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General Medicine & Family Medicine > Paediatrics/ Newborn and Infants > Flashcards

Paediatrics/ Newborn and Infants Flashcards

1
Q

What is a term infant?

A

A baby born between 37-weeks and 42-weeks gestation

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2
Q

What is a term Premature?

A

Less than 37 weeks

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3
Q

What is a term Postterm?

A

More than 42 weeks

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4
Q

When are Apgar scores measured?

A

At 1 and 5 minutes after birth

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5
Q

When should Apgar scores be repeated if the initial scores are less than 7?

A

At 10, 15, and 20 minutes after birth

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6
Q

What are the five Apgar categories?

A
  1. Heart rate
  2. Respiratory effort
  3. Muscle tone
  4. Reflex irritability
  5. Color
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7
Q

What is the maximum number of points on the Apgar score?

A

There are up to 2 points in each category for a maximum of 10 points.

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8
Q

How many vessels does a normal umbilical cord have?

A

Three (two arteries and one vein)

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9
Q

How long does it typically take an umbilical cord stump to fall off?

A

1-3 weeks

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10
Q

How should the umbilical cord be maintained?

A
  • Air dry by keeping the diaper below the umbilicus
  • alcohol is not recommended
  • bathe the baby with a sponge bath but do not immerse the abdomen in water.
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11
Q

What is the typical weight of a healthy newborn?

A

2.5-4 kg

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12
Q

What is the typical Length?

A

46-54 cm

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13
Q

What is the typical Head circumference?

A

32-38 cm

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14
Q

What is the definition of low birth weight (LBW)?

A

Less than 2500 g at birth

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15
Q

What are the causes of LBW?

A
  • Intrauterine growth restriction (IUGR)
  • prematurity
  • normal variant
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16
Q

What is the predominant cause of LBW in the United States?

A

Prematurity

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17
Q

What are the factors associated with IUGR (estimated fetal weight <10th percentile)?

A
  • Genetic abnormalities
  • multiple gestation
  • fetal insulin deficiency
  • placental insufficiency
  • maternal disease (eg, HTN, sickle cell disease)
  • drug use
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18
Q

What is large for gestational age (LGA)?

A

Larger than 90th percentile for gestational age

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19
Q

What is the weight of a term LGA baby?

A

More than 4000 g

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20
Q

What is the most common cause of LGA babies?

A

Maternal diabetes

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21
Q

Normal newborns may lose up to what percentage of their weight in the first week of life?

A

Up to 10%

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22
Q

A healthy baby should regain this weight by how many weeks of life?

A

2 weeks

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23
Q

In the first couple of months, about how much weight should a baby gain per day?

A

1 oz (or 28 g)

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24
Q

A normal baby’s respiratory rate and heart rate are slower than those of a normal adult. True or false?

A

False

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25
Q

A normal baby’s blood pressure is lower than that of a normal adult. True or false?

A

True

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26
Q

Doing a good initial heart examination rules out heart abnormalities. True or false? Why?

A

False

Some abnormalities may not be evident initially (eg, high pulmonary artery [PA] pressures on day one may diminish L → R shunting, so murmur of a ventral septal defect [VSD] is not appreciable)

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27
Q

When does the anterior fontanelle close?

A

During second year of life

28
Q

When does the Posterior fontanelle close?

A

First few months of life

29
Q

What is head “molding” in a newborn?

A

Irregularly shaped head with palpable ridges

30
Q

What causes head “molding” in a newborn?

A

Pressure in the birth canal during labor and delivery

31
Q

How long does head “molding” of newborn normally last?

A

It should disappear within a week

32
Q

What is caput succedaneum?

A

Diffuse soft tissue edema of the scalp

33
Q

What causes caput succedaneum?

A

Pressure on presenting part of scalp during delivery

34
Q

Does caput succedaneum require treatment?

A

No. It resolves on its own in a few days.

35
Q

What is cephalohematoma?

A

Hemorrhage below the lining of the bones of the skull

36
Q

What usually causes cephalohematoma?

