Perinatal/Newborn Health Screening Flashcards Preview

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Flashcards in Perinatal/Newborn Health Screening Deck (53):
1

Through what age is the prenatal history particularly important?

3 years

2

Low birth weight (LBW)

<2,500 g

3

Very low birth weight (VLBW)

<1,500 g

4

Extremely low birth weight (ELBW)

<1,000 g

5

Appropriate for gestational age (AGA) is between which percentiles?

10th - 90th percentiles

6

How long does a small for gestational age baby have to catch up?

2 years

7

What does APGAR stand for?

A - Appearance
P - Pulse
G - Grimace
A - Activity
R - Respirations

8

What is the timing of APGAR scoring?

1 and 5 minutes of life

9

What is the maximum APGAR score?

10

10

APGAR -
Number of potential scores per category?

3 total -

(they are 0, 1, 2)

11

What is the span in weeks of a "term" infant?

37 - 41 weeks

less is premature
more is post-term

12

Newborn -
average length
average weight
average head circumference

20-21 inches (51 cm)
7 lbs (3,100 g)
13-14 inches (33-35 cm)

13

Newborn -
Small for gestational age (SGA) - what are the two types and which is more common?

Symmetric IUGR
Asymmetric IUGR* (more common)

14

Newborn -
Symmetric IUGR
definition and examples

size parameters are all <10th percentile

usually suggests long term compromise or presence of intrinsic problem

genetic anomaly
environment (drugs, nicotine)

15

Newborn -
Asymmetric IUGR
definition and examples

head circ and length are normal, weight is < 10%
(usually occurs after 24 weeks)

maternal hypertension
cyanotic heart disease
multiple gestation
altitude

16

Newborn -
Large for gestational age (LGA)
definition and examples

>90th percentile for weight

maternal diabetes
Beckwith-Weidemann
large mother

17

Newborn - vital signs
temp
normal pulse
respirations
blood pressure

temp < 38
120 - 170 BPM
30 - 60 resp
<112/74

18

Newborn -
acrocyanosis

cyanosis of the extremeties (normal)

19

Newborn -
plethora

may indicate? risk for?

splotchy redness

DOES involve mucosal, palmar, and plantar surfaces

often indicates polycythemia (too many RBC)
risk for stroke

20

Newborn -
milia

pinpoint papules on face

spontaneous resolution by 3-4 weeks of life

21

Newborn -
miliaria

obstructed sweat glands

also known as "prickly heat"

("has an R in there, must be red")

22

Newborn -
erythema toxicum

most common newborn rash - appears day 2-5

red bloches that BLANCH with overlying papules

NO involvement of mucosa, palmar, and plantar surfaces

resolves by 14th day

23

Newborn -
cafe au lait spots

not normally seen in newborn

> 5 indicative of neurofibromatosis

24

Newborn -
junctional nevi
...if there are many, can be indicative of:


tuberous sclerosis
xeroderma pigmentosus
generalized neurofibromatosis

25

Newborn -
mongolian spots - how long do they last?

up to age 3-5 years

26

Newborn -
port wine stain - can be associated with what?

seizures and glaucoma

r/o sturge-webber

27

Newborn -
"strawberry mark" aka
resolve when?

hemangioma

normal begin to shrink and fade at 6 months of age

28

Primitive reflexes -
first to disappear?

stepping reflex disappears at 1 -2 months

29

Primitive reflexes -
disappearing in 3 - 4 month range

rooting
sucking
moro
tonic neck

30

Primitive reflexes -
when does the GRASP reflex disappear - palmar? plantar?

palmar grasp disappears at 3 - 6 months
plantar grasp disappears at 4 months

31

Primitive reflexes -
which is the last to disappear?

babinski disappears at 12 months or when walking

32

Newborn -
which post-birth head condition CROSSES THE MIDLINE?

caput succedaneum

simple swelling, resolves in 2-3 days

33

Newborn -
which post birth head condition does NOT cross the midline?

cephalohematoma

blood under periosteum, takes much longer to resolve

34

Newborn -
with what condition can white forelocks sometimes be associated?

Waardenburng syndrome - deafness and retardation

35

Newborn -
Which of the fontanels is larger and when does it close?

the anterior is larger (2 - 5 cm)

closes by 18 months

36

Newborn -
When does the posterior fontanel close?

closes by 2 - 3 months

may not be palpable at birth

37

Newborn -
common causes of widened fontanels?

prematurity
IUGR
Hydrocephalus
Down syndrome
Hypothyroidism

38

Newborn -
what does a black spot in the place of the red reflex indicate?

No clear pathway from lens to retina

39

Newborn -
what dose a whitish color in the place of the red reflex indicate?

could be retinoblastoma or congenital cataracts

40

Newborn -
choanal atresia

narrowing or blockage of the nasal airway by tissue, present at birth

41

Newborn -
epstein pearls - benign or malignant?

benign

42

Newborn -
pulse ox check - particulars and significance?

Pulse ox in all four extremeties

>2% difference among any is signficant

43

Newborn -
normal abdomen shape?

protruberant

44

Newborn -
% with murmur?

85%

45

Newborn -
number of arteries/veins in umbilical cord?

2 arteries
1 vein

46

Newborn -
% of males with undescended testicles?

3%

47

Newborn -
Barlow's
Ortalani's
Galeazzi

Need more info here

48

Newborn -
all 50 states require which newborn screening blood tests?

PKU
galactosemia
hemoglobinopathies
congenital hypothyroidism

49

Newborn -
what are reasons a newborn might be rescreened?

if initial testing is done before 24 hours of life
if infant is symptomatic

50

Newborn -
inborn errors of metabolism

phenylketonuria (PKU)
galactosemia

51

Newborn -
what can HYPOTHYROIDISM in the newborn cause?

mental retardation
neurologic abnormalities
metabolic abnormalities

52

Newborn -
typical presentation of CMV

microcephaly and hearing loss

53

Newborn -
typical presentation of RUBELLA

cardiovascular and ophthalmic complications