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Flashcards in newborn Deck (63):
1

down's syndrome
s/s and parent education

palpebral fissures ( upward slant eyes), macroglossia ( enlarged tongue, chronic open mouth), simian crease (transverse palmar cease), 50% change heart defects, early alzheimers, visual problems, low set ears

education:AVOID trampoline (esp

2

fetal alcohol syndrome s/s

microcephaly, shortened palpebral fissures (narrow eyes), flat nasal bridge, underdeveloped ears, smooth philtrum.

3

cryptochidism (undescended testes)
how to assess

empty scrotal sac.
infant sitting, warm to relax muscle, massage inguinal canal. Or exam after warm bath

increase risk of TESTICULAR CANCER if testes are not removed from the abdomen.
if does not descend after 1 year, surgical orchiopexy.

4

gonococcal ophthalmia neonatorum
s/s
tests
tx

2-4 days post birth
can cause blindness!- DON"T DELAY TX
s/s: red conjuntiva, discharge

tests: gonococcal Thayer Martin, herpes simplex culture, chlamydial PCR, gram stain of eye exudate.

hospital and tx with IV or IM ceftriaxone.


prophalaxis topical .5% erythromycin ointment ( 1cm rib be per eye)

5

chlamydial opthalmia neonatorum (Trachoma)
s/s
tests
tx

4-10 days after birth.

s/s: edematous eyelids, watery/purulant eyes

tests: sample of exudate and conjuntival cells

tx: systemic antibiotics, macrobid IM, tx only 80% effective and may need 2nd course. (i.e. azithromycin, erythromycin).

REPORTABLE DISEASE.

treat mom and sexual partner

** rule out chlamydial pneumonia with nasopharyngeal culture

6

chlamydial pneumonia

test with nasopharyngeal culture.
cough, rales, tachypnea, hyperinflation, diffused infiltrates on xray.

tx: erythromycin, DAILY follow up.

REPORTABLE DISEASE

7

SIDS

risk with premature/low birth weight, maternal smoking/drugs, poverty
cause unknown

only back sleeping and avoid "overheating" baby

8

weight loss >7%

weight loss should be regained 10-14 days. loss >7% abnormal assess for dehydration/lactation

9

when does mongolian spot fade

2-3 yrs
most common pigmented spots on babies

10

erythema toxicum

whitish/yellow pustules
erupts during the 2nd/3rd day.
resolves spontaniously 1-2 wks

11

faun tail nevus

hair at lumbosacral area, ultrasound of the lesion to r/o spin bifida

12

cafe au lait spots, when to rule out?

if >6 spots >5mm (.5cm), rule out neurofibromatosis or von recklinghausen's disease (neuro disorder marked by sz, learning disorder).

refer to neurologist!

13

port wine stain (nevus flammeus) when to r/o?

on the v1 and v2 branch of trigemenal nerve
refer ophthalmologist to r/o glaucoma.
blanches to pressure, irregular size
if half of face may be sign of trigemenal nerve involvement and STURGE-WEBER syndrome (neuro disorder). tx with pulse dye laser

14

if port wine stain more than half of the face, what is the sign of

trigemimenal nerve/sturge weber

15

newborn vision

newborns are nearsighted (myopia)
normal: 30/400

16

amblyopia

lazy eye, correct early

17

esotropia

misalignment of eyes ("cross eyed")

18

when to refer (eyes)

abnormal red reflex ( r/o retinoblastoma, cataract, glaucoma)
white reflex (r/o retinoblastoma)
strabismus ( r/o CN 3, 4, 6 abnormalities)
**vision 20/30 or worse in child >6yo
** > to line difference between each eye
new onset of strabismus

19

red reflex

to test for cataracts and retinoblastoma

red reflex showing a white colored pupil- congenital cataract

20

retinoblastoma

An eye cancer that begins in the back of the eye (retina), most commonly in children.

