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11 Neonatology > PE of Newborn > Flashcards

PE of Newborn Flashcards

1
Q

normal frontal circumference at term

A

32-37 cm

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2
Q

normal length at term

A

48-52 cm

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3
Q

normal chest circumference at term

A

30-35 cm

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4
Q

landmarks for head circumference

A

glabella/supraorbital ridge anteriorly

most prominent part of the occiput posteriorly

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5
Q

t/f the new ballard score is performed as soon as possible after initial stabilization or 12 hours after birth

A

true, consists of neuromuscular maturity and physical maturity

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6
Q

components of new ballard score

A

neuromuscular: posture, square window (wrist), arm recoil, popliteal angle, scarf sign, heel to ear
physical: skin, lanugo, plantar surface, breast, eye/ear, genitals

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7
Q

infant classification and maturity by gestational age

A

pre-term <37 w
term 37- 41 6/7 w
post term >42 w

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8
Q

abnormal skin findings in newborn

A 
pallor = low hgb
cyanosis = hypoxemia
plethora = polycythemia, over oxygenated, overheated
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9
Q

jaundice due to elevated bilirubin is most commonly observed beyond ___

A

the first 24 hours of life

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10
Q

clinical estimation of degree of jaundice

A

face only 5-8 mg/dl
face and upper trunk 8-12 mg/dl
lower trunk and extremity >12 mg/dl

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11
Q

t/f acrocyanosis is normal immediately after birth or few hours after birth

A

true, but can also be secondary to cold stress

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12
Q

t/f perioral cyanosis is always abnormal

A

false, common after birth

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13
Q

differential cyanosis points to

A

r-l shunt through pda

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14
Q

harlequin sign may be due to

A

immaturity of hypothalamic center that controls the dilatation of peripheral blood vessels

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15
Q

a reticular, lacy red pattern of the skin, marbled, purplish skin discoloration due to thermoregulation instability

A

cutis marmorata

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16
Q

a greasy white substance covering the skin, provides moisture barrier

A

vernix caseosa

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17
Q

when a baby’s skin resembles parchment

A

collodion infant

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18
Q

tiny sebaceous retention cysts that disappear a few weeks after birth

A

milia

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19
Q

numerous small areas of red skin with a yellow white papule in the center which contain eosinophils

A

erythema toxicum

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20
Q

skin lesion that does not blanch with pressure and does not disappear with time

A

port wine stain

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21
Q

mongolian spots disappear before age

A

4

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22
Q

small, flat, bright red umbilical lesions seen on occipital area, eyelids, and glabella

A

macular hemangioma

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23
Q

microcephaly vs macrocephaly

A

macro > 2 sd above mean

micro < 2-3 sd below mean

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24
Q

rate of hc increase

A

1 cm per month for first year (2 cm/mo for first 3 mo and then slower)

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25
Q

when do the fontanelles close

A

anterior (diamond) 9-18 mos

posterior 2-4 mos

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26
Q

head lesion that crosses the suture line and spontaneously resolves within days

A

caput succedaneum

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27
Q

what is a cephalhematoma

A
  • secondary to rupture of bv that traverse the periosteum
  • does not cross suture lines
  • resolves in 2-3 w
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28
Q

what is molding

A
  • temporary asymmetry of the skull due to birth (prolonged labor)
  • normal in 1 wk
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29
Q

what is subgaleal hematoma

A
  • caused by asphyxia, vacuum extraction, forceps delivery, or coagulopathy
  • crosses suture lines and onto neck/ear
  • progresses after birth
30
Q

congenital cataracts occur due to

A

maternal infection with rubella

31
Q

abnormal findings in the shapes of the eyes

A

lateral upward slope with inner epicanthal fold: trisomy 21

narrow palpebral fissure: fetal alcohol syndrome

32
Q

what is mobius syndrome

A

symmetric facial palsy caused by absence or hypoplasia of 7th nerve nucleus

33
Q

cause of facial nerve palsy

A

compression of facial nerve against sacral promontory or trauma with forceps

34
Q

how to measure position of ears

A

draw imaginary line from inner and outer canthi of eyes across face

35
Q

keratin containing cysts located on the hard and soft palate

A

epstein pearls

36
Q

cystic swelling in the floor of the mouth which disappears spontaneously

A

ranula

37
Q

small lesion on the oral mucosa secondary to trauma to the salivary glands

A

mucocele

38
Q

diseases with macroglossia

A

beckwith’s sydnrome and congenital hypothyroidism

39
Q

the scm is palpated to check for:

A

hematoma, thyroid enlargement, and thyroglossal duct cysts

40
Q

t/f cc should be 5 cm less than hc

A

false, 2 cm

41
Q

normal rr and hr

A

rr 30-60 rpm

hr 120-140 bpm

42
Q

signs of respiratory distress

A

retractions, nasal flaring, grunting, tachypnea

43
Q

absent or unequal breath sounds may indicate ___

A

pneumothorax or atelectasis

44
Q

absent breath sounds with presence of bowel sounds indicates __

A

diaphragmatic hernia

45
Q

t/f a murmur does not always signify the presence of heart disease and absence is not a reassurance of normalcy

A

true

46
Q

the most common murmur in the immediate newborn are ___ that represent thee transition from __ to ___

A

flow murmurs that represent transition from fetal to neonatal circulation

47
Q

scaphoid abdomen is associated with

A

congenital diaphragmatic hernia

48
Q

t/f a smooth scrotum suggests prematurity

A

true

49
Q

normal penile length at birth

A

2 cm, abnormally small = reduced androgen effect

50
Q

t/f hydrocele is uncommon

A

false, it’s common and disappears by 1 year

51
Q

t/f labia minora of term infants are enlarged and reddish in color

A

false, labia majora

52
Q

meconium should pass within ___

A

48 hours of birth

53
Q

abnormalities in the pulses

A

diminished in all extremities = poor co or peripheral vasoconstriction
absent or diminished femoral pulses = coarctation of aorta

54
Q

abnormal pigmentation or hairy patches over lower back suggests

A

spina bifida

55
Q

sacral or pilonidal dimple suggests

A

meningocoele

56
Q

best time to do a neuro exam

A

prior to feeding

57
Q

primitive reflexes

A

check slide

58
Q

t/f fine tremors are abnormal, and clonic movements are normal

A

false, fine tremor is usually normal, clonic movements are not normal and may have seizures

59
Q

erb duchenne paralysis involves

A

5th and 6th cn and is the most common brachial plexus injury (check slide)

60
Q

klumpke paralysis involves

A

7th and 8th cn and 1st thoracic nerve (+ horner’s syndrome)

61
Q

what is physiologic weight loss

A

loss of not more than 10% of body weight and recovered by 2nd week (30g/d)

62
Q

factors suggesting non-physiologic jaundice

A

check slide

63
Q

deep redness or purple lividity in a crying infant whose color may darken profoundly with closure of glottis preceding a vigorous cry

A

vasomotor instability

64
Q

what causes pseudomenses

A

withdrawal of maternal hormones

65
Q

what causes witch’s milk

A

elevated circulating endogenous steroid hormone and withdrawal of androgen after delivery

66
Q

elevations in temp noted on the 2nd-3rd day of life

A

inanition fever

67
Q

cause for inanition fever

A

low intake of fluids or exposed to high environmental temps,

68
Q

t/f 80% of newborns exhibit physiologic desquamation

A

false, 60%

69
Q

umbilical cord sloughs within ___, vessels functionally close but remain patent for ___

A

2 wks

10-20 d

70
Q

t/f normal newborns have higher hg and hct with larger rbcs than older children and adults

A

true

11 Neonatology (9 decks)

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