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NP > Perinatal/Newborn Health Screening > Flashcards

Perinatal/Newborn Health Screening Flashcards

1
Q

Through what age is the prenatal history particularly important?

A

3 years

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2
Q

Low birth weight (LBW)

A

<2,500 g

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3
Q

Very low birth weight (VLBW)

A

<1,500 g

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4
Q

Extremely low birth weight (ELBW)

A

<1,000 g

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5
Q

Appropriate for gestational age (AGA) is between which percentiles?

A

10th - 90th percentiles

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6
Q

How long does a small for gestational age baby have to catch up?

A

2 years

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7
Q

What does APGAR stand for?

A 
A - Appearance
P - Pulse
G - Grimace
A - Activity 
R - Respirations
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8
Q

What is the timing of APGAR scoring?

A

1 and 5 minutes of life

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9
Q

What is the maximum APGAR score?

A

10

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10
Q

APGAR -

Number of potential scores per category?

A

3 total -

they are 0, 1, 2

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11
Q

What is the span in weeks of a “term” infant?

A

37 - 41 weeks

less is premature
more is post-term

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12
Q

Newborn -
average length
average weight
average head circumference

A

20-21 inches (51 cm)
7 lbs (3,100 g)
13-14 inches (33-35 cm)

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13
Q

Newborn -

Small for gestational age (SGA) - what are the two types and which is more common?

A

Symmetric IUGR

Asymmetric IUGR* (more common)

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14
Q

Newborn -
Symmetric IUGR
definition and examples

A

size parameters are all <10th percentile

usually suggests long term compromise or presence of intrinsic problem

genetic anomaly
environment (drugs, nicotine)

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15
Q

Newborn -
Asymmetric IUGR
definition and examples

A

head circ and length are normal, weight is < 10%
(usually occurs after 24 weeks)

maternal hypertension
cyanotic heart disease
multiple gestation
altitude

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16
Q

Newborn -
Large for gestational age (LGA)
definition and examples

A

> 90th percentile for weight

maternal diabetes
Beckwith-Weidemann
large mother

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17
Q 
Newborn - vital signs
temp
normal pulse
respirations
blood pressure
A

temp < 38
120 - 170 BPM
30 - 60 resp
<112/74

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18
Q

Newborn -

acrocyanosis

A

cyanosis of the extremeties (normal)

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19
Q

Newborn -
plethora

may indicate? risk for?

A

splotchy redness

DOES involve mucosal, palmar, and plantar surfaces

often indicates polycythemia (too many RBC)
risk for stroke

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20
Q

Newborn -

milia

A

pinpoint papules on face

spontaneous resolution by 3-4 weeks of life

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21
Q

Newborn -

miliaria

A

obstructed sweat glands

also known as “prickly heat”

(“has an R in there, must be red”)

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22
Q

Newborn -

erythema toxicum

A

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

23
Q

Newborn -

cafe au lait spots

A

not normally seen in newborn

> 5 indicative of neurofibromatosis

24
Q

Newborn -
junctional nevi
…if there are many, can be indicative of:

A

tuberous sclerosis
xeroderma pigmentosus
generalized neurofibromatosis

25
Q

Newborn -

mongolian spots - how long do they last?

A

up to age 3-5 years

26
Q

Newborn -

port wine stain - can be associated with what?

A

seizures and glaucoma

r/o sturge-webber

27
Q

Newborn -
“strawberry mark” aka
resolve when?

A

hemangioma

normal begin to shrink and fade at 6 months of age

28
Q

Primitive reflexes -

first to disappear?

A

stepping reflex disappears at 1 -2 months

29
Q

Primitive reflexes -

disappearing in 3 - 4 month range

A

rooting
sucking
moro
tonic neck

30
Q

Primitive reflexes -

when does the GRASP reflex disappear - palmar? plantar?

A

palmar grasp disappears at 3 - 6 months

plantar grasp disappears at 4 months

31
Q

Primitive reflexes -

which is the last to disappear?

A

babinski disappears at 12 months or when walking

32
Q

Newborn -

which post-birth head condition CROSSES THE MIDLINE?

A

caput succedaneum

simple swelling, resolves in 2-3 days

33
Q

Newborn -

which post birth head condition does NOT cross the midline?

A

cephalohematoma

blood under periosteum, takes much longer to resolve

34
Q

Newborn -

with what condition can white forelocks sometimes be associated?

A

Waardenburng syndrome - deafness and retardation

35
Q

Newborn -

Which of the fontanels is larger and when does it close?

A

the anterior is larger (2 - 5 cm)

closes by 18 months

36
Q

Newborn -

When does the posterior fontanel close?

A

closes by 2 - 3 months

may not be palpable at birth

37
Q

Newborn -

common causes of widened fontanels?

A 
prematurity
IUGR
Hydrocephalus
Down syndrome
Hypothyroidism
38
Q

Newborn -

what does a black spot in the place of the red reflex indicate?

A

No clear pathway from lens to retina

39
Q

Newborn -

what dose a whitish color in the place of the red reflex indicate?

A

could be retinoblastoma or congenital cataracts

40
Q

Newborn -

choanal atresia

A

narrowing or blockage of the nasal airway by tissue, present at birth

41
Q

Newborn -

epstein pearls - benign or malignant?

A

benign

42
Q

Newborn -

pulse ox check - particulars and significance?

A

Pulse ox in all four extremeties

> 2% difference among any is signficant

43
Q

Newborn -

normal abdomen shape?

A

protruberant

44
Q

Newborn -

% with murmur?

A

85%

45
Q

Newborn -

number of arteries/veins in umbilical cord?

A

2 arteries

1 vein

46
Q

Newborn -

% of males with undescended testicles?

A

3%

47
Q

Newborn -
Barlow’s
Ortalani’s
Galeazzi

A

Need more info here

48
Q

Newborn -

all 50 states require which newborn screening blood tests?

A

PKU
galactosemia
hemoglobinopathies
congenital hypothyroidism

49
Q

Newborn -

what are reasons a newborn might be rescreened?

A

if initial testing is done before 24 hours of life

if infant is symptomatic

50
Q

Newborn -

inborn errors of metabolism

A

phenylketonuria (PKU)

galactosemia

51
Q

Newborn -

what can HYPOTHYROIDISM in the newborn cause?

A

mental retardation
neurologic abnormalities
metabolic abnormalities

52
Q

Newborn -

typical presentation of CMV

A

microcephaly and hearing loss

53
Q

Newborn -

typical presentation of RUBELLA

A

cardiovascular and ophthalmic complications

NP (76 decks)

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