21

auditory test newborn

test for CN 8 (acoustic) by use of "click" stimuli

22

risk for hearing loss
"HEARS"

hyperbilirubinemia, ear infection, apgar score low, rubella, cmv, toxoplasmosis, seizures

23

PKU

phenylketonuria.
mental retardation if not treated early
inability to metabolize phenylalanine to tyrosine because of the defect if phenylalaline hydrosylase.

Test ONLY after 48 hours, treated by following PKU free diet.

24

laboratory tests

PKU, TSH, sickle cell, h/h, lead

25

H/H

tests at 9-12 months.
newborns have Hemoglobin F/A. The have iron stores to last 6 months due to maternal RBC

26

lead screening

1-2 years for high risk children

27

how much Vit D supplement

minimum of 200IU if not more

28

how much calories in Breast milk or formula

20kcal/oz

29

cow's milk

avoid 1st yer
common cause of iron def anemia in babies

30

when is meconium passed

1st 24 hours after birth

31

caput succedaneum

diffused edema crosses midline, normal dt labor and resolved spontaniously

32

cephalohematoma

does NOT cross midline or suture lines, r/o skull fracture

33

birth weight

loses 7%, regains in 1-2 wks. double weight by 6 months triple by 1 year.

34

when to measure head circumference

at each wellness visit until 3 years old
(chest is 1-2cm less than head circumference)

35

when does baby have ALL their teeth

2.5 years old

36

first permanent teeth

6 years old

37

hypospadias

A condition in which the opening of the penis is on the underside rather than the tip.

refer

38

anal wink

look for contraction of perianal muscle. If not present, risk of spina bifida

39

when does morro reflex disappear

3-4 months
if NOT present, rule out spinal cord/brain lesion
if one side, r/o shoulder dystocia/fracture

40

when does stepping reflex disappear

6 wks

41

tonic neck reflex

(fencing reflex) neck turned on one side will cause limbs on same side to extend,opposite flex

42

if moro reflex strong on infant OLDER than 6 months..

indicative of brain damage

43

MMR

2 doses
given AFTER 12 months, then 4-6 years
live attenuated virus vaccine

44

avoid aspirin to children less than 1 year old

avoid salicylates 6 wks ( reyes syndrome), no aspirin products (pep to, alka seltzer, kaopectate)

45

influenza

do NOT give before 6 months
flu mist: age 2-49 yo healthy and non pregnant

46

DTAP

use for 7 years or younger ( if older use, TDAP)

47

age 12-15 months, which vaccines are completed

hep B
hib (hemophilus type b
pcv
rv
dtap
mmr
varicella
ipv (inactived polio)

48

ONLy vaccine at birth

hepatitis B

49

which vaccines NOT to give before 12 months

varicella, MMR ( live vaccine)

50

if hbsaG positive mother, what to give neonate

give hbig and hep b

51

when to give tdap booster

11-12 yo. if older than 12 replace one dose of TD with trap ( once in a lifetime)

52

fine motor, can feed self with spoon, drink from a cup
knows 4-6 words

15 months

53

can walk up steps, turns pages of book, point to 4 body parts, knows 10-20 words

18 months

54

rear facing

birth -2 yo

55

when to put child in back seat

until 13 yo

56

school age seat

booster seats, until child reaches 4 feet, 9 inches or is 8-12 yo.

57

physiologic jaundice

5mg/dl or higher
elevation of bilirubin due to increased breakdown of fetal RBC.

58

kernicterus

neuro disorder caused by high levels of bilirubin in infant
associated with mental retardation

59

physiologic anemia of infancy

hemoglobin drops at losel level at 2 months
temporary decrease in erythropoietin production by kidneys, which prompts gown marrow to product more.

60

infant colic rule of 3

last 3 hours or more during the day
under 3 months
occurs more than 3 days/week

61

coarctation of the aorta

congenital narrowing of portion of the heart. compare radial and femoral pulses simultaneously (bp @ arms vs legs).

if abnormal order keg, echo, chest x ray

62

neonates screening pulse

compare femoral and brachial pulse (wrist)

normal findings in older infant: systolic BP higher in legs than arms

63

barlow versus ortolani

barlow- push both knees together at midline downwards
ortalani- abduct/adduct frog leg position