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neonate > The health newborn infant > Flashcards

The health newborn infant Flashcards

1
Q

What is the typical weight loss range in newborns during the first 3 to 5 days of life?

A

Newborns may experience a weight loss of up to 10% of their birth weight during the first 3 to 5 days of life.

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2
Q

When is birth weight typically regained in newborns?

A

Birth weight is usually regained by the seventh day of life in newborns.

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3
Q

How does weight gain typically progress in infants during the first three months?

A

Subsequent weight gain in infants is usually about 200 g a week (25–30 g/day) for the first three months of life.

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4
Q

How does weight loss in preterm infants compare to term infants during the first days of life?

A

In preterm infants, weight loss may be greater, reaching up to 15% of their birth weight during the first few days of life.

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5
Q

How does the duration of weight regain differ between preterm and term infants?

A

Weight regain in preterm infants may take longer compared to term infants.

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6
Q

What is the typical range of head circumference at term?

A

The typical range of head circumference at term is 33 to 37 cm, with an average of 35 cm.

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7
Q

What is the average rate of increase in head circumference per week?

A

On average, head circumference increases by approximately 7 mm per week, with a range of 5 to 10 mm.

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8
Q

What is considered a typical increase in head circumference per week?

A

An average increase of approximately 7 mm per week is considered typical for head circumference during early development.

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9
Q

What is caput succedaneum?

A

Caput succedaneum refers to the oedematous thickening of the scalp in the presenting area during birth, which often crosses suture lines. It typically disappears within a few days after birth.

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10
Q

Describe the anterior fontanelle.

A

The anterior fontanelle is diamond-shaped and of variable size. It is normally slightly concave and may be observed to pulsate

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11
Q

When does the anterior fontanelle close

A

Typically, it closes by 18 months of age

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12
Q

How does caput succedaneum differ from cephalohematoma?

A

Caput succedaneum involves oedematous thickening of the scalp in the presenting area during birth and usually crosses suture lines, resolving within a few days. In contrast, cephalohematoma is a subperiosteal collection of blood, typically limited by suture lines, and may take weeks to months to resolve.

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13
Q

What is the typical shape and closure time of the posterior fontanelle?

A

The posterior fontanelle is typically small and triangle-shaped, closing by around 4 months of age.

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14
Q

Define moulding in newborns.

A

Moulding refers to the altered shape of the newborn’s head in response to pressure during birth, sometimes resulting in the overriding of cranial bones.

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15
Q

What is craniotabes, and when does it typically occur?

A

Craniotabes is the softening of the skull bones and is a normal finding in most newborns, especially in the parietal region. It may persist in many infants up to 3 months of age

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16
Q

What does persisting craniotabes suggests

A

Severe or prolonged craniotabes may suggest metabolic bone disease or osteogenesis imperfecta.

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17
Q

What is the typical appearance of the neck in a newborn?

A

A newborn typically appears to have a short neck.

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18
Q
A
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19
Q

What are examples of midline swellings that are rare in newborns?

A

Midline swellings such as dermoid and thyroglossal cysts are uncommon in newborns.

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20
Q

What is a sternomastoid ‘tumour,’ and when does it typically appear?

A

A sternomastoid ‘tumour’ is a hard lump that appears in the body of the sternomastoid muscle, usually a few days after birth.

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21
Q

What causes sternomastoid “tumor”

A

It is often caused by trauma or avascular necrosis.

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22
Q

What condition may result from a sternomastoid ‘tumour,’ and how is it treated?

A

A sternomastoid ‘tumour’ may cause torticollis, a condition characterized by the neck being twisted to one side. Torticollis usually improves with physiotherapy.

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23
Q

How common are sternomastoid ‘tumours’ in newborns?

A

Sternomastoid ‘tumours’ are uncommon in newborns.

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24
Q

What may cause difficulty in examining the eyes of newborn infants initially?

A

Strong reflex closure of the eyes may cause difficulty in examining newborn infants’ eyes initially.

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25
Q

What is the significance of the ‘red reflex’ in newborn eye examinations?

A

The ‘red reflex’ should be present, indicating the reflection of light from the back of the eye

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26
Q

What does a white pupil suggest

A

A white pupil may suggest conditions like cataracts or retinoblastoma

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27
Q

How does the appearance of the pupil contribute to eye examination findings?

A

The pupil should appear black and not grey. Abnormalities such as cataracts and retinoblastoma can cause a white pupil.

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28
Q

What can the color of the sclerae indicate in preterm infants?

