Newborn H&P

Question 1

APGAR Scores

Answer 1

Acquired at 1 and 5 minutes following
birth

Heart rate
Respiratory effort
Muscle tone
Reflex irritability
Skin color

7-10: no vigorous resuscitation required
4-6: requires stimulation and O2
0-3: requires assisted ventilation & possible cardiopulmonary support

Question 2

Normal hemoglobin in newborn

Answer 2

16-17g/dl

Question 3

Cutis Marmorata

Answer 3

normal skin finding: mottled appearance that will disappear over time

Question 4

Vernix Caseosa

Answer 4

normal skin finding: white to yellow waxy covering in newborns, most abundant in the creases and flexor surfaces

Question 5

Lanugo

Answer 5

normal skin finding: downy hair covering the body, more common with prematurity

Question 6

Erythema toxicum:

Answer 6

normal skin finding: Benign rash characterized by fleeting erythematous papules and pustules filled with eosinophils. Usually predominates on face and chest. Appears 1-14 days after birth and disappears over several days to weeks.

Question 7

Sebaceous gland hyperplasia:

Answer 7

normal skin finding: small yellow papules that are often seen over the nose and cheek; these disappear spontaneously

Question 8

Acne Neonatorum

Answer 8

normal skin finding: acne appearance likely from maternal hormonal influence, may take several months to disappear

Question 9

Mongolian spots

Answer 9

normal skin finding: bluish black macular lesions usually over lumbrosacral area. Seen in most native American, black, and Asian infants. This is NOT a bruise!

Question 10

Strawberry or capillary hemangiomas:

Answer 10

Perhaps worrisome: elevated collections of capillaries, variable appearance
Grow for 3-7 months, stabilize, then at about one year begin to involute. Patient usually without scar or blemish by five years of age
Leave these alone unless on the eyelid in which consult with ophthalmologist required

Question 11

Caput succedaneum

Answer 11

boggy swelling in subcutaneous tissues which crosses the suture lines. Head compression against cervix impedes venous return, reabsorbs within 1 to 3 days

Question 12

Cephalohematoma

Answer 12

blood collected below the periosteum and therefore confined to a single bone, will NOT cross the suture line
Not typically apparent until 24-48 hours after birth
Almost always parietal bone, usually results from fracture
Takes 4 weeks to resolve

Question 13

Average respiratory rate

Answer 13

40 Breaths Per minute

Question 14

Pulse

Answer 14

120-180 bpm

Question 15

Metatarsus Adductus

Answer 15

forefoot adduction, usually from intrauterine crowding (*intrauterine crowding causes an increased risk for Developmental Dysplasia of hip). The key with this is whether the foot can be straightened easily. If so, no tx necessary. If rigid, requires ortho consult for cosmo surgery

Question 16

Moro reflex

Answer 16

Dropping baby down (while supporting head and neck) symmetric abduction and extension
This is absent on the side of an Brachial Plexus Palsy

Question 17

Grasp reflex

Answer 17

Placing index finger in palm of hand will elicit grasp

Question 18

Plantar reflex

Answer 18

Touching base of toes causes toes to curl downward, same as grasp reflex

Question 19

Rooting reflex

Answer 19

Stroking the cheek will cause infant will turn head towards stimulus and open mouth

Question 20

Stepping reflex

Answer 20

When placed in standing position, will elicit stepping reflex