Perinatal and Newborn Health Flashcards
Newborn screening tests for hearing
BAER test (Brainstem auditory evoked response) observe response to loud voice/noise
When would you want to repeat the newborn screening blood tests?
- If the baby was initially screened before 24 hours of age
- If the infant appears symptomatic
Newborn screening exam includes
PKU
Galactosemia
Hemoglobinopathies
Congenital hypothyroidism
Barlow and Ortolani
- Used to check for hip dysplasia
- Barlow: femoral head slips/dislocates during ADDUCTION
- Ortolani: click felt as joint relocates during ABDUCTION
How many blood vessels in the umbilical cord?
2 arteries and 1 vein
What disorders could macroglossia suggest?
Hypothyroidism
Down’s syndrome
Mucopolysaccharoidosis
Choanal atresia
Narrowing or blockage of the nasal airway by tissue
What could it mean if sclera is blue?
osteogenesis imperfecta
may appear bluish in premies
Common causes of wide fontanels?
- premie, IUGR
- hypothyroidism
- hydrocephalus
- Down Syndrome
When does the posterior fontanel close?
May not be palpable at birth but should definitely be closed by 2-3 months
How big is the anterior fontanel?
When does it close?
2-5cm
by 18 months
Bossing
- Protuberant forehead
- Suggests Rickets, prematurity
Cephalohematoma
Does NOT cross the midline (blood is under periosteum)
Caput succadeneum
Cone head, crosses midline. Resolves in 2-3 days.
Hemangioma
“Strawberry mark”
shrink and fade after 6 months old, benign
What should be ruled out with port wine stain?
Sturge-Webber (seizures and glaucoma), especially if they come to the midline and go over the eye
Erythema toxicum neonatorum
- Most common newborn rash
- Blotchy red spots with overlying white or yellow pustules
- Appears at day 2-5, resolves by 2 weeks
- Benign
Miliaria
Obstructed sweat glands, “prickly heat”, benign
Newborn vital signs
Temp ≤ 100.4F
Pulse 120-170 BPM
Respirations 30-70 breaths per minute
BP less than 112/74 mmHg (systolic no less than 60)
What is asymmetric IUGR?
head circumference and length are normal, but weight is less than 10th percentile
What is symmetric IUGR?
head circumference, length, and weight are all less than 10th percentile
Definition of “term” baby
Born 37-41 weeks
Average newborn head circumference, weight, and length
13-14 inches head circumference
7 pounds
20-21 inches in length
Age of newborn viability?
Age of newborn viability PLUS lung maturity?
24 weeks
34 weeks
APGAR
Appearance, Pulse, Grimace, Activity, Respirations
Scored at 1 and 5 minutes
How can hypothyroidism affect infants?
What are some physical signs of hypothyroidism?
- mental retardation, neurologic and metabolic abnormalities
- macroglossia, wide fontanels
plethora
ruddy/blotchy skin associated with too many RBCs (polycythemia)
How many newborns have heart murmurs?
Up to 85 percent