A

In preterm infants, the sclerae may have a blue tinge due to the transmission of the darker color of underlying uveal tissue through the underdeveloped sclerae

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29
Q

What does a darker blue sclerae suggest

A

Darker blue sclerae may suggest osteogenesis imperfecta.

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30
Q

Why may the color of the iris be unpredictable in newborn infants?

A

The color of the iris in newborn infants is indefinite and not predictive of the color in older infants.

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31
Q

What is the significance of tears in newborn infants during the first few weeks?

A

Tears are rare in newborn infants during the first few weeks of life.

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32
Q

What visual abilities do newborn infants possess from birth?

A

Newborn infants are able to see from birth and should be able to follow a red or bright moving object.

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33
Q

Describe the appearance and significance of subconjunctival haemorrhage in newborns.

A

Subconjunctival haemorrhage appears as a bright red patch, often adjacent to the cornea, with no serious significance. It disappears within a few weeks and may be more common after traumatic delivery.

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34
Q

What condition may be indicated by abnormally large eyes in newborn infants?

A

Abnormally large eyes in newborn infants may indicate congenital glaucoma, which requires early treatment due to its importance.

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35
Q

What is the usual course of subconjunctival haemorrhage in newborns?

A

Subconjunctival haemorrhage usually resolves spontaneously within a few weeks.

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36
Q

What are some common findings related to the ears in newborn infants?

A

Common findings related to the ears in newborn infants include preauricular skin tags and sinuses, which typically cause no problems.

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37
Q

What maternal condition may be associated with hairy ears in newborn infants?

A

Hairy ears are common in newborn infants of diabetic mothers.

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38
Q

What potential significance do low set ears and unusual shapes of ears have in newborn infants?

A

Low set ears and unusual shapes of ears in newborn infants can be common findings in certain syndromes.

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39
Q

Congenital nasal obstruction

A

choanal atresia

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40
Q

Acquired nasal obstruction

A

nasal secretions

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41
Q

What is the significance of nasal obstruction in newborn infants?

A

may cause feeding problems or respiratory distress in newborn infants, as they are obligate nose breathers.

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42
Q

What are sucking blisters, and where are they commonly found in newborn infants?

A

Sucking blisters are thickened areas on the upper lip of newborn infants, usually located in the midline.

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43
Q

What are Epstein’s pearls, and where are they typically found in newborn infants?

A

Epstein’s pearls are small whitish inclusion cysts, usually visible in the midline on the hard palate of newborn infants. They are of no significance.

44
Q

What is tongue-tie, and how does it affect newborn infants?

A

Tongue-tie occurs when the frenulum linguae is inserted into or near the tip of the tongue in newborn infants. It rarely interferes with sucking or future speech.

45
Q

What do you do if you suggest nasal obstruction

A

try passing a nasogastric tube

46
Q

What is a ranula, and where does it typically occur in newborn infants?

A

A ranula is a cystic swelling that occurs in the floor of the mouth of newborn infants. It usually disappears spontaneously over time.

47
Q

What are adventitious teeth, and how do they differ from primary teeth when present at birth?

A

Adventitious teeth are occasionally present at birth and are typically loose, not interfering with sucking, and fall out spontaneously. In contrast, primary teeth present at birth may pose a potential aspiration risk.

48
Q

Vernix caseosa

A

Protective greasy white substance secreted by fetal sebaceous glands. Not present in
preterm infants, and decreases in quantity after term.

49
Q

Traumatic cyanosis of the face

A

Due to many small petechial haemorrhages in the skin after congestion of the head
with the cord around the neck.

50
Q

Superficial skin peeling

A

Common during the first week. It is especially marked in post-term or wasted infants.

51
Q

Hair

A

Colour at birth is poor guide to future shade

52
Q

Lanugo

A

Lanugo is fine facial and body hair
which is a feature of preterm infants.

53
Q

Role of lanugo

A

Lanugo plays an essential role in binding the vernix caseosa to the skin of fetuses

54
Q

Milia

A

White pin-head sized papules which are made up of keratin and sebaceous material
in sebaceous glands, causing blockage. These are due to fetal oestrogen, frequently
found on the nose and cheeks and resolve within the first few weeks.

55
Q

Blue spots (‘Mongolian spot’)

A

Flat blue-black areas over sacrum or buttocks, and occasionally on back, shoulders,
hands and feet. Usually disappear by 4 years.

56
Q

Vascular naevi

A

Salmon patches: pink-red superficial capillary haemangiomata may occur over the
upper eyelids, upper lip, middle of forehead, and on the nape of the neck (stork-bite).
They usually fade by 1 year.

