Perinatal/Newborn Health Screening Flashcards
Through what age is the prenatal history particularly important?
3 years
Low birth weight (LBW)
<2,500 g
Very low birth weight (VLBW)
<1,500 g
Extremely low birth weight (ELBW)
<1,000 g
Appropriate for gestational age (AGA) is between which percentiles?
10th - 90th percentiles
How long does a small for gestational age baby have to catch up?
2 years
What does APGAR stand for?
A - Appearance P - Pulse G - Grimace A - Activity R - Respirations
What is the timing of APGAR scoring?
1 and 5 minutes of life
What is the maximum APGAR score?
10
APGAR -
Number of potential scores per category?
3 total -
they are 0, 1, 2
What is the span in weeks of a “term” infant?
37 - 41 weeks
less is premature
more is post-term
Newborn -
average length
average weight
average head circumference
20-21 inches (51 cm)
7 lbs (3,100 g)
13-14 inches (33-35 cm)
Newborn -
Small for gestational age (SGA) - what are the two types and which is more common?
Symmetric IUGR
Asymmetric IUGR* (more common)
Newborn -
Symmetric IUGR
definition and examples
size parameters are all <10th percentile
usually suggests long term compromise or presence of intrinsic problem
genetic anomaly
environment (drugs, nicotine)
Newborn -
Asymmetric IUGR
definition and examples
head circ and length are normal, weight is < 10%
(usually occurs after 24 weeks)
maternal hypertension
cyanotic heart disease
multiple gestation
altitude
Newborn -
Large for gestational age (LGA)
definition and examples
> 90th percentile for weight
maternal diabetes
Beckwith-Weidemann
large mother
Newborn - vital signs temp normal pulse respirations blood pressure
temp < 38
120 - 170 BPM
30 - 60 resp
<112/74
Newborn -
acrocyanosis
cyanosis of the extremeties (normal)
Newborn -
plethora
may indicate? risk for?
splotchy redness
DOES involve mucosal, palmar, and plantar surfaces
often indicates polycythemia (too many RBC)
risk for stroke
Newborn -
milia
pinpoint papules on face
spontaneous resolution by 3-4 weeks of life
Newborn -
miliaria
obstructed sweat glands
also known as “prickly heat”
(“has an R in there, must be red”)
Newborn -
erythema toxicum
most common newborn rash - appears day 2-5
red bloches that BLANCH with overlying papules
NO involvement of mucosa, palmar, and plantar surfaces
resolves by 14th day
Newborn -
cafe au lait spots
not normally seen in newborn
> 5 indicative of neurofibromatosis
Newborn -
junctional nevi
…if there are many, can be indicative of:
tuberous sclerosis
xeroderma pigmentosus
generalized neurofibromatosis
Newborn -
mongolian spots - how long do they last?
up to age 3-5 years
Newborn -
port wine stain - can be associated with what?
seizures and glaucoma
r/o sturge-webber
Newborn -
“strawberry mark” aka
resolve when?
hemangioma
normal begin to shrink and fade at 6 months of age
Primitive reflexes -
first to disappear?
stepping reflex disappears at 1 -2 months
Primitive reflexes -
disappearing in 3 - 4 month range
rooting
sucking
moro
tonic neck
Primitive reflexes -
when does the GRASP reflex disappear - palmar? plantar?
palmar grasp disappears at 3 - 6 months
plantar grasp disappears at 4 months
Primitive reflexes -
which is the last to disappear?
babinski disappears at 12 months or when walking
Newborn -
which post-birth head condition CROSSES THE MIDLINE?
caput succedaneum
simple swelling, resolves in 2-3 days
Newborn -
which post birth head condition does NOT cross the midline?
cephalohematoma
blood under periosteum, takes much longer to resolve
Newborn -
with what condition can white forelocks sometimes be associated?
Waardenburng syndrome - deafness and retardation
Newborn -
Which of the fontanels is larger and when does it close?
the anterior is larger (2 - 5 cm)
closes by 18 months
Newborn -
When does the posterior fontanel close?
closes by 2 - 3 months
may not be palpable at birth
Newborn -
common causes of widened fontanels?
prematurity IUGR Hydrocephalus Down syndrome Hypothyroidism
Newborn -
what does a black spot in the place of the red reflex indicate?
No clear pathway from lens to retina
Newborn -
what dose a whitish color in the place of the red reflex indicate?
could be retinoblastoma or congenital cataracts
Newborn -
choanal atresia
narrowing or blockage of the nasal airway by tissue, present at birth
Newborn -
epstein pearls - benign or malignant?
benign
Newborn -
pulse ox check - particulars and significance?
Pulse ox in all four extremeties
> 2% difference among any is signficant
Newborn -
normal abdomen shape?
protruberant
Newborn -
% with murmur?
85%
Newborn -
number of arteries/veins in umbilical cord?
2 arteries
1 vein
Newborn -
% of males with undescended testicles?
3%
Newborn -
Barlow’s
Ortalani’s
Galeazzi
Need more info here
Newborn -
all 50 states require which newborn screening blood tests?
PKU
galactosemia
hemoglobinopathies
congenital hypothyroidism
Newborn -
what are reasons a newborn might be rescreened?
if initial testing is done before 24 hours of life
if infant is symptomatic
Newborn -
inborn errors of metabolism
phenylketonuria (PKU)
galactosemia
Newborn -
what can HYPOTHYROIDISM in the newborn cause?
mental retardation
neurologic abnormalities
metabolic abnormalities
Newborn -
typical presentation of CMV
microcephaly and hearing loss
Newborn -
typical presentation of RUBELLA
cardiovascular and ophthalmic complications
