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Flashcards in Pedia 3B - Applied Neonat Deck (345):
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GP of mother
A. Prenatal history
B. Natal history
C. Neonatal history

Prenatal

1

Severity of Jaundice
A. Prenatal history
B. Natal history
C. Neonatal history

Neonatal

2

Spontaneous breathing at birth
A. Prenatal history
B. Natal history
C. Neonatal history

Natal

3

Hx of Phototherapy

A. Prenatal history
B. Natal history
C. Neonatal history

Neonatal

4

APGAR
A. Prenatal history
B. Natal history
C. Neonatal history

Natal

5

History & PE
- Child swallows dirt, crayon, chalk etc

PICA

6

History & PE
Excessive thirst and water intake

Polydipsia

7

History & PE
Generalized Jaundice (sparring sclera)

Carotenemia

8

History & PE
Child regurgitates food into mouth & chews it

Rumination

9

History & PE
Blue without dyspnea

met-hemoglobunemia

10

History & PE
Generalized Cyanosis + Warm Extremities

Central Cyanosis

11

History & PE
Generalized Cyanosis (sparring tongue)
Cold extremities

Peripheral Cyanosis

12

History & PE
Failure of muscle coordination

Ataxia

13

History & PE
Pacified Swallowing

?
(Maybe it's supposed to be "Painful"? = Odynophagia)

14

History & PE
Difficult swallowing

Dysphagia
Odynophagia
Note that Odynophagia usually refers to painful swallowing while Dysphagia refers to difficulty swallowing

15

History & PE
Lycopenemia

Red skin

16

History & PE
Athetosis

Athetosis is a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet

17

Hx and PE
Unsteady gait

Ataxia

18

Hx and PE
Pulse
- INC w/inspiration
- DEC w/expiration

Sinus Arrhythmia

19

Hx and PE
Pulse volume DEC (or disappears) at the end of inspiration

Pulsus paradoxus

20

Hx and PE
Rapid, deep breathing in metabolic acidosis

Kussmaul's breathing

21

Hx and PE
Alternating periods of deep and shallow breathing with recurring periods of apnea

Biot's breathing

22

Hx and PE
Lying still in bed and do NOT want their abdomen touched

Peritoneal Irritation

23

Hx and PE
Irritability and dyspnea WORSE when laying flat

Congestive Heart Failure

24

Hx and PE
Shrill shrieking and high pitched cry

CNS disease

25

Hx and PE
Abdominal pain AGGRAVATED by palpation

Pain secondary to inflammation

26

Hx and PE
Abdominal pain RELIEVED by palpation

Pain secondary to SPASM

27

Hx and PE
4 month old with head circumference larger than the chest circumference

Normal
(Insert more info)

