly on the trunk → erythematous and raised yellow papule in the center → self limited

A

erythema toxicum

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2
Q

this is possible indicator that a baby was post term but also in normal term babies → typically resolves within a few weeks and not associated with later life conditions such as eczema

A

post-term desquamation

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3
Q

capillary malformation that causes the capillaries to appear closer to the skin and more red/pink color

A

Nevus simplex

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4
Q

abnormal migration of neural crest ccells moving towards the skin and likely in the sacral area → painless hyperpigmented spots

A

Mongolian Spots

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5
Q

discoloration of the skin due to vascular anomaly, will not cross midline → may need eye exam and brain imaging → do not fade in time and require interventional treatment

A

Port Wine Stain

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6
Q

benign noncancerous condition resulting in abnormal overgrowth of tiny blood vessels → appear within first 6 months of life → be concerned if too close to eye, in ear or nose, or multiple on the trunk of the body

A

capillary hemangioma

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7
Q

nevus present at birth and is melanocytic tumor → high malignancy potential and likely will need to be removed

A

melanocytic nevus

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8
Q

erythematous vesicular lesion in dermatomal pattern

A

Herpes Simplex

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9
Q

wide anterior fontanelle is associated with

A

congenital hyperthyroidism

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10
Q

external ear abnormalities can be associated with

A

kidney abnormalities

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11
Q

bleeding in the eye that is benign and seen after delivery → goes away by 2 months and should not affect vision

A

subconjunctival hemorrhage

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12
Q

You see a cyanotic and content baby. When you assess it begins to scream and turn normal pink color → you suspect?

A

choanal atresia

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13
Q

If a baby has cleft palate or lip you should assess them for

A

other midline abnormalities

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14
Q

How do you treat a baby born with teeth?

A

remove

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15
Q

benign tiny white cysts that appear in a babies mouth → looks like thrush

A

Epstein Pearls

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16
Q

baby can’t protrude tongue past lip and has trouble feeding → can’t move tongue side to side (Rooting Reflex)

A

Tongue Tied

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17
Q

internal rotation and wrist flexion → able to grab finger when you place it

A

Erbs palsy

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18
Q

Erbs Palsy is damage where?

A

upper nerve damage due to stretch and irritation

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19
Q

claw hand and unable to grab finger when placed

A

Klumpky’s Palsy

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20
Q

Klumpkys palsy results from

A

tearing of lower nerves

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21
Q

subcostal retractions + nasal flaring

A

respiratory distress

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22
Q

most important spot to check infants pulse

A

femoral

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23
Q

weakness of the rectal muscle → goes away as the abdominal muscles are strengthened

A

rectus diastasis

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24
Q

what do you want to do if infant has umbilical hernia?

A

push through and measure ring defect

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25
Q

unable to tell the geneder of baby due to virilized GU exam

A

congetintal adrenal hyperplasia

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26
Q

risk factors for developmental dysplasia of hip

A

female, breech, twin

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27
Q

adducting the hip while applying pressure to flexed knee and directing force posteriorly

A

Barlow test

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28
Q

testing for external rotation of the hip → flex hips and knee 90 degree and abduct the leg → assessing for hip dysplasia

A

Ortolani

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29
Q

flexing infants knees and bring flat feet and ankles towards the butt → checking knee height

A

Galeazzi

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30
Q

6 newborn reflexes

A

moro root palmar grasp pedal grasp suck gallant

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31
Q

subjective test that can assess mothers gestational age

A

Ballard Test

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32
Q

APGAR score assesses

A

activity (muscle tone) pulse grimace (reflex irritability) appearance (skin color) respirations

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33
Q

When do you perform the APGAR score?

A

1 minute → tolerate labor and being delivered? 5 minute → tolerate transition from mom to outside world?

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34
Q

when do you obtain blood spot specimen for newborn screening?

A

after 24 hours of protein containing foods

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35
Q

assess for life threatening defects that require catheter based intervention or heart surgery in neonatal period

A

critical congenital heart disease

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36
Q

probe microphone in ear canal to to measure cochlear response to stimulus

A

otoacoustinc emessions exam

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37
Q

electrodes are placed on the head to detect activity in auditory nerve and brainstem in response to stimulus

A

automatic auditory brainstem response (A-ABR)

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38
Q

which babies should get the car seat tolerance test?

A

babies with poor tone

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39
Q

Indications of failure of Car Seat Tolerance Test

A

apnea > 20 seconds bradycardia < 80 bpm desaturation < 88%

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40
Q

this cranial abnormality will cross suture lines and will self resolve

A

Caput

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41
Q

this cranial abnormality will not cross suture lines and the baby will most likely have jaundice

A

subdural hematoma

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42
Q

worst cranial abnormality → very swollen and full of blood

A

subgleal hematoma

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43
Q

crusty remnant of umbilical cord

A

umbilical granuloma

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44
Q

what should you do if the umbilical granuloma comes off before 2 weeks?

A

close it → apply silver nitrate to cauterize it

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45
Q

delayed reabsorption of lung fluid from pulmonary lymphatics → respiratory distress shortly after delivery (tachypnea, grunting, nasal flaring, retractions, cyanosis)

A

transient tachypnea of newborn (TTN)

46
Q

risk factor for transient tachypnea of newborn

A

C section without active labor

47
Q

Key CXR findings for transient tachypnea of newborn

A

hyperexpansion fluid in minor fissure

48
Q

Treatment for transient tachypnea of newborn

A

symptomatic → supplemental oxygen NPO if RR > 60

49
Q

cause of respiratory distress syndrome/hyaline membrane disease

A

surfactant deficiency → overly compliant chest wall → atelectasis

50
Q

risk factors for respiratory distress syndrome/hyaline membrane disease

A

prematurity

51
Q

key CXR findings for respiratory distress syndrome

A

“ground glass appearance” perihilar air bronchograms

52
Q

Treatment for respiratory distress syndrome

A

prevention → give mom steroids before she delivers Surfactant administration

53
Q

premature passage and aspiration of meconium in utero → presents like TTN, RDS and will have meconium stained amniotic fluid

A

meconium aspiration syndrome

54
Q

biggest risk factor for meconium aspiration syndrome

A

post-term gestation

55
Q

key CXR findings for meconium aspiration syndrome

A

diffuse patchy densities

56
Q

Treatment for meconium aspiration syndrome

A

antibiotics → ampicillin or gentamicin

57
Q

MC cause of neonatal pneumonia

A

Group B strep

58
Q

CXR findings of neonatal pneumonia

A

diffuce alveolar/interstitial disease asymmetric and localized pleural effusion

59
Q

neonatal pneumonia can be associated with

A

neonatal sepsis

60
Q

treatment for neonatal pneumonia

A

antibiotics → ampicillin or gentamicin

61
Q

any systemic bacterial infection documented by positive blood culture by 28 days of life → temperature instability, respiratory distress, feeding intolerance, abdominal distension, irritable, jaundice

A

neonatal sepsis

62
Q

MC cause of neonatal sepsis

A

Group B strep

63
Q

types of neonatal seizures

A

subtle, clonic, tonic, myoclonic

64
Q

MC cause of neonatal seizures

A

perinatal asphyxia

65
Q

best treatment for neonatal seizures

A

treat underlying cause anticonvulsant → phenobarbital, phenytoin, diazepam/lorazepam

66
Q

infant withdrawal once born after being exposed to opioids in utero

A

neonatal abstinence syndrome (NAS)

67
Q

most common systems affected in infant who was exposed to narcotics and barbituates (codeine, fentanyl, heroin, hydrocodone, hydromorphone, meperidine, morphine, oxycodone, buprenorphine, levophanol, cocaine) in uter

A

CNS GI autonomic NS

68
Q

infant with tremor, high pitch cry, irritability, excess suck, hyperalert, apnea, tachycardia was likely exposed to what in utero

A

stimulant (methamphetamine, cocaine)

69
Q

How long should you monitor an infant with NAS for withdrawal symptoms?

A

5 days

70
Q

20 point scale of symptoms baby may be having of NAS

A

Finnegan scoring system

71
Q

pharmacological treatment options for NAS

A

morphine methadone clonidine

72
Q

Prefered method for assessing NAS

A

Eat Sleep Console can eat > 30 mL? sleep undisturbed > 1 hr? easily consoled in < 10 min?

73
Q

This is a known preventable cause of Cerebral Palsy → hypotonia, delayed motor development, dental dysplasia, sensorineural hearing loss, cognitive impairment

A

Kernicterus (unconjugated bilirubin crosses the BBB and deposits in basal ganglia)

74
Q

when does physiologic benign hyperbilirubinemia appear?

A

DOL 1 - 7 (peak in 3 - 5)

75
Q

when does breast feeding benign hyperbilirubinemia appear?

A

DOL 1 - 7

76
Q

When does breast milk benign hyperbilirubinema appear?

