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Peds > Newborn Exam > Flashcards

Newborn Exam Flashcards

1
Q

Fetal to neonate physiology changes

A

Breathing, decreased pulm arterial resistance, closure of shunts, clamping cord, decreased venous return from placenta

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2
Q

Scores to assess the infant;s physiological status

A

Apgar at 1 and 5 minutes after birth

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3
Q

Apgar scores

A

1-10 with normal being 9, 4-7 needs attention, 0-3 is severe illness (MC ventilation)

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4
Q

Apgar score of

A

> 50% mortality and >60% permanent severe neuro sequelae

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5
Q

Apgar of 0

A

Absent HR, absent breathing, limp, nor reflexes, blue and pale

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6
Q

Apgar of 1

A

Below 100 HR, slow/weak cry, flexion of extremities, grimace, body pink, ext blue

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7
Q

Apgar of 2

A

HR over 100, crying, active motion, cough/sneeze/cry, completely pink (rare)

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8
Q

Time frame to perform newborn exam

A

Within 24 hours after birth

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9
Q

Normal HR

A

120-160

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10
Q

Normal Respiration

A

30-60

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11
Q

Normal SBP

A

70-105

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12
Q

Normal Temp

A

36.5-37.4 taken rectally; if outside range needs septic workup

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13
Q

Normal head circumference

A

33-37cm

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14
Q

Common reasons for large gestational size (>90%)

A

IDM, hypoglycemia

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15
Q

Common reasons for small gestational size (10%)

A

Hypoglycemia, temp instability, polycythemia

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16
Q

Ways to assess gestational age

A

LMP, ultrasound, physical characteristics of newborn

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17
Q

Neuron muscular maturity score

A

determined by supine posture., square window (wrist flexion), arm recoil, popliteal angle

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18
Q

Amount of time a newborn spends sleeping

A

80%

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19
Q

Main breathing pathway of the newborn

A

Obligate nasal breathers

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20
Q

Abnormal crying

A

Weak - illness; high pitched - neuro problems; hoarse - vocal cord paralysis, hypothyroidism, or trauma

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21
Q

Skin abnormalities

A

Pallor - anemia, mottling - sepsis or hypothermia, cyanosis - hypoxemia or methemoglobinemia, acrocyanosis - normal, plethora - polycthemia

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22
Q

Lanugo

A

Vanishes between 32-37th weeks, present between the shoulders

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23
Q

Subcutaneous fat necrosis presentation

A

MC on cheeks, butt, limbs and back; redness on skin; rubbery appearance

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24
Q

Extensive petechiae

A

Thrombocytopenia or severe illness

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25
Q

Craniosynostosis

A

Premature closing of the sutures

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26
Q

Fontanelle presentation

A

Ant:

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27
Q

Cephalohematoma

A

Doesn’t cross the suture lines

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28
Q

Caput succedaneum

A

Crosses suture lines

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29
Q

Pupillary response to light present at ______

A

28 weeks gestation

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30
Q

Leukocoria

A

Always abnormal, white reflex not red; could be caused by retinoblastoma, cataracts, persistent hyperplastic primary vitreous, retinal coloboma, chorio, retinopathy of primi

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31
Q

Preauricular pits

A

Common, deafness common if hereditary link

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32
Q

TM Presentation

A

Dull gray immobile

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33
Q

Choanal atresia

A

Unilateral or bilateral anatomical obstruction

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34
Q

Epstein pearls

A

Normal collection of epithelial cells in the mouth

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35
Q

Ranula

A

Benign mass of floor of tongue

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36
Q

Protruding tongue

A

Abnormal, associated with hemangioma, isolated macroglossia, hypothyroidism, Downs, Beckwith-Wiedemann

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37
Q

Ebbing and webbing suggest what?

A

Turner’s syndrome

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38
Q

Erb’s paralysis presentation

A

5th and 6th cervical root, spontaneously resolves

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39
Q

Klumpke Paralysis

A

8th cervical and 1st thoracic brachial plexus, claw-hand

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40
Q

Horner syndrome presentation

A

Ptosis, miosis, enopthalmos, and delayed pigmentation of the skin, injury to sympathetic fibers of T1

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41
Q

Supernumerary nipples

A

Common but may be associated with renal abnormalities

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42
Q

Widely spaced nipples with shield like chest associated with …

A

Turners syndrome

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43
Q

Time frame for normal auscultation of rales

A

1-2 hours

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44
Q

Thoracoabdominal asynchrony

A

Airway obstruction or stiff lungs

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45
Q

Persistent coughing is indicative of ….

A

Viral pneumonia

46
Q

Location of PMI

A

4-5th intercostal space left of sternum (more midline than older children)

47
Q

Sustained bradycardia is indicated of …

A

Asphyxia, increased ICP, hypothyroidism, congenital heart disease, heart block

48
Q

Sustained tachycardia indicates …

A

Fever, hypo olefin, drug withdrawal, congenital heart disease, tachyarrhythmias, anemia, hyperthyroidism

49
Q

Investigate any murmur with …

A

Cyanosis, evidence of poor perfusion, tachypnea, persistent past first day

50
Q

Where to evaluate pulses in neonate a

A

Brachial and femoral to r/o coarctation

51
Q

Location of liver in normal baby

A

1-2cm below right costal margin

52
Q

Location of spleen in normal baby

A

No more that 1cm below left costal margin

53
Q

First urination must occur within what time frame

A

24 hours of life

54
Q

Diastasis recti

A

Will close after one year

55
Q

Omphalocele

A

Abd contents pass through a peri umbilical defect near cord, covered by membrane

56
Q

Gastroschisis

A

Defect d/t primary failure of lat central folds leading to small and large intestine sitting outside abd, not membrane bound

