Perinatal/Newborn Health Screening

Question 1

Through what age is the prenatal history particularly important?

Answer 1

3 years

Question 2

Low birth weight (LBW)

Answer 2

<2,500 g

Question 3

Very low birth weight (VLBW)

Answer 3

<1,500 g

Question 4

Extremely low birth weight (ELBW)

Answer 4

<1,000 g

Question 5

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

Answer 5

10th - 90th percentiles

Question 6

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

Answer 6

2 years

Question 7

What does APGAR stand for?

Answer 7

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

Question 8

What is the timing of APGAR scoring?

Answer 8

1 and 5 minutes of life

Question 9

What is the maximum APGAR score?

Answer 9

10

Question 10

APGAR -

Number of potential scores per category?

Answer 10

3 total -

they are 0, 1, 2

Question 11

What is the span in weeks of a “term” infant?

Answer 11

37 - 41 weeks

less is premature
more is post-term

Question 12

Newborn -
average length
average weight
average head circumference

Answer 12

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

Question 13

Newborn -

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

Answer 13

Symmetric IUGR

Asymmetric IUGR* (more common)

Question 14

Newborn -
Symmetric IUGR
definition and examples

Answer 14

size parameters are all <10th percentile

usually suggests long term compromise or presence of intrinsic problem

genetic anomaly
environment (drugs, nicotine)

Question 15

Newborn -
Asymmetric IUGR
definition and examples

Answer 15

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

maternal hypertension
cyanotic heart disease
multiple gestation
altitude

Question 16

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

Answer 16

> 90th percentile for weight

maternal diabetes
Beckwith-Weidemann
large mother

Question 17

Newborn - vital signs
temp
normal pulse
respirations
blood pressure

Answer 17

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

Question 18

Newborn -

acrocyanosis

Answer 18

cyanosis of the extremeties (normal)

Question 19

Newborn -
plethora

may indicate? risk for?

Answer 19

splotchy redness

DOES involve mucosal, palmar, and plantar surfaces

often indicates polycythemia (too many RBC)
risk for stroke

Question 20

Newborn -

milia

Answer 20

pinpoint papules on face

spontaneous resolution by 3-4 weeks of life

Question 21

Newborn -

miliaria

Answer 21

obstructed sweat glands

also known as “prickly heat”

(“has an R in there, must be red”)

Question 22

Newborn -

erythema toxicum

Answer 22

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

Question 23

Newborn -

cafe au lait spots

Answer 23

not normally seen in newborn

> 5 indicative of neurofibromatosis

Question 24

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

Answer 24

tuberous sclerosis
xeroderma pigmentosus
generalized neurofibromatosis

Question 25

Newborn - | mongolian spots - how long do they last?

Answer 25

up to age 3-5 years

Question 26

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

Answer 26

seizures and glaucoma r/o sturge-webber

Question 27

Newborn - "strawberry mark" aka resolve when?

Answer 27

hemangioma normal begin to shrink and fade at 6 months of age

Question 28

Primitive reflexes - | first to disappear?

Answer 28

stepping reflex disappears at 1 -2 months

Question 29

Primitive reflexes - | disappearing in 3 - 4 month range

Answer 29

rooting sucking moro tonic neck

Question 30

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

Answer 30

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

Question 31

Primitive reflexes - | which is the last to disappear?

Answer 31

babinski disappears at 12 months or when walking

Question 32

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

Answer 32

caput succedaneum simple swelling, resolves in 2-3 days

Question 33

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

Answer 33

cephalohematoma blood under periosteum, takes much longer to resolve

Question 34

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

Answer 34

Waardenburng syndrome - deafness and retardation

Question 35

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

Answer 35

the anterior is larger (2 - 5 cm) closes by 18 months

Question 36

Newborn - | When does the posterior fontanel close?

Answer 36

closes by 2 - 3 months may not be palpable at birth

Question 37

Newborn - | common causes of widened fontanels?

Answer 37

``` prematurity IUGR Hydrocephalus Down syndrome Hypothyroidism ```

Question 38

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

Answer 38

No clear pathway from lens to retina

Question 39

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

Answer 39

could be retinoblastoma or congenital cataracts

Question 40

Newborn - | choanal atresia

Answer 40

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

Question 41

Newborn - | epstein pearls - benign or malignant?

Answer 41

benign

Question 42

Newborn - | pulse ox check - particulars and significance?

Answer 42

Pulse ox in all four extremeties >2% difference among any is signficant

Question 43

Newborn - | normal abdomen shape?

Answer 43

protruberant

Question 44

Newborn - | % with murmur?

Answer 44

85%

Question 45

Newborn - | number of arteries/veins in umbilical cord?

Answer 45

2 arteries | 1 vein

Question 46

Newborn - | % of males with undescended testicles?

Answer 46

3%

Question 47

Newborn - Barlow's Ortalani's Galeazzi

Answer 47

Need more info here

Question 48

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

Answer 48

PKU galactosemia hemoglobinopathies congenital hypothyroidism

Question 49

Newborn - | what are reasons a newborn might be rescreened?

Answer 49

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

Question 50

Newborn - | inborn errors of metabolism

Answer 50

phenylketonuria (PKU) | galactosemia

Question 51

Newborn - | what can HYPOTHYROIDISM in the newborn cause?

Answer 51

mental retardation neurologic abnormalities metabolic abnormalities

Question 52

Newborn - | typical presentation of CMV

Answer 52

microcephaly and hearing loss

Question 53

Newborn - | typical presentation of RUBELLA

Answer 53

cardiovascular and ophthalmic complications