57
Q

Strawberry naevus

A

A raised cavernous haemangioma with a surface resembling a strawberry. At birth,
the strawberry-to-be may show as a white (depigmented) patch of skin. Growth is
rapid and it may easily reach 4 cm in diameter. It usually starts to subside by 1 year
and most have disappeared by 7 years of age. Surgical removal is rarely necessary.

58
Q

Port wine mark (capillary haemangioma or naevus flammeus)

A

Is a low-flow capillary malformation that can occur anywhere and may be extensive.
It persists for life. If situated over the ophthalmic division of the trigeminal nerve it
may be associated with a meningeal haemangioma (Sturge-Weber syndrome). Large
marks may require laser treatment later.

59
Q

Erythema toxicum

A

Very common. Red blotchy rash with yellow central pin-head papules (which may
look like pustules but contain eosinophils) occurring between the second and eighth
days. Seldom seen in preterm infants and never on palms or soles. Cause unknown.
No treatment needed.

60
Q

Transient neonatal pustular melanosis

A

A benign condition in a well infant with 3 stages – vesicles, ruptured vesicles and
hyperpigmented macules

61
Q

Fat necrosis

A

Localised areas of induration on back, thighs, or face (after forceps delivery). It has
a dark red appearance and may fluctuate. Resolves spontaneously but needs to be
differentiated from skin abscesses. Can be painful.

62
Q

Sclerema

A

Very firm rubbery feel to the skin. Associated with severe infection, hypothermia or
severe hypoxia.

63
Q

Wasting

A

Dry, loose skin hangs in folds due to loss of muscle and subcutaneous fat resulting
from recent intrauterine starvation.

64
Q

What causes breast enlargement in newborn infants, and how long does it typically last?

A

Breast enlargement in newborn infants is common and usually lasts for a week or two, but it may persist for months. It is due to the effect of fetal estrogen and progesterone.

65
Q

What precaution should be taken regarding handling in newborns with breast enlargement

A

Handling should be avoided in newborns with breast enlargement, as it may cause mastitis.

66
Q

How common are supernumerary nipples in newborn infants?

A

Supernumerary nipples are common in approximately 1 in 40 newborn infants.

67
Q

What is the normal reason for infants to vomit?

A

Infants may vomit due to swallowing air while feeding or bringing up a small amount of milk when burped.

68
Q

When should persistent vomiting in infants be assessed and investigated?

A

Persistent vomiting in infants should be carefully assessed and investigated, especially if bile is present.

69
Q

What is the significance of occasional large vomits in infants?

A

Occasional large vomits in infants may occur without cause and are considered normal.

70
Q

Serious causes of vomiting

A
  • Alimentary tract obstruction due to atresia, meconium ileus, volvulus,
    strangulated hernia, inspissated cows’ milk, Hirschsprung’s disease and
    necrotising enterocolitis.
  • Marked gastro-oesophageal reflux.
  • Infection (including urinary tract).
  • Cerebral pathology (including intracranial bleed or meningitis).
  • Metabolic disorders.
71
Q

What is the typical composition of the umbilical cord in newborns?

A

The umbilical cord usually consists of two arteries and one vein.

72
Q

What conditions are associated with having only one artery in the umbilical cord?

A

Having only one artery in the umbilical cord is associated with a higher incidence of chromosomal, gastrointestinal, or renal abnormalities.

73
Q

What is the typical outcome for umbilical hernias in newborns?

A

Umbilical hernias are common in newborns and typically close spontaneously by the age of 5.

74
Q

When is meconium typically passed in newborns?

A

Meconium is typically passed within 48 hours of birth in the majority of infants.

75
Q

What should be considered if meconium is passed in utero?

A

If meconium is passed in utero, it may indicate fetal distress.

76
Q

What intervention may be used if obstruction is caused by a firm meconium plug?

A

If obstruction is caused by a firm meconium plug, it may be relieved by gently inserting a small glycerine suppository into the anus.

77
Q

How do breast milk stools typically appear?

A

Breast milk stools are usually bright yellow (varying from orange to green), may vary from watery to pasty, and may contain mucus.

78
Q

When do stools typically replace meconium in newborns?

A

Stools replace meconium on day 3 or 4.

79
Q

How many stools are usually passed by newborns each day, and what is the range of variation?

A

Newborns usually pass two to five stools each day. However, the variation can range from one stool a week to 12 stools a day.