28

Hx and PE
12 month old w/Head > Chest

Marasmus

29

Hx and PE
Noisy, musical respiratory sound
Heard even w/o stethoscope

Wheeze

30

Hx and PE
Sensory Changes

CNS disease

31

Hx and PE
Dark urine

Myoglobinuria

32

Hx and PE
Exaggerated reflexes

Peripheral nerve disease

33

Eye
Latent Tendency of eyes to deviate

Heterophoria

34

Eye
Partial or complete loss of vision

Amaurosis

35

Eye
Ideal condition of exact ocular balance

Orthophoria

36

Eye
Constant misalignment of the eyes

Heterotropia

37

Eye
Abnormal shape of the pupil

Dyscoria

38

Head Shape
Head is elongated in AP diameter

Scapho-cephaly

39

Head Shape
Top of the head is POINTED

Turri-cephaly

40

Head Shape
One side of the head is more rounded

Plagio-cephaly

41

Head Shape
Tower head

Oxi-cephaly

42

Chest
Pre-sternal edema

Mumps

43

Chest
Shield-shaped chest

Turner's

44

Chest
Absence of clavicle

Cleido-cranial dyostosis

45

Chest
Super-numary nipples

Renal abnormality

46

Chest
Pigeon Chest

Rickets

47

Behavioral Problems
Acting out

Adolescence

48

Behavioral Problems
Bed wetting

School age

49

Behavioral Problems
Breath holding

Pre-school

50

Behavioral Problems
Child neglect

Infancy

51

Prenatal, Natal, Neonatal
Gravida Parity

Prenatal

52

Prenatal, Natal, Neonatal
Mother's age

Prenatal

53

Prenatal, Natal, Neonatal
Polyhydramnios

Prenatal

54

Prenatal, Natal, Neonatal
Maternal intake of metformin

Prenatal

55

Prenatal, Natal, Neonatal
Phototherapy

Natal

56

Prenatal, Natal, Neonatal
APGAR

Natal

57

Prenatal, Natal, Neonatal
Meconium staining

Natal

58

Prenatal, Natal, Neonatal
NSD

Natal

59

Prenatal, Natal, Neonatal
Duration of nursery stay

Neonatal

60

Prenatal, Natal, Neonatal
Severity of Jaundice

Neonatal

61

History and PE
Health history of the yaya

Family history

62

History and PE
Are these the natural parents?

Family Hx

63

History and PE
Is there bed wetting?

Personal and Social

64

History and PE
What is the usual eating pattern?

Personal Social/
(Why not Nutritional??)

65

History and PE
Was phototherapy done?

Neonatal

66

History and PE
History of repeated accidents?

Past medical history

67

History and PE
What was the pattern of weight gain?

Nutritional

68

History and PE
What was the age of weaning?

Nutritional

69

History and PE
APGAR score

Natal

71

History and PE
What was the total duration of labor?

Natal

72

History and PE
40th week of gestation

Neonatal

73

History and PE
Exchange transfusion was done

Past medical history

74

History and PE
APGAR score of 9

Natal

75

History and PE
Two cord coils

Natal

76

History and PE
Presence of cataract

Neonatal

77

History and PE
Blood in sputum

Hemoptysis

78

History and PE
Patient is blue without dyspnea

Met-hemoglobinemia

79

History and PE
Purposeless, repetitive movement

Tics

80

History and PE
Double vision

Diplopia

81

History and PE
Involuntary discharge of urine occuring during sleep at night

Enuresis

82

History and PE
Sensation as if surrounding objects are going round and round

Vertigo

83

History and PE
Purposeless, non-repetitive involuntary movement

Chorea

84

History and PE
Slow writhing movements of the distal portion of the extremities

Athetosis

85

History and PE
Purposeless, non-repetitive movements

Chorea

86

History and PE
Purposeless, repetative movements

Tics

87

History and PE
Rapid oscillatory movements
Present at Rest

Tremor

88

History and PE
Slow rhytmic movements of the extremities and face

Athethosis

89

History and PE
Intermittent contractions of a single muscle group (or group of muscles) resulting in a quick jerky motion of a limb

Myoclonus

90

History and PE: Posture
Extension of the neck

Decerebrate

91

History and PE: Posture
Flexion of the elbows and wrists

Decorticate

92

History and PE: Posture
Extension of the lower limbs

BOTH
Decerebrate
Decorticate

93

History and PE: Posture
Pronation of the forearm

Decerebrate posture

94

History and PE: Posture
Extension at the elbows

Decerebrate

95

History and PE: Skin
Blanch w/pressure

Macules

96

History and PE: Skin
Do NOT blanch w/pressure

Petechiae

97

History and PE: Skin
Confluent papules

Plaques

98

History and PE: Skin
Larger lesions are called bullae

Vesicles

99

History and PE: Skin
Central portion of the lesion paler than periphery

Wheals

100

History and PE: Normal or Abnormal
Hydrocele at 3months

Normal

101

History and PE: Normal or Abnormal
L scrotum is lower than right

Normal

102

History and PE: Normal or Abnormal
Active bowel sounds in late intestinal obstruction

