Perinatal and Newborn Health

Question 1

Newborn screening tests for hearing

Answer 1

BAER test (Brainstem auditory evoked response)
observe response to loud voice/noise

Question 2

When would you want to repeat the newborn screening blood tests?

Answer 2

• If the baby was initially screened before 24 hours of age

- If the infant appears symptomatic

Question 3

Newborn screening exam includes

Answer 3

PKU
Galactosemia
Hemoglobinopathies
Congenital hypothyroidism

Question 4

Barlow and Ortolani

Answer 4

• Used to check for hip dysplasia
• Barlow: femoral head slips/dislocates during ADDUCTION
• Ortolani: click felt as joint relocates during ABDUCTION

Question 5

How many blood vessels in the umbilical cord?

Answer 5

2 arteries and 1 vein

Question 6

What disorders could macroglossia suggest?

Answer 6

Hypothyroidism
Down’s syndrome
Mucopolysaccharoidosis

Question 7

Choanal atresia

Answer 7

Narrowing or blockage of the nasal airway by tissue

Question 8

What could it mean if sclera is blue?

Answer 8

osteogenesis imperfecta

may appear bluish in premies

Question 9

Common causes of wide fontanels?

Answer 9

• premie, IUGR
• hypothyroidism
• hydrocephalus
• Down Syndrome

Question 10

When does the posterior fontanel close?

Answer 10

May not be palpable at birth but should definitely be closed by 2-3 months

Question 11

How big is the anterior fontanel?

When does it close?

Answer 11

2-5cm

by 18 months

Question 12

Bossing

Answer 12

• Protuberant forehead

- Suggests Rickets, prematurity

Question 13

Cephalohematoma

Answer 13

Does NOT cross the midline (blood is under periosteum)

Question 14

Caput succadeneum

Answer 14

Cone head, crosses midline. Resolves in 2-3 days.

Question 15

Hemangioma

Answer 15

“Strawberry mark”

shrink and fade after 6 months old, benign

Question 16

What should be ruled out with port wine stain?

Answer 16

Sturge-Webber (seizures and glaucoma), especially if they come to the midline and go over the eye

Question 17

Erythema toxicum neonatorum

Answer 17

• Most common newborn rash
• Blotchy red spots with overlying white or yellow pustules
• Appears at day 2-5, resolves by 2 weeks
• Benign

Question 18

Miliaria

Answer 18

Obstructed sweat glands, “prickly heat”, benign

Question 19

Newborn vital signs

Answer 19

Temp ≤ 100.4F
Pulse 120-170 BPM
Respirations 30-70 breaths per minute
BP less than 112/74 mmHg (systolic no less than 60)

Question 20

What is asymmetric IUGR?

Answer 20

head circumference and length are normal, but weight is less than 10th percentile

Question 21

What is symmetric IUGR?

Answer 21

head circumference, length, and weight are all less than 10th percentile

Question 22

Definition of “term” baby

Answer 22

Born 37-41 weeks

Question 23

Average newborn head circumference, weight, and length

Answer 23

13-14 inches head circumference
7 pounds
20-21 inches in length

Question 24

Age of newborn viability?

Age of newborn viability PLUS lung maturity?

Answer 24

24 weeks

34 weeks

Question 25

APGAR

Answer 25

Appearance, Pulse, Grimace, Activity, Respirations

Scored at 1 and 5 minutes

Question 26

How can hypothyroidism affect infants?

What are some physical signs of hypothyroidism?

Answer 26

• mental retardation, neurologic and metabolic abnormalities

- macroglossia, wide fontanels

Question 27

plethora

Answer 27

ruddy/blotchy skin associated with too many RBCs (polycythemia)

Question 28

How many newborns have heart murmurs?

Answer 28

Up to 85 percent