Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gen Med: Peds > Newborn Exam > Flashcards

Newborn Exam Flashcards

1
Q

Neonatal Hx includes?

A
  1. Maternal & paternal Hx
    a. Medical
    b. Genetic
  2. Maternal OB Hx
  3. Current OB Hx
    a. Antepartum
    b. Intrapartum
    - Gestational age of infant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Physical Exam @ Birth

A
  1. Observation
    - Cyanosis
    - Respiratory distress
    - Genetic anomalies
    - Rashes
  2. Auscultation
    - Lungs
    - Heart
  3. APGAR Score
  4. Skin color
    - Indicator of CO
  5. Skeletal
    - Detect obvious congenital anomalies
  6. Birth trauma
    - Fx clavicle
  7. Number umbilical cord vessels
    - 2 arteries and 1 vein
  8. Placenta
    - Placental infarcts or clots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the APGAR Score? (Look at the chart)

A
  1. Assessed at 1 & 5 minutes
    a. Low scores alert clinician to the need for resuscitation efforts
    - ≥ 7 normal
    - 4 - 6 fairly low
    - ≤ 3 critically low
    b. 10 min if score remains low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Physical Exam in Nursery

A
  1. Weight
  2. Height
  3. Head Circumference
  4. Chest Circumference
  5. Vital signs
    a. Temperature
    b. Pulse, Heart Rate
    - 100-180/min
    c. Respiration
    - 40-60/min
    d. Blood Pressure
    - @ 12 hr 50-70/25-45
    - @ 96 hr 60-90/20-60
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Exam of the Skin

A 
Color
Texture & Turgor	
Edema		
Birth Marks
Infectious lesions	
Capillary bleeding	
Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PE: Normal Skin Findings vs Abnormal Skin Findings

A
  1. Normal Skin Findings
    - Erythema toxicum
    - Milia
    - Miliaria
    - Mongolian spots
    - Hemangioma
    - Vervex caseosa
    - Lanugo
    - Mottling
  2. Abnormal Skin Findings
    - Pale conjunctiva
    - Jaundice
    - Cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Erythema Toxicum?

A
  • Small pustules on erythematous bases
  • Very common
  • Appears 3-5 days after birth
  • Spontaneous resolution 1-2 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Milia?

A
  • Tiny white papules
  • Keratin-filled epidermal cyst
  • Concentrated on nose, cheeks, forehead & chin
  • Resolves spontaneously 1-2 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Miliaria?

A
  • “Heat rash”
  • Blockage of sweat glands
  • Flushed macular appearance of neck, face, scalp & diaper area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are Mongolian Spots?

A
  • Hereditary in dark skinned infants
  • Entrapped melanocytes in dermis
  • Involves small to large blue black macules on back & buttocks
  • Present at birth or appears w/in 1st weeks of life
  • Disappear spontaneously by 4 yr but can persist for life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an Hemangioma?

A
  • Appear during 1st few weeks of life
  • Most common childhood tumor
  • Proliferation stage up to 12 mo
  • 50% disappear by age 5 yr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the “Stork Bite” Mark?

A
  • Salmon colored patches most commonly found on nape of neck
  • Due to stretching or dilation of blood vessels
  • Darker when infant cries
  • Fades when pressure applied
  • Frequently visible into adulthood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a Port Wine Stain?

A
  • Usually flat & pink
  • May deepen in color as child grows
  • Often on face, but can appear anywhere
  • Thickens & takes on a cobblestone-like appearance
  • Laser therapy best Tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Lanugo?

A
  • Thin hair overlying shoulder
  • Normally shed before birth @ 7-8 mo. of gestation
  • Usually present in premature infants
  • Sometimes present in full term
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Vernex Caseosa?

A
  • Waxy or greasy covering
  • Protects skin from damage by amniotic fluid
  • More abundant in pre-term infants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Mottling?