Abnormal

103

History and PE: Normal or Abnormal
Kidney felt best in deep inspiration

Normal

104

History and PE: Normal or Abnormal
Milky white breast secretions in a 5 day old neonate

Normal

105

History and PE: History
Yaya diagnosted w/milk TB

Family History

106

History and PE: History
Sources of support

Personal and Social

107

History and PE: History
Baby sleeps after feeding

Nutritional history

108

History and PE: History
Exchange Transfusion

Neonatal history

109

History and PE: History
Oligohydromnios

Natal history

110

History and PE: History
Term of pregnancy

Pre-natal

111

History and PE: History
Phototherapy

Neo-natal

112

History and PE: History
Polyhydramnios

Natal

113

History and PE: History
Meconium Staining

Natal

114

History and PE: History
Adequacy of milk intake

NONE

115

History and PE: History
Teenage pregnancy

Pre-natal

116

History and PE: History
G1P1

Pre-natal

117

History and PE: History
Birth weight

Natal

118

History and PE: History
Forceps delivery

Natal

119

History and PE: History
Induced Labor

Natal

120

History and PE: Pathologic or Physiologic
Cephalhematoma

Physiologic

121

History and PE: Pathologic or Physiologic
Ebstein pearls

Physiologic

122

History and PE: Pathologic or Physiologic
Erythematoxicum

Physiologic

123

History and PE: Pathologic or Physiologic
(+) Anlke clonus at 1 week of life

Physiologic

124

History and PE: Pathologic or Physiologic
Unequal moro reflex

PATHOLOGIC

125

History and PE: Pathologic or Physiologic
Caput succedanum

Physiologic

126

History and PE: Pathologic or Physiologic
Scaphoid abdomen at birth

Pathologic

127

History and PE: Pathologic or Physiologic
Bounding dorsalis pedis pulses

Pathologic

128

History and PE: Pathologic or Physiologic
Mila over the tip of the nose at 3 days of life

Physiologic

129

History and PE: Pathologic or Physiologic
Peripheral cyanosis at 4 hours of life

Physiologic

130

History and PE: Pathologic or Physiologic
36.7 C at 24h life

Pathologic

131

History and PE: Pathologic or Physiologic
Head circumerfence of 34cm

Physiologic

132

History and PE: Pathologic or Physiologic
Globular abdomen at 46H life

Physiologic

133

History and PE: Pathologic or Physiologic
RR = 60/min at 1 hour life

Physiologic

134

History and PE: Pathologic or Physiologic
Negative fencing reflex at 1 week of life

Pathologic

135

History and PE: Pathologic or Physiologic
Consumes 15cc breastmilk at 12h life

Physiologic

136

History and PE: Pathologic or Physiologic
(+) Palmar grasp at 24H life

Physiologic

137

History and PE: Pathologic or Physiologic
Passage of urine at 30H life in a 34 week neonate

Physiologic

138

History and PE: Pathologic or Physiologic
(+) crepitations over the clavicular area

Pathologic

139

History and PE: Pathologic or Physiologic
(+) Head lag at 2 weeks of life

Physiologic

140

History and PE: Pathologic or Physiologic
Umbilical cord stump falls off at 21 days

Pathologic

141

History and PE: Pathologic or Physiologic
Urethral discharge on 3 day old male

Pathologic

142

History and PE: Pathologic or Physiologic
Highly pigmented genitalia on a newborn female

Pathologic?

143

History and PE: T/F
In taking hx, remember to have a period of communication with the child even though the parents are talking

T

144

History and PE: T/F
In asking questions, use both open-ended and leading questions

T

145

History and PE: T/F
During the process of questioning, if a parent does not look in your eyes directly, it always means evasion

F

146

History and PE: T/F
Abdominal pain made worse by squeezing the abdomen is likey to be spastic in nature

T

147

History and PE: T/F
FF a hx of doctor-shopping by the family, one must be aware of the pediatric version of "Sandifier Syndrome"

T

148

History and PE: T/F
Gravida = number of pregnancies reaching age of viability

F

149

History and PE: T/F
Snoring = form of grunt which occurs during sleep

T
(Isn't snoring a form of Stridor?)

