Newborn care and common genetic disorders

Question 1

Caput succedaneum

Answer 1

edema of scalp, reabsorbs within 1-3 days

Question 2

Cephalohematoma

Answer 2

clotted blood between periosteum and skull. Reabsorbs within a couple weeks

Question 3

Leukocoria

Answer 3

not a normal finding, one eye does not have red reflex

Question 4

Eythema toxicum

Answer 4

benign rash

Question 5

Harlequin sign

Answer 5

abnormal sign indicating genetic disorder

Question 6

Hypo or epi spadius

Answer 6

abnnormal finding of urethra position

Question 7

pilonidal dimple

Answer 7

located on lower back, abnormal

Question 8

galactosemia

Answer 8

inability to metabolize galactose because of a congenital disorder

Question 9

How much vit D supplement should mom give?

Answer 9

400

Question 10

Dysmorphic Infant

Answer 10

face to body measurements, asymmetrical

Question 11

Chromosomal disorder examples

Answer 11

Downs, turners, cystic fibrosis, cleft lip

Question 12

How many days after discharge do you see infant?

Answer 12

3-5 days

Question 13

Where does bilirubin come from?

Answer 13

breakdown of Hgb or immature liver metabolism

Question 14

when does hyperbilirubinemia peak in a full term infant?

Answer 14

3-5 days

Question 15

when does hyperbilirubinemia peak in a premature infant?

Answer 15

5-7 days

Question 16

Anytime there is an increase of ___mg/dl/day of bilirubin we will be concerned

Answer 16

5

Question 17

breast milk jaundice treatment

Answer 17

no treatment

Question 18

when does breast milk jaundice peak?

Answer 18

10-15 days

Question 19

TORCH

Answer 19

toxoplasmosis, other (strep B), rubella (vision and hearing loss), cytomegalovirus, herpes

Question 20

Kernicterus

Answer 20

brain damage caused by bilirubin depositing in the brain, causes yellow discoloration of certain areas of brain

Question 21

which areas of the brain does Kernicterus effect?

Answer 21

basal ganglia and hippocampus

Question 22

does unconjugated bilirubin diffuse easily into brain?

Answer 22

yes

Question 23

what determines the amount of unconjugated bilirubin that gets diffused into brain?

Answer 23

the concentration

Question 24

what increases Kernicterus toxicity?

Answer 24

decreased bilirubin binding

Question 25

Risk Factors for Kernicterus

Answer 25

Sepsis, age post conception, hypoxia, low serum albumin

Question 26

Kernicterus stage 1 s/s

Answer 26

hypotonia, lethargy, decreased suck

Question 27

Kernicterus stage 2 s/s

Answer 27

spasticity with opisthotonus and seizures

Question 28

Kernicterus stage 3 s/s

Answer 28

spasticity is decreased

Question 29

Kernicterus stage 4 s/s

Answer 29

spasticity, athetosis, deafness and mental retardation

Question 30

belirubin red flag and what kind of work up should you do

Answer 30

<24 hours of age at onset check for UTI, hemolytic probs, congenital viral infection

Question 31

which test/lab results would indicate that an infant was at high risk for a bacterial infection if any are positive?

Answer 31

positive UA with nitrates >5, WBC>20,000, temp 39.6 and age <13 days

Question 32

What are you concerned about in the 1st 24hrs with jaundice?

Answer 32

hemolytic disorders, TORCH

Question 33

what are you concerned about in the 2nd day-3rd week with jaundice?

Answer 33

physiological, breaks milk, sepsis, polycythemia, cephalhematoma,

Question 34

what are you concerned about in the 3rd week with jaundice?

Answer 34

breast milk, hypothyroidism, pyloric stenosis, cholestasis

Question 35

non-physiologic hyperbilirubinemia starts when?

Answer 35

jaundice before 36 hours

Question 36

jaundic persists for how many days withnon-physiologic hyperbilirubinemia

Answer 36

>8 days

Question 37

non-physiologic hyperbilirubinemia: Direct bilirubin is >__mg/dl

Answer 37

2

Question 38

non-physiologic hyperbilirubinemia: Rise in bilirubin is >__5mg/dl/day

Answer 38

5

Question 39

how is bilirubin excreted?

Answer 39

its conjugated with water-soluble substances