A
  • Lacy light purple appearing discoloration of skin
  • Accentuated vasomotor response
  • Common in newborns when exposed to cold temp or high altitude
  • Asst. w/ trisomy 18 & trisomy 13
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Physical Exam: Head & Face

A
  1. Head ( symmetry of skull and face )
    - Molding (over-riding cranial bone)
    - Fontanelles ( soft, not sunken or bulging )
    - Head circumference 33-38 cm
    - Facial symmetry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fontanelles: When does the Anterior and Posterior close?

A
  1. Anterior
    - 1-4 cm in size
    - Closes @ 6-12 months of age
  2. Posterior
    - 1 cm in size
    - Closes @ 1-3 months of age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is cephalhematoma?

A
  • Hematoma between skull & periosteum
  • Boundaries limited by individual bones
  • 2° to prolonged labor or instrument delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is caput succedaneum?

A
  • Benign subcutaneous hematoma that crosses suture lines

- Tourniquet effect of the cervix during delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is molding?

A

Ridges that develop when one bone slightly overlaps the other during delivery

Complete resolution over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Facial Nerve Palsy?

A
  • Often 2° to birth trauma
  • Infant monitored closely to determine if resolves
  • May require PT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Physical Exam: Head & Neck

A
  1. Head and Neck
    a. Eyes
    b. Ears
    - Look for low set
    c. Nose breathers til 4 months
    d. Mouth
    - Cleft palate
  2. Neck
    a. Webbing
    - Congenital abnormalities
    b. Masses (thyroid rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Parts of the Eye Exam

A 
Red reflex 
Visual following at 5-6 wks
180 degree tracking at 4 months
Irritation & infection
PERRLA
Fundoscopic exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What to look for during the eye exam?

A
  1. Asymmetric red reflex warrants immediate referral to pediatric ophthalmologist
    - Congenital cataracts
    - Glaucoma
    - Retinoblastoma
  2. Brushfield spots asst w/ Down Syndrome
    - Grey or pale yellow spots @ periphery of iris
  3. Strabismus
    - Common in newborns
    - Resolves by 6 - 12 mo
  4. Subconjunctival hemorrhage (hyposphagma)
    - Commonly asst w/ traumatic delivery
    - Resolve spontaneously
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Low Set Ears

A
  • Draw imaginery line from canthus of eye straight back to occiput
  • Low set ears asst w/ trisomy 18
On Exam -->
a. Visualize TM’s
b. Hearing
-Auditory brainstem response
(Screening for congenital deafness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Bradycardia in an infant is under what?

A
28
Q

What does APGAR stand for?

A 
Activity
Pulse
Grimace
Appearance
Respiration

Can get a score of 0, 1, or 2
7 or above = NORMAL

29
Q

Nose

A
  1. Nasal patency is best checked by placing a cold metal object below nose to check for fogging
  2. Choanal atresia presents with unilateral or bilateral obstruction
    a. Usually asst w/ other congenital anomalies
30
Q

What is a large tongue often assisted with?

A

Trisomy 21

31
Q

Physical Exam: Heart & Lungs

A
  1. Breasts-galactorrhea
  2. Cardiopulmonary
    a. Chest wall deformity
    - Fractures from birth trauma
    - Clavicle most commonly fractured
  3. Respiratory
    a. Grunting
    - Asst w/ serious illness
    - Sign of resp distress
  4. Cardiovascular
    - VS
    - Murmurs
    - Altered position of heart sounds
32
Q

When does a hemangioma start to decrease and go away?

A

Normally around age 3, if not - can be lasered later on in life

33
Q

Chest Fractures or deformities in an infant

A
  1. Clavicle Fracture
  2. Prominent Xiphoid
    a. common finding in newborn
    b. becomes less prominent over time
  3. Pectus Excavatum
34
Q

What is Pectus Excavatum?

A
  1. With deep inspiration, sternum appears to be almost collapsed
  2. Can be found in normal infants
  3. Sometimes asst w/ connective tissue disorders
    a. Marfan Syndrome
35
Q

What are Retractions?