150

History and PE: T/F
Height should be measured in the supine position in infants and children below 2

T

151

History and PE: T/F
Head circumference is measured at the point of max: Glabella and 1 inch above occipital protuberance

F

152

History and PE: T/F
Normally at birth, head circumerence > chest circumferance and remains so until 6m of age

T

153

History and PE: T/F
Normally, the axillary temperature is lower than the oral

T

154

History and PE: T/F
Sinus arrythmia = rapid pulse during expiration and slower during inspiration

F

155

History and PE: T/F
A narrow blood pressure cuff will give spuriously high blood pressure
Broader cuff will give a lower reading

T

156

History and PE: T/F
Movement is lost in both pyramidal and extra-pyramidal dse

T

157

History and PE: T/F
(+) Moro reflex up to 6m is normal

F

158

History and PE: T/F
Absence of balancing reflex for sitting after 8 m is abnormal

T

159

History and PE: T/F
Knee jerk is an example of a deep reflex

T

160

History and PE: T/F
Social smile ~ 3 months

F

161

History and PE: T/F
Bloody vaginal discharge among newborns is pathologic

F

162

History and PE: T/F
Pleural pain gets worse on coughing.

T

163

History and PE: T/F
INC ICP gets worse w/coughing

T

164

History and PE: T/F
Sclera is spared in carotenemia and lycopenemia

T

165

History and PE: T/F
In PICA, aside from mental retardation, there is a Hx of swallowing any inedible thing

F

166

Condition: Polycythemia in IDM
CM:
Tx:

Condition:
CM: Phlethora
Tx: Partial Exchange transfusion

167

Condition: Hypocalcemia in IDM
CM:
Tx:

Condition:
CM: Lipsmacking
Tx: Ca bolus

168

Condition: RDS of prematurity
CM:
Tx:

Condition:
CM: EXP grunting
Tx: PEEP

169

Condition: ARF
CM:
Tx:

Condition:
CM: UO <1cc/kg/h
Tx: Fluids

170

Condition: Neonatal sepsis
CM:
Tx:

Condition:
CM: Poor suck
Tx: Ab coverage for G +/-

171

Condition: Hypoglycemia in IDM
Cause:

Condition:
Cause: Abrupt cessation of glucose production w/existing fetal hyper-insulinemia

172

Condition: Early hypocalcemia
Cause:

Condition:
Cause: Fxn'l hypo-parathyroidism

173

Condition:
Cause: Hyaline membrane disease in IDM

Condition:
Cause: Surfactant deficiency w/retained fetal lung fluid

174

Condition: Early hypocalcemia in IDM
Cause:

Condition:
Cause: Hypomagnasemia d/t maternal Mg renal losses

175

Condition: Neonatal seizures after double volume exchange transfusion
Cause:

Condition:
Cause: INC albumin binding of Ca

176

Condition: UTI
Symptomatology:

Condition:
Symptomatology: Failure to suck + Proteinemia

177

Condition: Group B Strep Pneumonia
Symptomatology:

Condition:
Symptomatology: Profound shock w/tachypnea and expiratory grunt w/air bronchgram

178

Condition: HMD type I
Symptomatology:

Condition:
Symptomatology: Progressive tachypnea, cyanosis, EXP grunting w/air bronchogram

179

Condition: Neonatal hypocalcemia
Symptomatology:

Condition:
Symptomatology: Jitteriness, excessive sweating, tachypnea at 3 days of life

180

Condition: Neonatal hypomagnesemia of IDM
Symptomatology:

Condition:
Symptomatology: Jitteriness, cyanosis excessive sweating at 4th day of life

181

SGA or LGA Associated
Hypoglycemia

Both

182

SGA or LGA Associated
Polycythemia

SGA

183

SGA or LGA Associated
Congenital infections

SGA

184

SGA or LGA Associated
Congenital malformations

SGA

185

SGA or LGA Associated
Long-term developmental problems

SGA

186

SGA or LGA Associated
Born to diabetic mother

LGA

187

SGA or LGA Associated
Hypo-calcemia

LGA

188

SGA or LGA Associated
Respiratory distress

LGA

189

SGA or LGA Associated
Caudal regression syndrome

LGA

190

SGA or LGA Associated
Congenital heart disease

LGA

191

Blue discoloration of the extremities
When exposed to cold

Acrocyanosis

192

_______ cyanosis, esp in peri-oral region, may indicate cardiopulmonary disease

Central

193

Poly-cythemic infants w/hematocrits above ____% may also look cyanotic at times if there is enough de-saturation of Hg (>__%)

Above 68%
>5%

194

Brown blood specimen

Met-hemoglobinemia

195

Factors associated w/Pallor (5)

D/t anemia
Peri-natal asphyxia w/profound circulatory disturbance
Hypo-glycemia
Seizures
Thermal cold stress

196

Jaundice d/t unconjugated bilirubin (skin color)

Yellow-orange

197

Jaundice d/t conjugated bilirubin

Yellow-green

198

Jaundice 5-8%

Face only

199

Jaundice 8-12%

Face + Upper trunk

200

Jaundice >12%

Lower extremities and trunk

201

Jaundice during ________ is NEVER considered physiologic

First 24h of life

202

Jaundice during initial 24h could indicate (2)

Hyper-bilirubinemia (d/t hemolytic dse such as Rh/ABO incompatibility)
Sepsis

203

Irregular, flat, erythematous
Blanch on pressure
Found on forehead, eyelids and nape of neck

Stork's bites
Capillary hemangiomas
Fade during first months of life

204

Irregular, raised, erythematous
Barely noticeable in NB then rapidly enlarge over next 2 months
Disfiguration
Almost always involute spontaneously

Strawberry or cavernous lesions (larger hemangiomas)

205

Large hemangiomas that consume large numbers of platelets

Kasselbach-Merritt Syndrome

206

Small whitish papules
Nose, cheeks, forehead
Retained sebaceous material

Milia
Disappear during first weeks of life

207

Obstruction of eccrine sweat galnds
Pinpoint vesiculo-papular rash
Scalp, forehead, skinfold
Disappear w/in 1-2 weeks if not overheated

Miliaria
Superficial - crystallina
Deep-seated w/reddish appearance - rubra

208

MC rash of newborn period
Begins 2nd/3rd days
White papulo-vesicular lesions on erythematous base
NOT on palms/soles

Erythema toxicum
Benign :)

209

Papulo-vesicular
ANY body surface
Rupture--> pigmented macule w/scaly ring

Pustular melanosis
Black infant

210

MC type of nevus
Large, flat, greyish-blue
Lower trunk or buttocks

Mongolian spot

211

Light brown macules w/irregular borders
Any skin surface

Cafe-au-lait
No significance

212

Large and numerous cafe-au-lait spots may indicate

Neurofibromatosis

213

MC skull trauma

Caput succedaneum (edema of skull)

214

Collection of blood in periosteum
Single bone
10-20% associated w/fractures
Depression of the skull

Cephalo-hematoma
Liquifies at center
Calcifies at periphery

215

Size of fontanels
- Anterior
- Posterior

A - 2-3cm (48h of life)
P - 1cm

216

Normal head circumference

32-37 cm

217

Eye
Lateral upward slow
Inner epi-canthal fold

Trisomy 21
Could also be normal

218

Lateral downward slow

Renal dysplasia/hypoplasia (Potter syndrome)