A

Small tearing of vessels during delivery

37
Q

What are worrisome causes of cephalohematoma?

A
  • Skull fracture
  • coagulopathy
  • intracerebral hemorrhage
38
Q

What kind of treatment does an uncomplicated cephalohematoma require?

A

Usually none (resolves on its own), but the baby may need treatment for hyperbilirubinemia from blood resorption

39
Q

Which crosses suture lines, cephalohematoma or caput succedaneum?

A

Caput succedaneum

40
Q

What does an absent red reflex indicate?

A

Something is inhibiting light from getting to the retina (eg, cataract, tumor)

41
Q

Intermittent strabismus is normal until what age?

A

3 months

42
Q

What test on physical exam can assess ocular alignment?

A

The Hirschberg corneal light reflex test

43
Q

How is the The Hirschberg corneal light reflex test performed?

A

The examiner notes the position of the corneal reflection from a light held 3 feet away from both eyes. Even with eye movement, the light should reflect in the same location of the cornea in each eye.

44
Q

What will you see with left exotropia (left eye deviated laterally) in the Hirschberg corneal light reflex test?

A

The corneal reflection on the right will be over the pupil while the reflection on the left will be over the medial iris.

45
Q

What is pseudostrabismus?

A

The perception of medial deviation (esotropia)

46
Q

What contributes to pseudostrabismus?

A

Prominent medial canthal folds and a flat nasal bridge

47
Q

What is the most common birth defect?

A

Hearing loss

48
Q

What procedures are available to screen infants for hearing loss?

A

Measurement of otoacoustic emissions (OAEs) and/or auditory brain response (ABR)

49
Q

All infants should be screened for hearing loss by what age?

A

1 month of age

50
Q

Why is it so important to test for hearing loss in infants?

A

Hearing loss can significantly delay a child’s development, especially language acquisition.

51
Q

Small, low-set, or floppy ears may be a sign of what other abnormalities?

A
  • Chromosomal abnormality, renal abnormality
52
Q

A common benign newborn rash consisting of small white papules on a blotchy erythematous base is called what?

A

erythema toxicum

53
Q

What is the required treatment for erythema toxicum?

A

None (disappears on its own)

54
Q

A female baby has swollen nipples and white vaginal discharge with a tinge of blood. Is this normal? What is the cause?

A

Yes.

Baby’s exposure to maternal hormones

55
Q

What is the American Academy of Pediatrics’ stance on routine circumcision?

A

Not medically necessary

56
Q

The Ortolani and Barlow maneuvers test for what abnormality?

A

Developmental hip dysplasia

57
Q

What are some late diagnostic signs of developmental hip dysplasia?

A

Asymmetry of the following:

  • thigh folds
  • hip abduction and/or
  • knee height
58
Q

Lumbosacral dimples or hair tufts are concerning for what type of abnormality?

A

Underlying vertebral/spinal cord abnormality (eg, neural tube defect)

59
Q

Does stroking the sole of the foot normally cause an infant’s toes to go up or down?

A

Up

60
Q

Stroking a newborn’s cheek causes him to turn his head to the same side and make sucking motions with his mouth. What is this called?

A

Rooting reflex

61
Q

When does the Moro reflex (startle reflex) normally disappear?

A

3-4 months

62
Q

Every US state has a newborn screening program for metabolic and other inherited disorders. True or false?

A

True

63
Q

Most state newborn screens include testing for what disorders?

A

Hypothyroidism, phenylketonuria, galactosemia, sickle cell disease

64
Q

What is the most common chromosomal abnormality?

A

Down syndrome (Trisomy 21)

65
Q

What are the most frequent causes of death in infants (<12 months old)?

A
  • Sudden infant death syndrome (SIDS)
  • perinatal conditions (eg, complications of prematurity)
  • congenital abnormalities
  • chromosomal abnormalities
66
Q

About how many hours does a newborn sleep per 24 hours?

A

16-20

Tip: when you begin examining a newborn and s/he is not crying, take advantage of the opportunity to auscultate the heart and lungs and check for a red reflex.

General Medicine & Family Medicine (150 decks)

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