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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
Craniosynostosis
Premature closing of the sutures
26
Fontanelle presentation
Ant:
27
Cephalohematoma
Doesn't cross the suture lines
28
Caput succedaneum
Crosses suture lines
29
Pupillary response to light present at ______
28 weeks gestation
30
Leukocoria
Always abnormal, white reflex not red; could be caused by retinoblastoma, cataracts, persistent hyperplastic primary vitreous, retinal coloboma, chorio, retinopathy of primi
31
Preauricular pits
Common, deafness common if hereditary link
32
TM Presentation
Dull gray immobile
33
Choanal atresia
Unilateral or bilateral anatomical obstruction
34
Epstein pearls
Normal collection of epithelial cells in the mouth
35
Ranula
Benign mass of floor of tongue
36
Protruding tongue
Abnormal, associated with hemangioma, isolated macroglossia, hypothyroidism, Downs, Beckwith-Wiedemann
37
Ebbing and webbing suggest what?
Turner's syndrome
38
Erb's paralysis presentation
5th and 6th cervical root, spontaneously resolves
39
Klumpke Paralysis
8th cervical and 1st thoracic brachial plexus, claw-hand
40
Horner syndrome presentation
Ptosis, miosis, enopthalmos, and delayed pigmentation of the skin, injury to sympathetic fibers of T1
41
Supernumerary nipples
Common but may be associated with renal abnormalities
42
Widely spaced nipples with shield like chest associated with ...
Turners syndrome
43
Time frame for normal auscultation of rales
1-2 hours
44
Thoracoabdominal asynchrony
Airway obstruction or stiff lungs
45
Persistent coughing is indicative of ....
Viral pneumonia
46
Location of PMI
4-5th intercostal space left of sternum (more midline than older children)
47
Sustained bradycardia is indicated of ...
Asphyxia, increased ICP, hypothyroidism, congenital heart disease, heart block
48
Sustained tachycardia indicates ...
Fever, hypo olefin, drug withdrawal, congenital heart disease, tachyarrhythmias, anemia, hyperthyroidism
49
Investigate any murmur with ...
Cyanosis, evidence of poor perfusion, tachypnea, persistent past first day
50
Where to evaluate pulses in neonate a
Brachial and femoral to r/o coarctation
51
Location of liver in normal baby
1-2cm below right costal margin
52
Location of spleen in normal baby
No more that 1cm below left costal margin
53
First urination must occur within what time frame
24 hours of life
54
Diastasis recti
Will close after one year
55
Omphalocele
Abd contents pass through a peri umbilical defect near cord, covered by membrane
56
Gastroschisis
Defect d/t primary failure of lat central folds leading to small and large intestine sitting outside abd, not membrane bound
57
Prune belly
Absence of ant wall musculature, associated with urinary tract anomalies and cryptochidism
58
Normal contents of umbilical cord
2 arteries and 1 vein
59
Normal separation of umbilical cord
3 weeks
60
Delayed umbilical cord separation associated with ...
Leukocyte adhesion deficiency or chronic granule atoms disease
61
Umbilical polyp
Small granuloma that occurs at cord separation
62
Normal timeframe for vaginal discharge
Up to 1 week
63
MC of blood in vaginal d/c
Withdrawal of maternal hormones
64
Normal length of penis
3-4cm
65
Normal appearance of scrotum
Rugae and pigmentation
66
Hypospadias
Contraindication for circumcision
67
Normal timeframe of passing of meconium
Within first 12 hours of birth
68
Location of meconium in the bowel
Lower colon and anorectal region
69
Common issues caused by meconium in the bowel
Obstruction, ulceration, perforation
70
Meconium ileus
Lower intestinal obstruction resulting from impaction, associated with CF or perforation
71
Midline abnormalities of spine
Dimples, tufts of hair, pillonidal sinuses
72
MC fractures of a newborn
Femur, humerus, or clavicles
73
Normal ROM of the hips
Hips flexed to 90 degrees and legs can be abducted tunnel the knees touch the table
74
Barlow determines what
Whether the femoral head can be displaced from the acetabulum
75
Ortolani determines what
If the femoral head can be replaced
76
Phocomelia most commonly caused by
Thalidomide use during pregnancy
77
Achondroplasia
Short limbs
78
Arthrogryposis multiple congenita is what
Severe contractures of multiple joints
79
Mental alertness assessed with
Transient eye opening, movement of face and ext
80
Irritability is
Inconsolable infant who cries spontaneously
81
Lethargy is
Infant doesn't respond to appropriate stimuli
82
Primary neonatal reflexes
Moro reflex, finger grasp, automatic walking, rooting, suck-swallow reflex
83
Tendon reflexes are
Biceps, knee, ankle; clonus and babinski are normal
84
Prophylaxis in neonates tests for
Neonatal ophthalmia, hemorrhage, hep B, cord care, circumcision if requested
85
MC of neonatal ophthalmia
N. gonorrhea
86
Prevention of neonatal ophthalmia
Silver nitrate, tetracycline, or erythromycin within 1 hour of birth
87
Prevention of hemorrhagic disease of the newborn
Vitamin K IM
88
Hep B prevention
Immunization and if mom is +, give HBIG
89
Cord care
Leave stump exposed to air, swab with alcohol, avoid moist coverings
90
T/F: Glucose screening is recommended
False
91
Glucose level for treatment
92
Newborn screening nationwide
Hypothyroidism and phenylketonuria
93
Direct Coombs test indicated if
Mom is O or Rh negative
94
Jaundice presents as
Excess bilirubin in the skin and sclerae
95
Peak level of bilirubin is
DOL#4
96
Discharge level of bilirubin in most babies
DOL#2
97
Treatment of jaundice
Phototherapy and fluids
98
Erythroblastosis fetalis
Hemolytic disease of the newborn, maternal antibodies active against RBC antigens of fetus and are passed through placenta
99
Prevention of erythroblastosis fetalis
RhoGAM during third trimester and at delivery of D-positive infant
100
Apnea defined as
Cessation of airflow for >15-20 seconds
101
ALTE defined as
Description of acute, unexpected episode including apnea, color change, marked change in muscle tone, choking or gagging
102
ALTE work up
Septic work up, esophageal pH monitoring, EEG, CBC, ABG, tox screen, EKG a
103
SIDS is defined as
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
SIDS etiology
1. Underlying vulnerability 2. Trigger event 3. Vulnerable development stage of CNS or immune
105
MC of post-neonatal infant death
SIDS a
106
Risk factors of SIDS a
Young maternal age, maternal smoking, no prenatal care (or late)
107
SIDS protective factors
Room-sharing, breastfeeding, pacifier use, fan use, immunization
108
Dermal Melanocytosis is _____
Mongolian spot - 90% AA, Indian and Asian infants
109
Bulging fontanelle associated with
Hydrocephalus
110
Depressed fontanelle suggests
dehydration
111
Large fontanelle suggests
hydrocephalus, hypothyroidism, rickets

Peds (16 decks)

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