219

Narrow palpebral fissures
Reduced inter-canthal distance

Fetal alcohol syndrome

220

Conjunctiva
- First 24-48h:
- After second day:
- After 4-5days:
- Several weeks:

Conjunctiva
- First 24-48h: Erythema + Discharge from Silver nitrate
- After second day: Gonococcal ophthalmia
- After 4-5days: Blenorrhea (Chlamydia or viral conjunctivas)
- Several weeks: Also Chlamydial + pneumonia and esosinophilia

221

Blue sclera

Osteogenesis imperfecta
Cutis laxa
Normal

222

D/t INC in venous pressure during delivery
Benign

Subconjunctival hemorrhages

223

Clouding of cornea (hazy grey)
(-) ROR

Cataracts
Glaycoma

224

White reflex on ophthalmoscopy

Retino-blastoma

225

Blushfield spots (small white spots at periphery of iris)

Trisomy 21
Normal

226

SGA
Salt and pepper appearance of retina

Congenital infection
- Cytomegalic inclusion disease
- Toxoplasmosis

227

Ear:
Anotica (Treacher-Collins syndrome)

Absence of ear

228

Pre-auricular pits are N/Ab

Normal

229

Ear examination of infant

Upward and anteriorly

230

Ear examination in an older child

UBO

231

Appearance of tympanic membrane in newborn

Less translucent
INC vascularity

232

Red bulging tympanic membrane

Otitis media

233

Cyanosis at rest
Disappears w/crying

Choanal atresia

234

Large tongue

Normal

235

Excessively large tongue (5)

Hemangioma
Lymphangioma
Hypothyroidism
Mucopolysaccharidosis
Beckwith Syndrome

236

Small epithelial inclusion cysts of the palate

Benign "Epstein's Pearls"

237

Retention cysts along gyms

Ranula
Benign

238

Small Jaw
+ Glossoptosis + high arched palate

Normal
Pierre Robin Syndrome

239

MC mass in neck

Cystic hydromas

240

Neck mass
Soft
Lymphoid
(+) Transillumination
Ant triangle

Cystic hygromas

241

Neck Mass
Firm
SCM
(-) Transillumination

Branchial cleft cysts

242

MC Midline mass

Thyroglossal duct cyst
Goiters are rare unless endemic to area

243

Webbing of neck (3)

Turner
Noonan
Klippel-Feil

244

Most important sign of lung disease in neonate
Seen in resp distress, atelectasis, airway obstruction, aspiration
Reduced lung volume

Retractions

245

Newborn RR

Variable
Ranges 30-60 bpm
Mean: 40

246

Newborn breathing

Abdominal
Little use of accessory
Normalized at 8-12 hours

247

Contractions and cyanosis <8hours of life

Normal as fetal lung fluid is cleared

248

Cessation of breathing >15s
Cessation of breathing <15s + bradycardia

Apnea

249

Breasts in NB

Days 2-3

250

Dull percussion note in NB

Pleural effusion
Lobar atelectasis

251

Hyper-resonant percussion in NB

Pneumothorax
Lung cysts
Lobar emphysema

252

Breath sounds in NB ideally listened for at

Midaxillary line in midthorax

253

Breath sounds in NB and infant are more

Broncho-vesicular

254

Unilateral absence of breath sounds (40

Atelectasis
Pleural effusion
Pneumothorax
Cystic malformations

255

Bowel sounds in chest should alert to

Diaphragmatic hernia

256

Stridor on INSP

MC Laryngomalacia
Also
- Tracheomalacia
- Laryngeal web
- Vocal cord paralysis
- Vascular ring

257

Excessive mucus in upper airway results in
(Clears on coughing or crying)

INSP Rhonchi

258

Crackles or rales associated with

Pneumonia
Delayed resorption of fetal lung fluid
Meconium aspiration
Pulmonary edema

