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Flashcards in Infant Deck (47)
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1
Q

Normal newborn heart rate:

A

120-150bpm

2
Q

normal newborn resp rate:

A

40

3
Q

In addition to the normal stuff you do during an adult abdominal exam, what else are you doing for the newborn?

A

palpate kidneys, check umbilicus

4
Q

This is a genetic anomaly that is characterized by the stomach pushed out through abdominal abnormality and covered in umbilical sheath.

A

omphalocele

5
Q

This abdominal abnormality is similar to the omphalocele, but is not a/w with a genetic disease, and does not involve the umbilical sheath.

A

gastrochisis

6
Q

T/F: you should retract the foreskin on all newborn exams to check for hypospadias

A

FALSE: don’t retract foreskin, phimosis is normal until age 5. (but do check for hypospadias)

7
Q

Mom is worried, her newborn girl seems to be having a vaginal bloody discharge. What should you tell her?

A

It is very common as a result of w/d from maternal hormones

8
Q

Where is a common place for a newborn to have a fracture as result of difficult vaginal birth?

A

clavicles

9
Q

When this abnormality is missed, it is a common source for litigation because if caught and treated before 6 months of age, any future sequelae can be avoided. You can identify this condition using what 2 special tests?

A

hip dysplasia. Barlow and Ortaloni

10
Q

During the ________ special test, the hip is dislocated due to internal rotation. During the _______ test, the hip clunks back into place with external rotation

A

barlow, ortaloni

11
Q

singal palmar crease is indicative of ________

A

down’s/trisomy

12
Q

clinical term for “webbed digits”

A

syndactly

13
Q

clinical term for “club foot”

A

congenital talipes equinovarus

14
Q

what are some spinal defects that would lead you to suspect spina bifida?

A

Mild: hairy tufts, pigmentation change, clefts
Moderate: meningocele
Severe: Meningomyelocele, teratomas, sinus tracts

15
Q

How can you edu mothers about prevention of spinal defects/spina bifida?

A

take folic acid!!

16
Q

This newborn skin abnormality is important to document b/c it looks like bruising and could be confused with child abuse

A

Mongolian spots

17
Q

This skin finding is pretty common, it involves papules filled with eosinophils. Benign, no tx required

A

ETN–Erythema toxicum neonatorum

18
Q

This skin finding involves papules that are filled with neutrophils. They do NOT have an erythematous base, and are completely benign. They often heal as freckles.

A

TPN–Transient pustular melanosis

19
Q

These 2 skin findings are a result of withdrawal from mom’s hormones. They are benign and will self resolve after several days if newborn’s skin is kept clean.

A

neonatal acne and sebaceous gland hyperplasia

20
Q

This is a self-limited skin finding known as an “angel kiss” or a “stork bite”

A

hemangioma

21
Q

This is a common skin irritation of the scalp in newborns

A

cradle cap aka seborrhea dermatitis

22
Q

Average head circumference for newborn

A

34-35cm

23
Q

Term for when both nares are NOT patent bilaterally

A

coanal atresia

24
Q

When examining the skull, the ________fontanelle is easiest to palpate, and should close by _________months of age

A

anterior, 12

25
Q

Head trauma from vaginal birthing is common. Which type is well localized (does not cross suture lines), and can be a/w jaundice or skull fx?

A

cephalohematoma

26
Q

Which birthing head trauma is generalized, boggy feeling, and likely benign?

A

Caput succedaneum

27
Q

absent red reflex is indicative of what?

A

leukocoria–>retinoblastoma

28
Q

Newborn reflexes:

A

1) palmar/plantar grasp
2) rooting
3) moro (drop)
4) stepping reflex

29
Q

At what gestational age do you declare an infant “premature”?

A

<37 weeks

30
Q

At what gestational age do you declare an infant “post-term”?

A

> 42 weeks

31
Q

post term infants are at risk for? (3)

A

1) asphyxia
2) mesoconium aspiration
3) trisomies

32
Q

What is the most accurate way to assess gestational age?

A

early US

33
Q

If mom had no prenatal care, and no US prior to giving birth in the ED, what test could you use to determine gestational age?

A

Ballard test

34
Q

The Ballard tests adds what two scores together (and compares with gestational estimation of age) to determine true gestational age?

A

1) neuromuscular maturity (involve general posture)
2) physical maturity (development)

added scores are ideally 40 = 40 weeks

35
Q

What’s the preferred tx of neonatal jaundice?

A

phototherapy converts bilirubin to urobilirubin to be excreted in urine

36
Q

Aside from a single palmar crease, what are some other physical exam findings that would indicate Down’s/Trisomy 21?

A

1) sandal toe
2) poor tone
3) almond eyes
4) flat nose
5) small ears
6) Brushfield (white) spots on iris
7) large fontanelles

37
Q

50% of Down’s babies will also have what congenital defect?

A

AV septal defect

38
Q

Fetal development of the lungs is finishing around ___ weeks. So if baby is born sooner than this, _________disease is common.

A

34-36 weeks, hyaline membrane dz (no surfactant production)

39
Q

What will hyaline membrane dz look like on CXR?

A

ground glass

40
Q

You see lots of air in the abdomen on a neonatal KUB. What do you suspect?

A

necrotizing enterocolitis (bacteria producing gasses as waste product)

41
Q

Infant comes in with parents c/o ABDOMINAL DISTENSION, blood in stool, diarrhea, feeding intolerance, lethargy, temperature instability and vomiting. What tests will you order to help dx? What do you suspect prior to getting results?

A

Suspect necrotizing enterocolitis. Order CBC, lactic acid level, CXR

42
Q

How will you tx necrotizing enterocolitis?

A

1) rest gut
2) decompress gut w/ NG tube
3) IV fluids
4) abx

43
Q

Undescended testicle?

A

cryptorchidism

44
Q

Cryptorchidism is common, especially in premature males. At what age do you start to become concerned if there are no signs of dropping? And then what do you do?

A

6 months. (Most will descend by 3 mo). If not, refer to Uro for sx intervention

45
Q

Apgar scores should be recorded how long after birth?

A

1 minute and 5 minutes. (20 minutes is ok for depressed/distressed baby)

46
Q

There are 5 Apgar categories. What are they?

A

1) HR
2) resp effort
3) muscle tone
4) response to cath in nose
5) color

47
Q

Apgar scores are doled out 0-2 for each category with a max healthy score of 10. What are the criteria?

A

1) 0–no pulse, 1– 100bpm, reg
2) 0–no effort, 1–slow/irreg, 2–strong, crying
3) 0–no tone, 1–some flexion, 2–active movement
4) 0–no response, 1–grimace, 2–cough/sneeze
5) 0–pale/blue, 1–pink trunk, blue extremities, 2–all pink