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Pediatrics Module > PANCE book - Exam of newborn > Flashcards

PANCE book - Exam of newborn Flashcards

1
Q

Ballard score

A

newborn assessment of activity, position, and tone to evaluate neuromuscular and physical maturity

rubric estimates gestational age

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2
Q

Causes of infant’s being small for gestational age

A

maternal drug use, chromosomal abnormality, viral infection, multiple birth, advanced maternal age, placental insufficiency, or lack of maternal weight gain

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3
Q

What is advanced maternal age?

A

> 35 yo

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4
Q

Most common cause of being large for gestational age

A

maternal diabetes

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5
Q

When should complete newborn exam be done?

A

within 24 hrs of birth

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6
Q

erythema toxicum

A

common rash in newborns 3-5 days old

small pustules with erythematous bases

spontaneous resolution in 1-2 wks

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7
Q

milia

A

common newborn rash

very small, white papules mostly on face

resolves w/o treatment in 1-2 months

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8
Q

miliaria

A

common newborn rash; “heat rash”

caused by blockage of eccrine sweat glands, resulting in flushed macular appearance

light clothing and decreased humidity speeds resolution

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9
Q

Mongolian spots

A

blue-black macule concentrated on back and buttocks of dark-skinned infants

most resolve in 4 yrs but may persist for life

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10
Q

craniosynostosis

A

premature fusion of one or more sutures

necessary to refer to neuro

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11
Q

Anterior fontanelle closes around _____ months and posterior fontanelle closes at _____ months.

A

10-26 mon

1-3 mon

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12
Q

If a third fontanelle is seen along sagittal suture this may be associated with ________.

A

Trisomy 21

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13
Q

caput succedaneum

A

fluid accumulation under scalp secondary to birth trauma

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14
Q

subgaleal hemorrhage

A

occurs beneath scalp; uncommon but results in enough blood loss to cause hemorrhagic shock!

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15
Q

How is hearing assessed in newborns?

A

auditory brain stem response or evoked otoacoustic emission testing

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16
Q

Absence of red reflex in infant may suggest what?

A

congenital cataracts, glaucoma, or retinoblastoma

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17
Q

Brushfield spots

A

gray/yellow spots at periphery of iris associated with Down syndrome

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18
Q

subconjunctival hemorrhages in newborns

A

benign finding associated with trauma of delivery; resolves with time

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19
Q

strabismus in newborns

A

“cross eyed”

almost always present in newborn period and is not pathologic unless persists past 4 months

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20
Q

choanal atresia

A
  • unilateral or bilateral nasal obstruction
  • bilateral results in respiratory distress as infants are obligate nasal breathers
  • obstruction confirmed with CT
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21
Q

esophageal atresia presents as..

A

excessive drooling

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22
Q

Epstein pearls

A

small, pearly nodules along midline of hard palate; benign cysts

23
Q

What indicates a submucosal cleft?

A

bifid uvula

24
Q

Mouth findings of trisomy 21 infants

A

large tongue

25
Q

webbed or redundant skin of neck may suggest _________.

A

Turner syndrome

26
Q

Midline/thyroid neck mass finding

A

thyromegaly; congenital hypothyroidism and requires immediate attention to prevent growth failure/cretinism

27
Q

neck mass finding within sternocleidomastoid suggests ________.

A

Torticollis, hematoma

28
Q

signs of respiratory distress

A

grunting, intercostal retractions, tachypnea (+60), cyanosis

29
Q

finding with pneumothorax or diaphragmatic hernia

A

decreased breath sounds unilaterally

pneumothorax would also have mediastinal shift

30
Q

Most common causes of respiratory distress in newborn

A

aspiration, congenital pneumonia, transient tachypnea

31
Q

Concerning findings in heart exam

A

rapid heart rate, cyanosis, CHF, diminished peripheral pulses

*murmurs may or may not be pathologic

32
Q

Prune belly or absence of abdominal musculature may indicate what?

A

renal anomalies

33
Q

What are prominent kidneys suggestive of?

A

hydronephrosis or cystic kidney disease

34
Q

severely scaphoid belly + respiratory distress indicates?

A

diaphragmatic hernia

35
Q

What may delayed stool production (+24 hrs) indicate?

A

Hirschsprung disease

36
Q

signs of neurotubular defect or spina bifida on exam

A

gluteal cleft with pits, birthmarks, or tufts of hair

37
Q

Normal HR at birth to 6 months

A

average 130-140, normal range up to 180-190

38
Q

Avg HR 6-14 years old

A

90

39
Q

respiratory rate at birth

A

30-60 bpm

40
Q

respiratory rate 8-15 yrs old

A

15-25 (similar to adult)

41
Q

When should testes descend?

A

usually at 3 months and 80% by 9 mon; if over 1 year refer to urologist

42
Q

Concerns of prolonged empty scrotal sac?

A

testicular cancer and infertility; refer to endocrinologist

43
Q

hydrocele

A

commonly observed (80% of newborns) collection of fluid in scrotum due to patency of vaginalis process

44
Q

How is hydrocele mass differentiated from inguinal hernia?

A

transillumination

45
Q

Which conditions are commonly associated with ambiguous genitalia?

A 
chromosomal anomalies
adrenal hyperplasia (affects testosterone)
46
Q

How to treat vaginal adhesions in newborns?

A

estrogen or beclomethasone cream x 5-10 days

if doesn’t resolve, refer to urologist

47
Q

Exams to test for developmental hip dislocation

A

Barlow maneuver: adduct fully flexed hip while pushing thigh posteriorly; dislocation + test

Ortolani maneuver: grasp medial aspect of flexed knee and fully abduct hip; feel for spasm or clunk

48
Q

When should newborn’s hip clicking need ultrasound and referral to pediatric ortho?

A
  • If Barlow and/or Ortolani maneuvers are positive

- If hip click persists past 1 month old

49
Q

sucking and rooting reflex

A

earliest reflexes

when face stroked the baby will turn head towards that side and if offered nipple or finger will suckle

50
Q

Moro reflex

A

allow infant’s head to drop 1-2 cm and observe for abduction of shoulders and elbows with spreading and extending of fingers; then adduction and flexion of same

disappears by 3-4 months old

51
Q

grasp reflex

A

placement of finger in palmar or plantar surface elicits grasping response

disappears by 4 months old

52
Q

Babinski reflex of infant

A

test is positive with upgoing plantar

may exist until 2 yo

53
Q

traction response

A

pull infant by arms to sitting position

observe initial head lag, coming briefly to midline, then falling forward

54
Q

Placing reflex

A

when infant dangled over flat surface with toe barely touching, triggers stepping response or extremity flexion

Pediatrics Module (15 decks)

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