259

Cardinal signs of heart disease in a neonate

Cyanosis
Respiratory distress

260

NB Blood pressure
Systolic
Diastolic
Mean

S 40-80
D 20-55
M 25-60

261

NB HR

90-160 (usually 120-140 term)

262

Single umbilical vessel associated with

Genito-urinary anomalies

263

Cardinal signs of intestinal obstruction

- Abdominal distension
- Failure to pass mecoium
- Bilious vomiting

264

Bruits heard in abdomen

Renal artery stenosis

265

High pitched bowel sounds

Mechanical obstruction

266

(-) Bowel sounds

Ileus
Septicemia

267

Liver in neonate found __ to __ cm below costal margin

1-2cm

268

Hard or nodular liver

Intrinsic liver pathology

269

Firm or rubbery liver

Extrinsic pathology (CHF)

270

Splenic enlargement beyond ___ cm below L costal margin is abnormal

1cm

271

Separation of musculature of the abdomen at midline

Diastasis recti
Associated w/circular umbilical hernia

272

Tufts of hair, pilonidal sinus, soft lumps may indicate

Spina bifida occulta

273

Male phallus at least __ cm in length

1cm

274

Urethral opening proximal to end of phallus
1'
2'
3'

Hypospadias
1' - Urethral opening on glans but proximal to tip
2' - Opening along shaft
3' Opening anywhere from perineum to base

275

Caudal curve of penis

Chordee

276

Unilaterally cyanotic scrotum shortly after birth

Intra-uterine testicular torsion
Painless but can rarely be saved

277

Discharge from female NB
- White
- Blood tinged

Normal d/t hormones

278

Membrane at opening of vagina

Hydro-metro-colpos

279

Silk sign

INdirect hernia

280

Usual signs of indirect hernia in infants
- Male
- Female

Hydrocele
Prominence of labia majora

281

MCC Ambiguous genitalia

Congenital adrenal hyperplasia

282

Ovarian enlargement in NB

Cyst
Torsion

283

Uterine enlargement in NB

Hydro-metro-colpos

284

Fusion of digits

Syndactly

285

Unequal limb size is associated with

congenital malformations
Hemangiomas
Lymphangiomas
Intrauterine positional anomalies

286

Hip dislocation

Ortolani
Barlow
Asymmetry of gluteal folds

287

Optimal time to perform neurological examination

Prior to feeding

288

Frog-leg position

Hypotonic infants
Normal in pre-mature

289

Disconjugate gaze is normal up to

6 months
Esp immediately ff sleep

290

CN IX & X assessed by

Effective coordination of swallowing

291

Assessment of CN XII

Sucking and Milk expression

292

Reflexes
Appears:
Disappears:
Moro

Appears 28w
Complete 32w
Disappears 4m

293

Reflexes
Appears:
Disappears:
Palmar

Appears 28 (same as moro)
Developed by 32w
Disappears 2-3m

294

Reflexes
Appears:
Disappears:
Tonic Neck/Fencing

Appears: 35w
Peak: 1m postnatal
Disappears: 6m

295

Reflexes
Appears:
Disappears:
Stepping (involuntary walking)

Appears 35-36w
Disappears: 2m

296

Prematurity
Birthweight
Weeks Gestational Age
Mild

2000-2500 gm
35-37 weeks

297

Prematurity
Birthweight
Weeks Gestational Age
Moderate

1000-2000
29-35 weeks

298

Prematurity
Birthweight
Weeks Gestational Age
Severe

<1000
24-28 weeks

299

Skin - Shiny and translucent

Very premature

300

Sudden twitching of all extremities
Tremulousness of single extremities

NOT seizures
Immature, poorly myelinated CNS

301

Single most devastating problem for premature baby

Intra-ventricular hemorrhage
Apnea, cyanosis and autonomic instability

302

Seizures in NB

Sublte
Cyclic flexing of digit or extremity
Lip smacking
Repetitive mouthing movements
Yawning
Apnea

