The Term Infant

Question 1

When is a baby considered to be at ‘term’?

Answer 1

After 37 weeks gestation

Question 2

When is a baby considered to be post term?

Answer 2

After 41 weeks gestation

Question 3

What is the ‘normal’ birth weight?

Answer 3

2. 5 - 4.0kg
   - >4kg is large for gestation age
   - <2.5kg is small for gestational age

Question 4

What is the Apgar score?

Answer 4

Objective measure of perinatal adaptation

Question 5

Which screening tests are carried out on newborns?

Answer 5

Newborn examination
Universal hearing screening
Hip screening
Cystic fibrosis
Haemoglobinopathies
Metabolic disease

Question 6

Which metabolic diseases are screened for in a newborn?

Answer 6

PKU (phenylketonuria)
MCADD
MSUD (maple syrup urine disease)
IVA (isovaleric acidaemia)
GA1 (glutaric aciduria type 1)
HCU (homocystinuria - pyridoxine unresponsive)

Question 7

What are you looking for on the head during newborn exam?

Answer 7

Occipito-frontal circumference (OFC)
Overlapping sutures
Fontanelles
Ventouse/forceps marks
Moulding
Cephalhaematoma
Caput succedaneum

Question 8

What are you looking for in the eyes during the newborn exam?

Answer 8

Size
Red reflex
Conjunctival haemorrhage
Squints 
Iris abnormality

Question 9

What are you looking for in the ears during the newborn exam?

Answer 9

Position
External auditory canal
Tags/pits
Folding

Family history of hearing loss?

Question 10

What are you looking for in the mouth during the newborn exam?

Answer 10

Shape
Philtrum (line from lip to nose)
Tongue tie
Palate
Neonatal teeth
Ebsteins pearls (whitish cysts on gums and roof of mouth - harmless)
Sucking/rooting reflex

Question 11

Which abnormalities might you look for in the face during the newborn exam?

Answer 11

Facial palsy

Dysmorphism

Question 12

Which respiratory signs are you looking for during the newborn exam?

Answer 12

Chest shape
Nasal flaring
Grunting
Tachypnoea
In-drawing
Breath sounds

Question 13

Which cardiovascular signs are you looking for during the newborn exam?

Answer 13

Colour/saturation --> CHD screening
Pulses --> femoral
Apex
Thrills/heaves
Heart sounds

Question 14

Which abdominal signs are you looking for during the newborn exam?

Answer 14

Moves with respiration
Distension
Hernia
Umbilicus
Bile stained vomiting
Passage of meconium
Anus

Question 15

Which genitourinary signs are you looking for during the newborn exam?

Answer 15

Normal passage of urine
Normal genitalia
Undescended testes
Hypospadius

Question 16

Which musculoskeletal signs are you looking at during the newborn exam?

Answer 16

Movement + posture
Limbs + digits
Spine
Hip examination

Question 17

What are you looking for in the neurological part of the newborn exam?

Answer 17

Alert, responsive
Cry
Tone
Posture
Movement
Primitive reflexes
- suck
- rooting
- moro
- ATNR
- stepping
- grasp

Question 18

What is the acronym for the components of the Apgar score?

Answer 18

Appearance (skin colour)
Pulse
Grimace (reflex irritability)
Activity (muscle tone)
Respiration

Question 19

How is Appearance graded in the Apgar score?

Answer 19

2 = no cyanosis
1 = blue in extremities/body pink
0 = blue or pale

Question 20

How is Pulse graded in the Apgar score?

Answer 20

2 = > 100
1 = < 100
0 = absent

Question 21

How is Grimace graded in the Apgar score?

Answer 21

2 = cry or pull away when stimulated
1 = grimace/feeble cry when stimulated
0 = no response

Question 22

How is Activity graded in the Apgar score?

Answer 22

2 = flexed arms + legs that resist extension
1 = some flexion
0 = no tone

Question 23

How is Respiration graded in the Apgar score?

Answer 23

2 = strong cry
1 = weak, irregular, gasping
0 = absent

Question 24

What is considered a normal Apgar score?

Answer 24

8 or more