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Flashcards in Rita's Newborn Questions Deck (96)
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1

You are examining a 2 day old born vaginally who has a well-demarcated lump that does not cross midline. What is the most likely dx?
a) A cephalohematoma
b) A caput succedaneum
c) A mass

a) A cephalohematoma

--take longer to go away than caputs
--Caput succedaneums DO cross midline

2

What is the most common disease identified in the neonatal screening?
a) Phenylketonuria
b) Maple syrup urine disease
c) Hypothyroidism
d) Galactosemia

c) Hypothyroidism

3

Which of the following tests results from neonatal screening indicates possible hypothyroidism?
a) Normal TSH, low T3
b) Low TSH, high T4
c) Low T3, high T4
d) High TSH, low t4

d) High TSH, low t4

4

What will the average 8 lbs newborn weigh at 2-week check?
a) 7.5 lbs
b) 8.5 lbs
c) 9.5 lbs
d) 9 lbs

b) 8.5 lbs

5

What is expected DAILY wt gain for a 6 week old baby?
a) 5 ounce
b) 1 ounce
c) 2 ounces
d) 8 ounces

b) 1 ounce

6

When should you do the newborn screen?
a) At birth
b) After 24 hrs
c) After 48 hrs
d) After 24 hrs post feeding

d) After 24 hrs post feeding

7

How many kcal does a 0-6mos full-term baby need per kg?
a) 65
b) 105
c) 135
d) 150

b) 105

135kcal = lower limit of normal for preemies!

8

What test evaluates gestational age?
a) Dubowitz scale
b) Apgar
c) Hurwitz scale

a) Dubowitz scale

9

Which one of the following is a contraindication to breastfeeding?
a) c/s
b) mom taking Flagyl
c) mom has a hx of genital herpes

b) mom taking Flagyl

10

Which of the following is not associated with a significant increase in alpha feta protein taken in a pregnant mother?
a) Down syndrome
b) Multiple gestation
c) Spinal bifida occulta
d) Fetal death

a) Down syndrome

11

Which nutrient is not absorbed as well by preemies as opposed to full-term infants?
a) Carbohydrate
b) Fat
c) Protein

b) Fat

--harder to digest!

12

A newborn has retinitis, growth retardation, jaundice, hepatosplenomegaly, petechia, and microcephaly. What is the most likely dx?
a) CMV
b) rubella
c) toxoplasmosis

c) toxoplasmosis
--> chorioretinitis!

CMV --> hearing problems

13

What is the tx of moderate jaundice at home?
a) breastfeed
b) offer glucose water
c) home phototherapy
d) stop breastfeeding for 24 hrs

a) breastfeed

14

Which of the following is an example of the best nutrition intake?
a) A 2yo taking >32 ounces of milk
b) a 3yo on skim milk
c) A 9 month old on whole cow's milk

b) a 3yo on skim milk

A 2yo taking >32 ounces of milk
--> will be Fe-deficient...Fe is critical for brain growth!
A 9 month old on whole cow's milk
--> will be Fe-deficient...formula only until 1yr!

15

What is the normal weight gain for babies per month during the first 2 months of life?
a) 12 ounces
b) 16 ounces
c) 18-24 ounces
d) 36 ounces

c) 18-24 ounces
--> 1-2 lbs or 18-32 ounces = ideal answer

36 ounces
--> >2 lbs/month...too much!

16

When is jaundice pathological in a full-term infant?
a) Day 1 of life
2) Day 4 of life
3) Day 5 of life

a) Day 1 of life

17

A 12 hour old breastfeeding full-term newborn has an elevated direct and total bilirubin. What are you concerned about?
a) Biliary atresia
b) Physiological jaundice
c) Breast milk jaundice
d) Hepatitis A

a) Biliary atresia

--> direct bili = conjugated

18

Which is the best way to transition BF baby to formula?
a) slow wean over months
b) just go to formula
c) substitute one feeding every 2-3 days

c) substitute one feeding every 2-3 days

19

What best describes erythema toxicum?
a) flesh colored umbilical papules
b) multiple non erythematous macular lesions
c) erythematous papules
d) grouped vesicles

c) erythematous papules

flesh colored umbilical papules = Molluscum

grouped vesicles = herpes

20

A newborn has ABO incompatibility. What is the most likely tx?
a) exchange transfusion
b) Phototherapy
c) RhoGAM
d) IV antibiotics

b) Phototherapy

exchange transfusion = for Rh disease

RhoGMA = given for Rh

21

Which of the following is the least likely to cause a bilirubin of 19 in an 18 hour old newborn with 2 feedings of breastmilk?
a) RH or ABO disease
b) Breast Feeding Jaundice
c) Sepsis
d) Congenital spherocytosis

b) Breast Feeding Jaundice

Congenital spherocytosis = generally, mild hemolytic anemia

22

Which one of the following is the appropriate tx of a newborn of a Hepatitis B positive mom?
a) Give Hepatitis B vaccine
b) Give hepatitis B vaccine and Hep B immune globulin
c) give Hep B immune globulin
d) Do nothing

b) Give hepatitis B vaccine and Hep B immune globulin
--> within 12 hrs!

23

Which of the following is not a long-term effect of toxoplasmosis in a newborn?
a) hydrocephalus
b) microcephaly
c) chorioretinitis
d) learning disability
e) anemia

e) anemia

24

Which of the following is not a presenting sign of symptomatic toxoplasmosis in a newborn?
a) maculopapular rash
b) generalized lymphadenopathy
c) Thrombocytopenia
d) Hepatosplenomegaly
e) Hearing loss

e) Hearing loss
--> is CMV!

25

What is the most common way to acquire toxoplasmosis?
a) consumption of poorly cooked meats
b) accidental ingestion of sporulated oocysts from soil or food
c) blood product transfusion
d) congenital transmission of primary maternal infections

b) accidental ingestion of sporulated oocysts from soil or food

26

How long does it take for a IgM-specific antibodies to be detected in toxoplasmosis infections?
a) one week
b) two weeks
c) three weeks
d) four weeks

b) two weeks

27

What do you need to screen for in child with asymptomatic CMV infection?
a) Vision
b) PPD
c) hearing

c) hearing

28

Which one of the following port wine stains on a newborn face is worrisome?
a) on the eyelid
b) covering the entire right side of the face
c) on the chin
d) on the nape of the neck

b) covering the entire right side of the face
--> Sturge Weber!...see glaucoma, seizures...

29

What is the most common underlying problem of neonates with jaundice in the US?
a) RH negative sensitization
b) G6PD deficiency
c) ABO sensitization
d) Biliary atresia

c) ABO sensitization

G6PD deficiency = only African Americans

30

If a 3 week old thriving baby, who is breastfeeding, has no BM for 4 days. You would consider this to be:
a) normal
b) A sign of Hirschsprung's
c) A sign of constipation
d) A sign of malrotation

a) normal
--> breastmilk so well-matched to baby that no residue is left!

--after 5-7 days without BM --> then worry

in formula-fed baby, be worried after > 2 days w/no BM