Newborn Exam

Question 1

Describe TORCH infections

Answer 1

Toxoplasmosis
Other (e.g. syphilis, parovirus, varicella) 
Rubella
Cytomegalo virus 
Herpes simplex 

cogenital infections that disrupt fetal development

Question 2

Describe symmetric IUGR

Answer 2

head circumference proportional to that of body

• less common
• more concerning
• occurs earlier and throughout gestation

Question 3

What may be causes of symmetric IUGR?

Answer 3

• TORCH infections
• single gene defect
• chromosomal/aneuploidy

Question 4

Describe asymmetric IUGR

Answer 4

aka “head-sparing”

head circumference > abdominal circumference

• more common
• occurs later in gestation

Question 5

What may cause asymmetric IUGR?

Answer 5

extrinsic factors

• malnutrition
• poor placental perfusion
• cHTN

Question 6

What is the incurving reflex?

Answer 6

infant turns head to side that is stroked

Question 7

What may hypertonia be related to?

Answer 7

• CNS irritability
• hemorrhage
• infection

Question 8

What may hypotonia be related to?

Answer 8

• immaturity
• hypoxemia
• sepsis

Question 9

When does crying duration peak?

Answer 9

4-5 months

Question 10

What is expected weight gain in a NB?

Answer 10

0.5-1 oz/day

• regain birth weight by 2 wks
• double birth weight by 1yo

Question 11

At which point is acrocyanosis pathologic?

Answer 11

> 24-48h

Question 12

What is Harlequin sign?

Answer 12

harmless, unilateral color change d/t autonomic vasomotor instability; lasts 10-20mins

Question 13

What is erythema toxicum?

Answer 13

generalized yellow or white papules 1-3mm in diameter EXCEPT for on palmar surfaces

Question 14

When should strawberry hemangioma be referred?

Answer 14

when located near eyes

Question 15

What can mottled skin indicate?

Answer 15

cold stress/hypothermia

Question 16

What is average NB weight?

Answer 16

2500-4000g

5lbs 8oz - 8lbs 13oz

Question 17

What is average NB length?

Answer 17

46-56cm

18-22in

Question 18

What is average NB head circumference?

Answer 18

31-38cm

12-15in

Question 19

Describe normal fontanelles

Answer 19

anterior = 1-4cm diamond

posterior = triangle

Question 20

Posterior fontanel closes (before/after) anterior fontanel.

Answer 20

before

Question 21

When should molding resolve?

Answer 21

b/w 24-48h

Question 22

How far can NBs see?

Answer 22

8-10in from face

Question 23

When do NBs develop their permanent eye color?

Answer 23

3-6mo

Question 24

What is normal chest measurement?

Answer 24

AP diameter 1:1

circumference = 33cm (or 2cm less than head circumference)

Question 25

When should one be able to auscultate bowel sounds?

Answer 25

1-2h of life

Question 26

When will the cord fall off?

Answer 26

7-10 days

Question 27

Describe Barlow and Ortolani maneuvers

Answer 27

assess for hip dysplasia B: dislocates hip O: reduces hip

Question 28

Describe a NB neuro exam

Answer 28

1) reflexes 2) cranial nerves 3) Brazelton neonatal behavioral assessment scale = behavioral capabilities

Question 29

What are NB reflexes?

Answer 29

1) Moro reflex (birth --> 6-8mo) 2) Glabellar tap reflex = facial nerve; tap on forehead b/w eyes 3) blinking reflex (25wks GA) 4) pupillary (red) reflex 5) gag reflex (36wks GA) 6) swallowing reflex (12wks GA) 7) cough reflex 8) walk/step reflex 9) plantar grasp reflex (birth --> 8-10mo) 10) trunk incurvation/Galant reflex (birth --> 2mo) 11) Babinski reflex (birth --> 8-9mo) 12) rooting reflex (birth --> 3-4mo) 13) suck reflex 14) palmar grasp reflex 15) crossed extensor 16) tonic neck/fencing reflex

Question 30

Differentiate among pre-term GAs

Answer 30

Extreme PT: <28wks Very Pt: 28-32wks Late PT: 34-36wks

Question 31

Differentiate among term GAs

Answer 31

Early term: 37-38wks Term: 39-40wks Post-term: >42wks

Question 32

When is the Dubowitz/Ballard scores most accurate?

Answer 32

12-48h of life

Question 33

When should the anterior fontanel close?

Answer 33

by 12-18mo

Question 34

How long do NBs sleep?

Answer 34

first few days: 16-18h/day | by 4wks: 8-20h/day