303

NB Blood pressure
Systolic
Diastolic
Mean

S 40-80
D 20-55
M 25-60

304

NB HR

90-160 (usually 120-140 term)

305

Single umbilical vessel associated with

Genito-urinary anomalies

306

Cardinal signs of intestinal obstruction

- Abdominal distension
- Failure to pass mecoium
- Bilious vomiting

307

Bruits heard in abdomen

Renal artery stenosis

308

High pitched bowel sounds

Mechanical obstruction

309

(-) Bowel sounds

Ileus
Septicemia

310

Liver in neonate found __ to __ cm below costal margin

1-2cm

311

Hard or nodular liver

Intrinsic liver pathology

312

Firm or rubbery liver

Extrinsic pathology (CHF)

313

Splenic enlargement beyond ___ cm below L costal margin is abnormal

1cm

314

Separation of musculature of the abdomen at midline

Diastasis recti
Associated w/circular umbilical hernia

315

Tufts of hair, pilonidal sinus, soft lumps may indicate

Spina bifida occulta

316

Male phallus at least __ cm in length

1cm

317

Urethral opening proximal to end of phallus
1'
2'
3'

Hypospadias
1' - Urethral opening on glans but proximal to tip
2' - Opening along shaft
3' Opening anywhere from perineum to base

318

Caudal curve of penis

Chordee

319

Unilaterally cyanotic scrotum shortly after birth

Intra-uterine testicular torsion
Painless but can rarely be saved

320

Discharge from female NB
- White
- Blood tinged

Normal d/t hormones

321

Membrane at opening of vagina

Hydro-metro-colpos

322

Silk sign

INdirect hernia

323

Usual signs of indirect hernia in infants
- Male
- Female

Hydrocele
Prominence of labia majora

324

MCC Ambiguous genitalia

Congenital adrenal hyperplasia

325

Ovarian enlargement in NB

Cyst
Torsion

326

Uterine enlargement in NB

Hydro-metro-colpos

327

Fusion of digits

Syndactly

328

Unequal limb size is associated with

congenital malformations
Hemangiomas
Lymphangiomas
Intrauterine positional anomalies

329

Hip dislocation

Ortolani
Barlow
Asymmetry of gluteal folds

330

Optimal time to perform neurological examination

Prior to feeding

331

Frog-leg position

Hypotonic infants
Normal in pre-mature

332

Disconjugate gaze is normal up to

6 months
Esp immediately ff sleep

333

CN IX & X assessed by

Effective coordination of swallowing

334

Assessment of CN XII

Sucking and Milk expression

335

Reflexes
Appears:
Disappears:
Moro

Appears 28w
Complete 32w
Disappears 4m

336

Reflexes
Appears:
Disappears:
Palmar

Appears 28 (same as moro)
Developed by 32w
Disappears 2-3m

337

Reflexes
Appears:
Disappears:
Tonic Neck/Fencing

Appears: 35w
Peak: 1m postnatal
Disappears: 6m

338

Reflexes
Appears:
Disappears:
Stepping (involuntary walking)

Appears 35-36w
Disappears: 2m

339

Prematurity
Birthweight
Weeks Gestational Age
Mild

2000-2500 gm
35-37 weeks

340

Prematurity
Birthweight
Weeks Gestational Age
Moderate

1000-2000
29-35 weeks

341

Prematurity
Birthweight
Weeks Gestational Age
Severe

<1000
24-28 weeks

342

Skin - Shiny and translucent

Very premature

343

Sudden twitching of all extremities
Tremulousness of single extremities

NOT seizures
Immature, poorly myelinated CNS

344

Single most devastating problem for premature baby

Intra-ventricular hemorrhage
Apnea, cyanosis and autonomic instability

345

Seizures in NB

Sublte
Cyclic flexing of digit or extremity
Lip smacking
Repetitive mouthing movements
Yawning
Apnea