80
Q

What are the characteristics of stools produced by infants fed with cow’s milk (formula)?

A

Stools from infants fed with cow’s milk (formula) are pale yellow, firmer, and less frequent, with up to 5 stools a day or one stool every second day.

81
Q

How would you describe “starvation stools” seen in under-fed infants?

A

“Starvation stools” in under-fed infants are characteristically small and dark green in color.

82
Q

What could be the cause of blood in infant stools, and how can it be distinguished from fetal blood?

A

Blood in infant stools may be due to swallowed maternal blood, which can be distinguished from fetal blood by the Apt test.

83
Q

In what scenario are loose green stools commonly observed in infants?

A

Loose green stools are commonly observed in infants undergoing phototherapy.

84
Q

What is a common and normal occurrence related to the back of newborns?

A

A coccygeal sinus is common and normal in newborns.

85
Q

How would you characterize a benign sacral midline dimple in newborns?

A

A benign sacral midline dimple typically has a visible intact base and a diameter of less than 0.5 cm.

86
Q

What should be considered if any sacral patch, dimple, or sinus is observed in newborns?

A

Any sacral patch, dimple, or sinus in newborns may indicate an underlying occult spina bifida or tethering of the spinal cord and warrants further investigation.

87
Q

What is the typical timeframe for newborn infants to pass urine after birth?

A

Newborn infants should pass urine within the first 24 hours after birth, often immediately after birth.

88
Q

What might dribbling urine suggest in newborn boys?

A

What might dribbling urine suggest in newborn boys?

89
Q

What is the normal frequency of bladder emptying in newborns during the first few weeks?

A

In the first few weeks, the infant bladder is emptied up to 20 times a day.

90
Q

How might urates affect the appearance of urine and nappies in newborns?

A

Urates may heavily color the urine, leaving a brick-red stain on the nappy, which can sometimes be mistaken for blood.

91
Q

What are the risks associated with urine collection in newborns?

A

While collecting urine using a collecting bag is the most common method, contamination is a risk. Uncontaminated urine may be obtained by suprapubic bladder puncture or urethral catheterization.

92
Q

What is the term used to describe the normal decrease in urine output seen in newborn infants during the first few days after birth?

A

Physiological oliguria.

93
Q

How long does physiological oliguria typically last in newborn infants?

A

Physiological oliguria usually persists for the first three days after birth.

94
Q

How does the kidney function of a newborn infant compare to that of an older child?

A

The newborn kidney is less able to excrete a solute load and has a reduced concentrating capacity compared to an older child.

95
Q

What implications does the reduced kidney function of newborns have?

A

The reduced kidney function in newborns means that they may be more susceptible to electrolyte imbalances and may require careful monitoring of fluid intake and output.

96
Q

How does the reduced concentrating capacity of the newborn kidney affect urine production?

A

The reduced concentrating capacity means that newborns may produce more dilute urine compared to older children, which can affect their ability to maintain fluid balance.

97
Q

What is the typical location of testes in male infants at birth?

A

What is the typical location of testes in male infants at birth?

98
Q

What is the recommended course of action if testes are incompletely descended in infants at six months?

A

Infants with undescended testes at six months should be referred for surgery at one year of age.

99
Q

How do the genitalia of preterm infants typically differ from those of term infants?

A

Preterm infants tend to have incompletely descended testes and a less well-developed scrotum compared to term infants.

100
Q

What condition is more common in males, especially if born preterm, and requires repair to prevent incarceration?

A

Inguinal hernia is more common in males, especially if born preterm, and should be repaired to prevent incarceration.

101
Q

What is a common condition in male infants characterized by a soft swelling of the scrotum that easily transilluminates?

A

Fluid hernia is a common condition in male infants, characterized by a soft swelling of the scrotum that easily transilluminates.

102
Q

What is the typical adherence of the foreskin to the glans penis in newborns?

A

The foreskin is normally adherent to the glans penis in newborns and cannot be pulled back without trauma.

103
Q

At what age do approximately 90% of males become fully retractable?

A

Approximately 90% of males become fully retractable by the age of 3 years.

104
Q

What is the significance of a mucoid vaginal discharge in female infants at birth?

A

A mucoid vaginal discharge is present in nearly all mature female infants at birth and is of no pathological significance.

105
Q

What phenomenon occasionally occurs at the end of the first week in female infants, which is attributed to fetal hormone withdrawal?

A

Vaginal bleeding occasionally occurs at the end of the first week in female infants, which is a fetal hormone withdrawal effect of no pathological significance.

neonate (34 decks)

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