Exam and Management of the Neonate Flashcards Preview

PCM IV Exam I > Exam and Management of the Neonate > Flashcards

Flashcards in Exam and Management of the Neonate Deck (27):
1

Components of routine delivery room care of healthy, term infants

Warming, drying, clearing of airways

Comprehensive review of maternal history and complete physical exam

Prophylactic care to prevent serious disorders

Family education

Discharge care/evlaution

2

5 clinical components of the APGAR score

Heart rate
Respiratory effort
Muscle tone
Reflex irritability
Color

3

Why is vitamin K injected immediately after birth?

Prevents excessive bleeding of newborn (helps babies clot)

4

Why is topical erythromycin ophthalmologic ointment applied immediately after birth?

Prevention of GC (ophthalmia neonatorum)— less against chlamydia

5

Age at which majority of newborns regain their birth weight

10-14 days

6

Expected daily weight gain after the first week for healthy term infant

15-30g/day

7

Maximum acceptable weight loss in the week following birth for healthy term infant

Up to 10% loss is acceptable in most situations

[7% loss or greater demands close follow-up]

8

Blue discoloration of the perioral area (seen with sucking/feeding), feet, and hands; normal for the first 24 hours and closely associated with cool surroundings

Acrocyanosis

9

Bluish discoloration of tongue/mucous membranes persisting after first 10 minutes of life is always abnormal — think cardiac disease/pulmonary disease

Central cyanosis

10

Importance of looking for the “red reflex” in newborns

Ensures lack of opacity of the lens and cornea and to look for intraocular mass (retinoblastoma)

[note: in whites the reflex is red, in darker skinned infants may be more pearly gray; finding a “white” red reflex indicates pathology in need of URGENT referral]

11

Pierre-Robin sequence is associated with _______

Micrognathia

12

Choanal atresia is associate with ________ ______

CHARGE syndrome

13

PE finding indicative of soft palate cleft

Bifid uvula

14

What are epstein pearls?

Inclusion cysts on the back of the hard palate — normal PE finding

15

Describe supernumery nipples

May develop inferior to true nipples, anywhere along the mammary line

Seen in 1% of normal population, more commonly in African-Americans

16

What are supernumery nipples associated with in the white population?

Renal anomalies (hydronephrosis, hypoplasia, etc)

17

What is the difference between omphalocele and gastroschisis?

Omphalocele = abdominal wall defect in which contents protrude through umbilical cord (covered with peritoneum)

Gastroschisis = abdominal wall defect in which contents are exposed at site just to the right of umbilicus

18

Normal number of arteries and veins in an umbilical cord

3 vessels total (2 arteries, 1 vein)

19

Compare and contrast cephalohematomas and caput succedaneums

Cephalohematoma —(subperiosteal blood) may be bilateral and DO NOT CROSS SUTURE LINES. Increase in size after delivery, can be tense or fluctuant, late can mimic a fracture on x-ray, take weeks to months for resolution

Caput succedaneum — boggy area of edema and/or bruising, CROSSES SUTURE LINES, gone in days, present at birth (generally does not enlarge)

20

Define “molding”

Change in fetal head shape as permitted by sutures + fontanelles as it passes through the birth canal

21

Importance of examining lumbosacral spine in every infant

Look for presence of the following:

Hair tuft

Dimples separate from gluteal crease (suggests possible spinal dysraphism/tethered cord)

Skin tags or pits

Lipoma, hemangioma

22

Name the 2 maneuvers used to examine the hips in a newborn baby

Ortolani
Barlow

23

External urethral meatus on ventral shaft of penis

Hypospadias

24

White cheesy skin stuff that babies have all over (especially inguinal/axillary), appears at about 35 weeks and may be gone at 41 weeks

Vernix

25

Benign rash of the newborn that usually appears the second to third day of life (gone in 7-14 days) with erythematous base with 1-2 mm pustules or papules, sparing the palms and soles. Pustule/vesicles contain debris and eosinophils

Erythema toxicum neonatorum (flea-bite syndrome)

26

1-2 mm white firm papules on the face and bridge of nose (and sometimes scalp); resolve spontaneously by a few months — appear at 36 weeks gestation

Milia

27

Slate blue/grey or black spots that are macular to patch size; more common in darker skinned races but affects all; they are benign and tend to resolve over several years

Dermal melanosis