A
  1. One of the most important physical findings in a newborn
    a. Sign of resp distress
  2. Asst w/sepsis, pulmonary pathology, cardiac disease, metabolic disorders, polycythemia
36
Q

Cardiac Exam of the Infant

A
  1. Heart rate is rapid
    a. Avg 140 bpm
  2. Murmurs are common
    a. Not always asst w/ pathology
  3. Congenital heart disease signs
    a. Cyanosis, CHF, ↓ peripheral pulses
37
Q

Abdominal Exam of the Infant

A
  1. Check for diaphragmatic hernia
    a. Severe scaphoid belly + resp distress
  2. Masses &/or distention
  3. Liver & kidneys
    a. Prune belly or absence abd musculature asst w/ renal anomalies
    b. Prominent kidneys suggest hydronephrosis
38
Q

What is a Meconium Stained Umbilical Cord?

A
  1. Cord is about 7 hrs old
  2. Cord was stained by meconium in utero –> dark green color
  3. Indicates meconium present in amniotic fluid for some time
    a. R/O Meconium Aspiration
39
Q

Which head delivery injury needs an X-ray?

A

Cephalo Hematoma!!!

NOT CAPUT SUCCEDANEUM (more swelling and a superficial bruise)

40
Q

What is Meconium Aspiration Syndrome?

A
  1. Rapid or labored breathing
  2. Cyanosis
  3. Slow heartbeat (
41
Q

What is Diastasis Recti?

A
  1. Separationbetween the 2 sides ofrectus abdominis muscle
  2. Spontaneously resolves
  3. More common inpremature& African-Americannewborns
42
Q

Physical Exam: Genitalia & Anus

A
  1. Inspect & palpate for anal patency
  2. Male genitalia
    a. Inguinal hernia
    b. Hypospadias
  3. Female Genitalia
    a. Imperforate hymen
    b. Vaginal bloody discharge
  4. Ambiguous genitalia
43
Q

Normal Female Genitalia

A
  1. When examining the genitalia of a girl, it is important to visualize hymenal tissue
  2. Hymenal tissue is light pink tissue that can be seen between labia minora
  3. There should be a central opening, bulging suggests imperforate
44
Q

What are hypospadias?

A

Opening of urethra on ventral (underside of) penile shaft

45
Q

How common are congenital hip dislocations/dysplasia?

A

1 in 500 infants

Higher frequency in breech births

46
Q

What is the Barlow Maneuver?

A
  1. Attempt to dislocate hip w/posterior pressure
  2. W/knees adducted & fully flexed, examiner’s thumb & index finger grasp knees while middle finger placed on outside of femur
  3. (+) test is palpable click
47
Q

What is the Ortolani Maneuver?

A
  1. Grasp medial aspect of flexed knee w/ thumb & fully abduct hips
  2. (+) test spasm or “clunk” as hips are brought to full abduction
48
Q

Physical Exam: Extremities

A 
Inspect for:
-Rudimentary digits
-Club foot
-Spinal deformities
(Spinal bifida)
49
Q

What is Club Feet?

A

Severe eversion of plantar surface

Warrants immediate Ortho referral

50
Q

What is Spina Bifida?

A
  1. Tufts of hair or hemangiomas that cross midline may represent spina bifida
    a. Portion of spinal cord & meninges exposed through gap in vertebral column
51
Q

Neuro Exam of the Infant

A
  1. Newborn Reflexes
    - Sucking & rooting
    - Moro or startle reflex
    - Palmar grasp
    - Placing reflex
    - DTR’s
52
Q

What is Rooting?

A

Stroking face of newborn elicits turning of head toward stimulus

53
Q

What is Sucking?

A

When offered a nipple, the infant will instinctively suckle

54
Q

What is the Moro Reflex?

A
  • Also called startle reflex
  • Allow infant’s head to drop suddenly by 1-2 cm
  • Observe for abduction at shoulders & elbows along w/ spreading & extending fingers
  • Disappears by 3-4 months of age
55
Q

What is the palmers Grasp?

A

Placement of examiner’s finger in infant’s

Disappears by 4 months of age

56
Q

What is the Traction Response?