A

DOL 6 to 1-3 months

77
Q

increased bilirubin production + impaired ability to remove bilirubin → increased HCt and shorter RBC lifespan + immature UDP glucuronyl transferase

A

physiologic benign hyperbilirubinemia

78
Q

exacerbated phyiologic hyperbilirubinemia + caloric deprivation → increased enterohepatic circulation + dehydration + delayed meconium passage

A

breast feeding hyperbilirubinemia

79
Q

things that increase bilirubin production

A

hemolysis (isoantibodies, enzyme defects, structural defect) birth trauma polycythemia

80
Q

Treatment for indirect hyperbilirubinemia

A

indirect sunlight phototherapy IVIG

81
Q

Treatment for direct hyperbilirubinemia

A

GI/surgery/NICU consult AVOID PHOTOTHERAPY

82
Q

management for GERD

A

more frequent, smaller volume feedings change formula or moms diet keep upright 30 min after feeding H2 antagonist (ranitidine), PPI (lansoprazole/omeprazole)

83
Q

lacrimal duct gets blocked + white sclera

A

lacrimal duct stenosis

84
Q

red conjunctivities that occurs due to erythromycin eye drops

A

chemical conjunctivitis

85
Q

This conjunctivitis presents in the first week of life

A

gonorrheal conjunctivitis

86
Q

this conjunctivitis presents in the second week of life

A

chlamydial conjuctivitis

87
Q

How can you prevent neonatal conjunctivitis?

A

erythromycin ophthalmologic ointment

88
Q

treatment for gonorrheal conjunctivitis

A

ceftriaxone

89
Q

treatment for chlamydial conjunctivitis

A

erythromycin

90
Q

Best lab to get for neonatal sepsis

A

blood culture

91
Q

Treatment for neonatal sepsis

A

ampicillin and getnamicin

92
Q

TORCH infections

A

Toxoplasmosis Other (syphilis, Hep B, VZV, Parvo B19) Rubella CMV HSV, HIV

93
Q

microcephaly intracranial calcifications rash IUGR jaundice hepatosplenomegaly elevated LFT thrombocytopenia

A

shared characteristics of TORCH infection

94
Q

Presentation of Toxoplasmosis

A

TOXOGONDI Tremors 0 - zero hearing X - optic chiasm 0 - zero IQ Greatly reduced head (microcephaly) water On the brain (hydrocephalus) Nothing (asymptomatic) Diffuse intracranial calcifications Icteric (hepatosplenomegaly)

95
Q

How will newborn with syphilis present at birth?

A

asymptomatic

96
Q

1 - 2 months old + maculopapular rash + snuffles + lymphadenopathy + hepatomegaly + thrombocytopenia + anemia + meningitis + chorioretinitis + osteochondritis

A

syphilis

97
Q

Hutchinson teeth + mulberry molar + hard palate perforation + CN VIII deafness + bony lesions + saber shins + saddle nose deformity

A

syphilis

98
Q

Treatment for syphilis

A

penicillin G

99
Q

Baby exposed to Hep B (+) mom’s blood during delivery, treatment?

A

Hep B vaccine and HBIG within 12 hours afte birth

100
Q

Treatment for VZV in neonate

A

acyclovir VZIG

101
Q

MC presentaiton of Parvo B19

A

fetal hydrops

102
Q

Treatment for Parvo B19

A

supportive care +/- IVIG - most die

103
Q

Mc congenital infection in the US → can be transmitted transplacental, during delivery, postnatally

A

cytomegalovirus

104
Q

“blueberry muffin rash” + Periventricular calcifications + hepatosplenomegaly + jaundice + thrombocytopenia + retinitis + hypotonia + lethargy + sensorineural deafness + development delay

A

CMV

105
Q

Treatment for CMV

A

ganciclovir

106
Q

“blueberry muffin rash” + sensorineural deafness + cataracts and congenital glaucoma + pulmonary stenosis and PDA

A

Rubella/German Measles

107
Q

treatment for HSV in infant

A

acyclovir

108
Q

transmission risk factors for HIV

A

breastfeeding

109
Q

Management for HIV

A

antiretroviral prophylaxis (Zidovudine or triple drug therapy)

110
Q

Gold standard for diagnosing Hiv

A

HIV DNA/RNA PCR

111
Q

When can a baby who has had a circumcision go home?

A

after it has peed → usually monitor 2-3 hours

112
Q

benign condition when infant is born with vesicle and superficial pustules that easily burst that progress to hyperpigmented freckles that resolve within 48 hours, macules can last several months

A

neonatal pustular melanosis

Pediatrics Exam 1 (7 decks)

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