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DRT PEDS > Prenatal > Flashcards

Prenatal Flashcards

1
Q

Prenatal History

A

consists
-review of pregnancy
-past pregnancies
-mothers and fathers medical and genetic histories

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2
Q

Pregnant History

A

-determine is mother used any foreign substances
-xenobiotics
-medications
-any health problems the mother experienced during pregnancy (placenta previa, abruptio placentae, gestational diabetes, HTN)

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3
Q

Review of past pregnancies

A

-hx of congenital anomalies, still birth, genetic disorders

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4
Q

Perinatal History

A

-newborns weight, height, and Apgar score
-duration of labor
-use of analgesia or anesthesia
-type of delivery
-complications
-prolonged labor, meconium, staining or aspiration, use of forceps or vacuum

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5
Q

Apgar Score

A

-recored at 1 min and 5min after birth
-total of 10 points
-each test receives 0, 1, or 2
-repeat test every 5 min for 20min or until scores are above 7 in two consecutive tests

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6
Q

low Birth Weight of newborn

A

Low birth weight (LBW): <2,500g
very low birth weight (VLBW): <1,500g
Extremely low birth weight (ELBW): <1,000g

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7
Q

Average Height and Weight of newborns

A

length 51cm
head circumference 35cm
Males- 3.6kg
Females- 3.5kg

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8
Q

best out comes for newborns. at what gestational age?

A

born at 37-41 weeks

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9
Q

Premature and post-term gestational age?

A

premature before 37weeks
post-term after 42 weeks

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10
Q

LGA (large for gestation age)

A

-genetic risk factors: Beckwith-Wiedemann syndrome, Simpson-Golabi Behmel syndrome
-Maternal risk factors include maternal diabetes, and maternal obesity.

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11
Q

SGA (small for gestation age)

A

-intrauterine growth restrictions (IUGR)

caused by:
-maternal, placental, or neonatal factors
-maternal starvation, medical disorders, substance abuse, and intrauterine infection
-Placental injuries and structural anomalies
-Neonatal factors are inborn errors of metabolism, genetic syndromes, karyotypic abnormalities

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12
Q

2 types of SGA ?

A

Asymmetric IUGR
-head and length WNL
-Weight below 10th percentile

Symmetric IUGR
-reducation in both body and head growth
-intrinsic factors are the cause

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13
Q

Asymmetric IUGR

A

reductions of fetal nutrients:
-chronic HTN
-pre-eclampsia
-renal or cyanotic heart disease
-hemoglobinopathies
-abruptio placentae
-multiple gestation
-high altitude

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14
Q

Symmetric IUGR

A

intrinsic causes:
-chromosomal abnormalities
-congenital infections

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15
Q

New Born Vitals

A

temp: 36.1-37C
respirations: 30-60breaths per min
heart rate: 120-160bpm

check bp if cardio or renal problems suspected
below 112/74 is normal

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16
Q

Newborns skin

A

-turns red when crying
-when cold extremities turns bluish with a mottled tint

Macular stains may be associated with extracutaneous disorders, such as spinal dysraphism or Beckwith-Wiedmann syndrome

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17
Q

Hemangiomas

A

-strawberry marks (red/crimson macules)
-vascular neoplasm
-disappear by age 5

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18
Q

Milia

A

-milk spots
-white papules
-disappear 3-4weeks

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19
Q

erythema toxicum

A

-white papules w/ erythematous base
-resolve with 2 weeks

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20
Q

Mongolian Spots

A

-African American and Asian newborns common
-blue-black macule with indefinite borders on buttocks
-disappear in 1st year

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21
Q

MIliaria

A

-thin wall vesicles
-nonerythematous
-non-pigmented
-caused by blockage of sweat glands
-usually resolves when newborn is removed from the warm humid environment

22
Q

Port Wine stains

A

-sometimes associated with structural anomalies (sturge-Weber syndrome)

23
Q

Cafe au lait

A

-light brown macule with well-defines boards
-6 or more spots may indicate neurofibromatosis

24
Q

How is the vestibulo cochlear nerve assessed

A

startle or blink response to sudden loud noises

25
Q

rooting, sucking, moro reflexes disappear?

A

3-4 months

26
Q

Microcephaly
Macrocephaly

A

-a head circumference smaller than two standard deviations
-a head circumference larger than two standard deviations

27
Q

new borns hair

A

-should be uniform in color and distribution
-white forelocks may indicate deafness
- multiple hair whorls may be Down syndrome (trisomy 21)

28
Q

fontanels

A

-should be flat and soft
anterior
-diamond and closes 18months
posterior
-triangular and closes 2-3months

tense and bulging indicate intracranial pressure

sunken indicate dehydration

29
Q

Wide fontanels

A

indicate underlying condition:
-IUGR
-hydrocephalus
-Down syndrome
-Hypothyroidism

30
Q

edema that crosses the midline

A

Caput Succedaneum
-resolves w/in a few days

31
Q

Abnormally wide interpuppillary distance

A

indicates trisomy 13 or Apert Syndrome

32
Q

Blue Sclera

A

indicates Osteogenisis Imperfecta

33
Q

Excess skin or webbing

A

indicates genetic disorder like Turners Syndrome

34
Q

new born breast tissue may hypertrophy bc?

A

maternal hormones

35
Q

Newborn Cardiovascular

A

-first few days the PMI is located on fourth intercostal space at or to the left or. the midclavicular line
-120-160bpm
-sleeping may be 85-90bpm
-asymptomatic rhythms are relatively. common in preterm

36
Q

PDA and murmurs of newborns

A

85% of all newborn have murmurs
-usually cease once the ductus arterioles closes

37
Q

diminished femoral pulses in new born

A

-coarctation of the aorta

38
Q

Ejection clicks

A

-further eval required
-indictes pulmonary or aortic valve stenosis

39
Q

Abdomen of the newborn

A

-slightly protuberant
-palpation of lover that is soft with a smooth edge
-may also be able to locate tip of spleen

40
Q

GU

A

Females:
-labia major may be reddened and swollen
-clear white vaginal discharge, blood tinged may be normal first few days of life

Males:
-penis should be stretched to asses length
-phimosis is common
-circumcision should be postpone of hypospadias is presents
-testes moth and firm and equal
-blue testes – may be torsion
-testes concerned with undescended by age 6months

41
Q

Sacral Dimpling

A

not a cause for concern unless dimples are larger than 0.5cm or located 2.5cm from the anal verge
-screen for neural tube defects

42
Q

lower back tufts of hair or skin tags?

A

-Spina Bifida

43
Q

Single Palmer crease?

A

Trisomy 21

44
Q

DDH/ developmental Dysplasia of the Hips

A

Barlow Maneuver/ Ortolani Maneuver

Barlow:
-causes posterior dislocation of an unstable hip

Ortalani:
-makes a click sounds with reduction of the dislocation

45
Q

Mandatory Screenings of the Newborn

A

PKU/ Phenylketonuria
galactosemia
SCD
congenital hypothyroidism

46
Q

Newborn hearing assessment

A

-Startle reflex
-BSAER/ brain stem auditory response test
-if hearing loss indicated, tx begins by 6months

47
Q

Cystic Fibrosis screened how?

A

dried blot spot test
-confirmed with sweat test

48
Q

PKU

A

-developmental delay
-seizures
-agression
-autism
-hyperactivity

49
Q

Galactosemia

A

liver dysfunction and coagulopathies
-may develop sepsis

50
Q

Dried Blood spot screens for?

A

Hemoglobinopathies
-sickle cell
-thalassemia

DRT PEDS (11 decks)

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