A
  1. Pull infant by arms to sitting position

2. Observe head lag initially, finally coming to midline before falling forward

57
Q

What is the placing reflex?

A

When dangling infant, natural response will be toes/foot touch table w/stepping response

58
Q

DTR’s of the Newborn

A
  1. Reflexes in newborn are brisk
  2. (+) Babinski may be noted as late as 2 yr of age
    - Upward fanning of toes
59
Q

NYS Newborn Screening: Endocrine Disorders

A

Congenital adrenal hyperplasia

Congenital hypothyroidism

60
Q

NYS Newborn Screening: Hemoglobinopathies

A

Sickle cell disease.

Sickle cell trait (sickle cell carrier)

61
Q

NYS Newborn Screening: Infectious Disease

A

HIV

62
Q

NYS Newborn Screening: Inborn Errors of Metabolism - AA Disorders

A 
Homocystinuria 
Hypermethioninemia 
Branched-chain ketonuria (Maple syrup urine disease -MSUD) 
Phenylketonuria
Tyrosinemia
63
Q

NYS Newborn Screening : Inborn Errors of Metabolism - Fatty Acid Oxidation Disorders

A

Carnitine-acylcarnitine translocase deficiency.
Carnitine palmitoyltransferase I deficiency
Carnitine palmitoyltransferase II deficiency
Carnitine uptake defect
2,4-Dienoyl-CoA reductase deficiency
Long-chain hydroxyacyl-CoA dehydrogenase deficiency
Medium-chain acyl-CoA dehydrogenase
Medium-chain ketoacyl-CoA thiolase deficiency
Medium/short-chain hydroxyacyl-CoA dehydrogenase deficiency.
Mitochondrial trifunctional protein deficiency
Multiple acyl-CoA dehydrogenase deficiency - MADD, also known as glutaric acidemia type II (GA-II)
Short-chain acyl-CoA dehydrogenase deficiency
Very long-chain acyl-CoA dehydrogenase deficiency

64
Q

NYS Newborn Screening : Inborn Errors of Metabolism - Organic Acid Disorders

A

Cobalamin A,B cofactor deficiency
Cobalamin C,D cofactor deficiency
Glutaric acidemia type I
3-Hydroxy-3-methylglutaryl-CoA lyase
Isobutyryl-CoA dehydrogenase deficiency
Isovaleric acidemia
Malonic acidemia
2-Methylbutyryl-CoA dehydrogenase deficiency
3-Methylcrotonyl-CoA carboxylase deficiency
3-Methylglutaconic acidemia
2-Methyl-3-hydroxybutyryl-CoA dehydrogenase deficiency
Methylmalonyl-CoA mutase deficiency
Mitochondrial acetoacetyl-CoA thiolase deficiency
Multiple carboxylase deficiency
Propionic acidemia

65
Q

NYS Newborn Screening: Inborn Errors of Metabolism - Urea Cycle Disorders

A

Argininemia
Argininosuccinic acidemia
Citrullinemia
Hyperammonemia/ hyperornithinemia/ homocitrullinemia

66
Q

NYS Newborn Screening: Other Genetic Conditions

A

Biotinidase deficiency
Cystic fibrosis
Galactosemia

67
Q

Common Inborn Errors of Metabolism

A
  1. Hypothyroidism
    a. 1:4500 live births
    b. Signs/Sx’s
    - Mental retardation, lethargy, thick tongue
    - 75% newborns asymptomatic
    c. Rx: thyroid replacement
  2. Congenital adrenal hyperplasia
    a. 1:5000 live births
    - Ambiguous genitalia
    b. Rx: corticosteroid replacement
  3. Phenylketonuria
    a. 1:12,000 live births
    b. Signs/Sx’s
    - Mental retardation, seizures. Autism
    c. Rx: Low protein diet, avoid phenylalanine
  4. Galactosemia
    a. 1:60,000 live births
    - Mental retardation, neonatal jaundice
    b. Rx: lactose & galactose free diet

Gen Med: Peds (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions