Physical Assessment

Question 1

Transilluminator

Answer 1

Light indicates fluid
No light indicates solid
Hydroceles, hydrocephalus

Question 2

Ophthalmoscope

Answer 2

Red reflex - light reflects off fundus of eye (red appears as indication of lack of opacity - cataracts, glaucoma, retinal blastoma)

Question 3

APGAR

Answer 3

HR, respiratory efforts, gone, reflex irritability, color
Scored 0-2
HR - 1 for <100, 2 for >100

Question 4

Hypotelorism

Answer 4

Close set eyes

Question 5

Hypertelorism

Answer 5

Far set eyes

Question 6

Ear issues

Answer 6

Can mean renal issues, developed at the same time

Question 7

Philtrum

Answer 7

Flattened can be associated with fetal alcohol syndrome

Question 8

Cystic hygroma

Answer 8

Fluid filled sacs result from blockage in lymphatic system, may require immediate intubation or trach

Question 9

PMI

Answer 9

left of sternum, 4th intercostal space

Question 10

Pulse pressure

Answer 10

Diff between systolic and diastolic, term should be 25-30, premature 15-25
Gest age

Question 11

Murmur

Answer 11

Murmur
Turbulent blood flow
Thrill - palpable turbulence

Question 12

P wave

Answer 12

Depolarization of atria

Question 13

QRS

Answer 13

Depolarization of ventricles

Question 14

T wave

Answer 14

Repolarization of ventricles

Question 15

Simean crease

Answer 15

Single palmar crease
Can indicate Down syndrome

Question 16

Asymmetry of gluteal folds

Answer 16

Hip dislocation
Ortolani and Barlow maneuvers

Question 17

Talipes equinovarus

Answer 17

Club foot

Question 18

Erythema toxicim

Answer 18

Benign
Small white pinpoint papules (red elevation of skin)

Question 19

Milia

Answer 19

Yellow or white papules, due to retained keratin and secretions of sebaceous glands

Question 20

Epstein pearls

Answer 20

Milia in mouth

Question 21

Hyperpigmented macule

Answer 21

Mongolian spot, usually on butt flanks or shoulders

Question 22

Transient neonatal pustular melanosis

Answer 22

Similar to Milia but present at birth, will rupture within 48 hours
Contains neutrophils

Question 23

Nevus simplex

Answer 23

Stork bite

Question 24

Nevus flammeaus

Answer 24

Port wine

Question 25

TTN

Answer 25

Chest X-ray - overexpansion, haziness, increased vascular markings, fluid in the fissures

Question 26

Meconium aspiration xray

Answer 26

Hyper inflation, patchy infiltrates

Question 27

RDS XRAY

Answer 27

atelectasis, air bronchograms, diffuse granular infiltrates

Question 28

Turner syndrome

Answer 28

Occurs in females, SGA, broad chest, wide spaced nipples, edema in extremities, short webbed neck

Question 29

Trisomy 18

Answer 29

Prominent occiput, low set ears, small eyes and jaw, clenched hands with overlapping fingers, rocker bottom feet

Question 30

Trisomy 21

Answer 30

Brushfield spots, small ears, simean creases, excess skin at nape of neck, large tongue

Question 31

Klinefelter syndrome

Answer 31

Males, long limbs, elbow dysplasia, clinodactyly of 5th finger

Question 32

Transposition of great vessels

Answer 32

Aorta arises from right ventricle and pulmonary artery arises from left ventricle Marked cyanosis because aorta carried deoxygenated blood from right ventricle to systemic circulation

Question 33

Aortic stenosis

Answer 33

Reduces blood flow to body Usually asymptomatic at birth Pallor, mottling, poor perfusion May develop when PDA closes

Question 34

Coarctation of the aorta

Question 35

Cafe au lait

Answer 35

Presence of 6 or more associated with neurofibromatosis

Question 36

Craniotabes

Answer 36

Soft spots on the skull that collapse and recoil with pressure Result from bone reabsorption due to pressure of skull against maternal pelvis

Question 37

Cicatricial scarring

Answer 37

Finding of congenital varicella

Question 38

10-12 inches

Answer 38

Newborns can focus on objects at this distance

Question 39

Erbs palsy

Answer 39

Injury to brachial plexus, shoulder dystocia Asymmetric Moro reflex

Question 40

Bell’s palsy

Answer 40

Damage to facial nerve caused by pressing against maternal pelvis

Question 41

Neonatal myoclonus

Answer 41

Episodes of repetitive jerking or jitteriness that doesn’t stop with restraint

Question 42

Congenital syphalis

Answer 42

Purple by or bloody nasal discharge and copper colored maculopapular rash that blisters and peels

Question 43

CMV symptoms

Answer 43

Blueberry muffin and hepatosplenomegaly

Question 44

Positive direct antigen test (DAT)

Answer 44

Presence of maternal antibodies causing hemolysis Immune mediated hemolysis

Question 45

Transient neonatal pustular melanosis

Answer 45

More common in pigmented skin Mixture of vesicle and pustules and pigmented macules

Question 46

Port wine stains

Answer 46

Can indicate sturge Weber syndrome is over trigeminal area Can indicate underlying hemangiomas

Question 47

Congenital hypothyroidism

Answer 47

If symptoms are present, include large fontanelle, umbilical hernia, coarse facial features, thick skin, delayed bone age

Question 48

Congenital adrenal hyperplasia

Answer 48

Female - abnormal genitalia Male - may be undiagnosed until 7-24 days, symptoms after that are hypoglycemia, hyponatremia, hypotension, shock

Question 49

Prader Willi syndrome

Answer 49

Rare genetic syndrome, hypogonadism, lethargy, hypotonia, feeding difficulty

Question 50

Chlamydia eye

Answer 50

Symptoms at 5-7 days, conjunctivitis, edema, purulent discharge

Question 51

Stepping reflex

Answer 51

Supporting infant under arms and placing foot on edge of surface, infant should support own weight and make stepping motion

Question 52

Babinski reflex

Answer 52

Foot goes into plantar flexion after stimulation of sole

Question 53

Galant reflex

Answer 53

Apply pressure on spine, pelvis should flex toward side of spine stimulated

Question 54

Tonic neck reflex

Answer 54

Turning head to one side, infant should extend upper extremity to side where head is turned and flex opposite extremity