The care of the newborn and the preterm infant

Question 1

Apgar score based on?

Answer 1

Physiologic responses to the birth process. If we need to resuscitate the newborn

Question 2

Low Apgar score <7 what to do?

Answer 2

Assisted ventilation, facemask and endotrachial tube. ABCDE.

Question 3

SGA

Answer 3

Infants who are mildly to moderately SGA, appear smaller than normal and decreased fat.

Question 4

IUGR can be asymmetrical or symmetrical

Answer 4

Asymmetrical -

Symmetrical -

Question 5

Early term infant

Answer 5

Between 37-38 weeks

Question 6

Full term infant

Answer 6

Between 39-40 weeks

Question 7

Post term infant

Answer 7

> 42 weeks

Question 8

Extreme low body weight

Answer 8

< 1000 g

Question 9

Low body weight

Answer 9

< 2500 g

Question 10

Very low body weight

Answer 10

< 1500 g

Question 11

Measurements normal range

Answer 11

10th - 90th percentile

Question 12

Length

Answer 12

50 cm

Question 13

Weight

Answer 13

3 - 4 kg

Question 14

Head circumference

Answer 14

33 - 37 cm

Question 15

Vital signs

Answer 15

RR: 40-60 breaths pm
Hr: 120 - 160 bpm

Question 16

pH

Answer 16

> 7.2 slightly more acidic than adults

Question 17

Urine and meconium first passage

Answer 17

Urine within 24 h

Meconium within 48 h

Question 18

Losing weight after birth

Answer 18

Loss up to 7% of birth weight in the first 5 days

Question 19

Newborn screening: endocrine

Answer 19

Congenital hypothyroidism

Congenital adrenal hyperplasia

Question 20

Newborn screening: metabolic condition

Answer 20

Disorders of fatty acid metabolism 
Amino acid metabolism
- phenylketonuria 
- homocyteinuria 
- maple syrup urine disease

Question 21

Newborn screening: hemoglobinopathies

Answer 21

Sickle cell disease

Beta thalassemia

Question 22

Newborn screening: Other conditions

Answer 22

Hearing loss 
CF
Congenital heart defects
Galactosemia 
Severe combined immunodeficiencies 
Glycogen storage  disease type II (Pompe disease)
Spinal muscular atrophy

Question 23

Postnatal assessment methods

Gestational age

Answer 23

Estimated gestational age: new Ballard Score
Combining physical and neurologic criteria
(easier than Dubowitz method)

Question 24

Physical criteria postnatal assessment

Answer 24

Creases on the sole of the foot 
Presence and size of breast nodule 
Lanugo
Ear cartilage characteristics 
Appearance of genitalia

Question 25

Neurological criteria postnatal assessment

Answer 25

Posture
Active and passive tone
Reflexes

Question 26

Ballard method

Answer 26

Shorter than Dubowitz
Depend upon six physical and neurologic critera
Most reliable between 30 and 42 hours of age

Question 27

Dubowitz and Ballard score

Answer 27

Both inaccurate in premature infants < 1500g