57
Q

Prune belly

A

Absence of ant wall musculature, associated with urinary tract anomalies and cryptochidism

58
Q

Normal contents of umbilical cord

A

2 arteries and 1 vein

59
Q

Normal separation of umbilical cord

A

3 weeks

60
Q

Delayed umbilical cord separation associated with …

A

Leukocyte adhesion deficiency or chronic granule atoms disease

61
Q

Umbilical polyp

A

Small granuloma that occurs at cord separation

62
Q

Normal timeframe for vaginal discharge

A

Up to 1 week

63
Q

MC of blood in vaginal d/c

A

Withdrawal of maternal hormones

64
Q

Normal length of penis

A

3-4cm

65
Q

Normal appearance of scrotum

A

Rugae and pigmentation

66
Q

Hypospadias

A

Contraindication for circumcision

67
Q

Normal timeframe of passing of meconium

A

Within first 12 hours of birth

68
Q

Location of meconium in the bowel

A

Lower colon and anorectal region

69
Q

Common issues caused by meconium in the bowel

A

Obstruction, ulceration, perforation

70
Q

Meconium ileus

A

Lower intestinal obstruction resulting from impaction, associated with CF or perforation

71
Q

Midline abnormalities of spine

A

Dimples, tufts of hair, pillonidal sinuses

72
Q

MC fractures of a newborn

A

Femur, humerus, or clavicles

73
Q

Normal ROM of the hips

A

Hips flexed to 90 degrees and legs can be abducted tunnel the knees touch the table

74
Q

Barlow determines what

A

Whether the femoral head can be displaced from the acetabulum

75
Q

Ortolani determines what

A

If the femoral head can be replaced

76
Q

Phocomelia most commonly caused by

A

Thalidomide use during pregnancy

77
Q

Achondroplasia

A

Short limbs

78
Q

Arthrogryposis multiple congenita is what

A

Severe contractures of multiple joints

79
Q

Mental alertness assessed with

A

Transient eye opening, movement of face and ext

80
Q

Irritability is

A

Inconsolable infant who cries spontaneously

81
Q

Lethargy is

A

Infant doesn’t respond to appropriate stimuli

82
Q

Primary neonatal reflexes

A

Moro reflex, finger grasp, automatic walking, rooting, suck-swallow reflex

83
Q

Tendon reflexes are

A

Biceps, knee, ankle; clonus and babinski are normal

84
Q

Prophylaxis in neonates tests for

A

Neonatal ophthalmia, hemorrhage, hep B, cord care, circumcision if requested

85
Q

MC of neonatal ophthalmia

A

N. gonorrhea

86
Q

Prevention of neonatal ophthalmia

A

Silver nitrate, tetracycline, or erythromycin within 1 hour of birth

87
Q

Prevention of hemorrhagic disease of the newborn

A

Vitamin K IM

88
Q

Hep B prevention

A

Immunization and if mom is +, give HBIG

89
Q

Cord care

A

Leave stump exposed to air, swab with alcohol, avoid moist coverings

90
Q

T/F: Glucose screening is recommended

A

False

91
Q

Glucose level for treatment

A
92
Q

Newborn screening nationwide

A

Hypothyroidism and phenylketonuria

93
Q

Direct Coombs test indicated if

A

Mom is O or Rh negative

94
Q

Jaundice presents as

A

Excess bilirubin in the skin and sclerae

95
Q

Peak level of bilirubin is

A

DOL#4

96
Q

Discharge level of bilirubin in most babies

A

DOL#2

97
Q

Treatment of jaundice

A

Phototherapy and fluids

98
Q

Erythroblastosis fetalis

A

Hemolytic disease of the newborn, maternal antibodies active against RBC antigens of fetus and are passed through placenta

99
Q

Prevention of erythroblastosis fetalis

A

RhoGAM during third trimester and at delivery of D-positive infant

100
Q

Apnea defined as

A

Cessation of airflow for >15-20 seconds

101
Q

ALTE defined as

A

Description of acute, unexpected episode including apnea, color change, marked change in muscle tone, choking or gagging

102
Q

ALTE work up

A

Septic work up, esophageal pH monitoring, EEG, CBC, ABG, tox screen, EKG a

103
Q

SIDS is defined as

A

Unexpected death of an infant younger than 1 year of age with unexplained cause after autopsy, death scene, and review of history; do of exclusion

104
Q

SIDS etiology

A
  1. Underlying vulnerability
  2. Trigger event
  3. Vulnerable development stage of CNS or immune
105
Q

MC of post-neonatal infant death

A

SIDS a

106
Q

Risk factors of SIDS a

A

Young maternal age, maternal smoking, no prenatal care (or late)

107
Q

SIDS protective factors

A

Room-sharing, breastfeeding, pacifier use, fan use, immunization

108
Q

Dermal Melanocytosis is _____

A

Mongolian spot - 90% AA, Indian and Asian infants

109
Q

Bulging fontanelle associated with

A

Hydrocephalus

110
Q

Depressed fontanelle suggests

A

dehydration

111
Q

Large fontanelle suggests

A

hydrocephalus, hypothyroidism, rickets

Peds (16 decks)

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