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Patho II > Newborn exam > Flashcards

Newborn exam Flashcards

1
Q

what are the key components for newborn Hx

A 
prenatal visits
previous pregnancies- any complications
health of other children
any complications during pregnancy
history of genetic conditions in family
lab findings: screening for Group B strep and blood type
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2
Q

If the mom is hyperglycemic during pregnancy what is going on in fetus

A

seeing high sugar so produce hyperinsulinemia

post birth- hypoglycemic

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3
Q

what do you note under the general observation for neonate exam

A

muscle tone and movement

color

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4
Q

if the neonate is pale what can that suggest?

A

anemia

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5
Q

what can strep B cause in neonate

A

sepsis

can kill infant in 4-5 days

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6
Q

if the baby is jaundice 12 hrs after birth what are you going to look into

A

hemolytic disease

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7
Q

what is harlequin skin

A

one side red, one side not

unknown cause–> no consequence

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8
Q

what are normal newborn vitals

A

temp 36.5-37.5
Resp 30-60 breaths/min
HR 100-160 bpm
take length, weight, head circumference for growth charts

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9
Q

what is caput succedaneum

A

tissue edema ABOVE periosteum which cross suture lines

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10
Q

what is cephalohematoma

A

bleeding and fluid UNDER periosteum that occurs approx 2.5% births that does NOT cross suture lines

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11
Q

what are vital signs that are pertinent for emergency

A

hypothermia

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12
Q

what is choanal atresia

A

failure of communication between nose and pharynx

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13
Q

what are symptoms of choanal atresia

A

infants have difficulty breathing and have cyclic cyanosis

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14
Q

how do you confirm choanal atresia

A

pass small feeding tube into each nostril and should pass into nasopharynx easily.

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15
Q

what fontanels do you palpate

A

anterior and posterior

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16
Q

if the posterior fontanel is still open around 3mo
umbilical hernia
jaundice
what is your primary Dx

A

congenital hyperthyroidism

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17
Q

when do you worry about caput succedaneum

A

if there is a lot of blood that can be leaking out

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18
Q

what is Tx for cephalohematoma

A

usually heals itself. reabsorbs

19
Q

What do you look for in neonates for eye exam

A

red reflex! also symmetry, set/shape, discharge, erythema

absence–> immediate attention

20
Q

what can cause cataracts in newborn

A

retinoblastoma tumor

galactosemia- hepatomegaly also present

21
Q

what are epstein pearls

A

inclusion cysts in mouth

go away

22
Q

crepitus over clavicle is indicative of what

A

previous fracture

23
Q

how many spots must you listen to on cardiac exam of neonate

A

4 spots

24
Q

what pulse do you check in neonate? why?

A

femoral

if diminished–> could be coarcation of the aorta

25
Q

if the umbilical cord does not have 3 vessels- 2 aa 1 v

what is it assoc with

A

other anomalies

26
Q

what is a meconium stained umbilical cord suggestive of

A

stress in-utero
meconium in amniotic fluid
could have meconium in the lungs- immediate resuscitation

27
Q

are umbilical hernias emergency

A

no

28
Q

what do you look for on back of neonate

A

sacral dimples, hair, abnormal coloration, findings suggestive or neurotube defects

29
Q

what is a meningocele vs myelomeningocele

A

meningocele is just CSF outpouching

myelomeningocele is outpouch of both CSF and nerves

30
Q

a butterfly mark on sacrum may mean what

A

possibility of underlying defects (occult spinal dysraphism) and may need to be investigated if other findings are present

31
Q

what are the hip tests

A

barlow and ortolani tests

32
Q

describe GU exam for male neonate

A

check that testes are descended into scrotum

check for hypospadias

33
Q

what are the 3 types of hypospadias

A

subcoronal- opening is near head of penis
midshaft- opening is along shaft of penis
penoscrotal- opening is where penis and scrotum meet

34
Q

what is CO named in newborn

A

combined ventricular output

35
Q

how much of the CO in neonate goes to placental circulation?

fetal brain?

A

umbilical-placental receives 40%

fetal brain receives 20-30%

36
Q

what are the transition halmarks of newborn circulation

A 
umbilical-placental circulation stops
Mean pulm artery pressure drops
pulm blood increases
pulm vasc R drops
R atrial P drops (decreased IVC flow)
L atrial P rises from inc in pulm blood flow(causes foramen ovale to close)
37
Q

how big is the ductus arteriosus in fetus

A

size of descending aorta

38
Q

what molecuel maintains the patent dutus

A

PGE2 prostacyclin I2

39
Q

when does the ductus arteriosus close

A

around 15 hrs of age

40
Q

what causes right to left shunting through the ductus

A

increased pulmonary vascular R

especially in hypoxia

41
Q

what are the resp transitions in neonate

A

after birth the lung compliance improves and airwayR decreases and functional residual capacity is established
surfactant!

42
Q

when does glycogenolysis begin in fetus

A

around end of third trimester

43
Q

if baby is seizing what should be included on differential

A

hypoglycemia

Patho II (7 decks)

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