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Flashcards in Variations Booklet Deck (72):
1

What accounts for the general redness of the neonate?

High circulation rate, and thin skin

2

What happens to infant color with vigorous crying?

Purple lividity d/t sluggish circulation

3

What causes mottling?

General circulatory instability

4

What is the Harlequin color change?

a cutaneous condition seen in newborn babies characterized by momentary red color changes of half the child, sharply demarcated at the body's midline

5

How do you differentiate ecchymosis from localized cyanosis?

Cyanosis has momentary blanching pallor

6

What is acrocyanosis?

Peripheral cyanosis of the neonate. Benign and transitory, unless accompanied by midline cyanosis

7

How does jaundice progress?

From head down

8

When is newborn jaundice concerning?

Before 24 hours of age, or persisting beyond 3 weeks

9

What are milia of the neonate? Is treatment warranted?

Common, benign keratin filled cysts that appear as superficial, uniform, pearly white to yellowish domed lesions measuring 1-2 mm in diameter

Arise from not fully developed sebaceous glands--No treatment needed

10

When do forcep marks disappear?

Within 2 months

11

What nerve may be affected with forceps/suction? What does this result it?

CN VII, resulting in facial palsy

12

Swelling of the head that crosses midline = ? What causes this? Is treatment necessary?

Caput succedaneum
Birthing process
Will resolve within a few days

13

What are cephalohematomas? Is treatment necessary?

Rupture of the subperiosteal
No treatment--will resolve within 2-3 weeks, but may need to monitor bili levels

14

Where does facial nerve injury usually occur?

At the exit of the nerve from the stylomastoid foramen

15

What is Mobus syndrome?

Failure of CN VII to develop in birth, resulting in permanent facial asymmetry, and an inability to suck

16

What is plagiocephaly? Is treatment needed?

a condition characterized by an asymmetrical distortion (flattening of one side) of the skull. It is characterized by a flat spot on the back or one side of the head caused by remaining in a supine position for too long

Self limiting

17

What is the eye color of most caucasians infants? Why?

Blue, due to a lack of pigment deposition

18

What are Brushfield spots, and what are they associated with?

Speckling of the Iris by white spots-- associated, but not specific to Down syndrome

19

What causes the bluish tinge to the sclera of infants?

Immature sclera

20

True or false: Subconjunctival hemorrhages at birth are concerning

False-- self limiting

21

When is visual fixation present and the ability to follow?

by term

22

How can you induce eye opening in an infant?

Hold them upright and tip them forward

23

Pupillary reflexes are developed when?

after 28-30 weeks gestation

24

True or false: nystagmus early in life is normal

True, but only for 3-6 months

25

What is Graefe's sign?

A band of white sclera above the iris when the eyes are not moving. This is not indicative of intracranial HTN

26

What is the setting sun sign? What does this indicate?

Repeated head nods cause the irises to deviate downward, and appear to sink beneath the lower lids.

This can be benign, or indicate impingement of the dilated suprapineal recess on the tectum

27

True or false: the Doll's eye movements should always be normal in an infant

True

28

What is the most common cause of chemical conjunctivitis in the newborn?

Use of silver nitrate drops in the treatment of gonococcal conjunctivitis

29

What is the etiology and prognosis for a subconjunctival hemorrhage in a neonate?

Usually d/t birthing trauma, but can be caused by coughing spells.

Self limiting.

30

What is the most common type of tumor in infancy?

Hemangiomas

31

What are nevus flammeus (port wine stains)? Prognosis?

Vascular malformations of mature, dilated dermal capillaries.

May involve hypertrophy of underlying structures, and poor self image

32

What is the most common vascular malformation of the infant?

-Salmon patches

33

What are salmona patches/stork bites?

Small pink-red patches on the infant's neck eyes, or upper lids.

Benign and self limiting

34

What are strawberry marks? When do these usually appear? Prognosis?

Bright or dark red, raised/bump lesion on the head, chest or upper back, that looks like a strawberry, formed by hemangiomas.

At birth or in the first two months
Grows for several months, then fades, with complete disappearance by age 9

35

What are cavernous hemangiomas? Prognosis?

Large hemangioma that involved deeper layers of skin than strawberry marks. Also more blue in color.
Grow rapidly at first, but then shrinks at 12-18 months to completely fade away

36

What is nevus spilus? Prognosis?

Brown patch within which are darker flat or raised melanocytes

Benign unless grows a ton or has dysmorphic features

37

What are congenital pigmented nevi?

Birthmarks. Benign

38

What are mongolian spots? In whom do they usually occur? Prognosis?

Blue to slate gray areas on the back (usually) that look like bruises. More common in blacks, asians, and native americans. Disappear within the first year.

39

What are accessory nipples?

Solitary or multiple nipples in a unilateral or bilateral distribution along the anterior axillary fold.

Benign.

40

What is the prognosis for ankyloglossia?

Benign unless hinders speech

41

What is geographic tongue? Prognosis?

an inflammatory condition of the mucous membrane of the tongue characterized by areas of smooth, red depapillation which migrate over time

Totally benign.

42

What is the treatment for neonatal teeth?

Removal if present a choking hazard

43

How common is thrush in the neonate?

Somewhat common, and usually benign.

44

What are retention cysts? Prognosis/treatment?

Clusters of small, white or yellow follicles or ulcers on an erythematous base in the oropharynx

Self limiting.

45

What are epstein pearls? Prognosis/treatment?

White remnants of sebaceous glands on the hard palate. Benign and self limiting

46

What are mucoceles? Prognosis/treatment?

painless, bluish, fluctuant, tense papules on the lips, tongue, or buccal mucosa.

Resection is curative

47

What is congenital epulis? Prognosis/treatment?

Granular cell tumor found on the anterior maxillae.
Resection is curative.

48

What is the treatment for an absent antihelix?

Molding or otoplasty once greater than 5 yo

49

Before what gestational week is cartilage not present in any part of the ear? When is it fully formed?

34 weeks

37-40 weeks

50

What are the ear characteristics in fragile X syndrome?

Large and prominent

51

What are the ear characteristics with Patau syndrome?

Malformed

52

What forms at the same time the ear forms in gestation?

Genital tract

53

What abdominal organ pathology is correlated with low set ears?

Renal agenesis

54

What branchial arch does the pinna develop from? Tragus?

Second for pinna
First for tragus

55

What are preauricular skin tags/tragal defects associated?

Other first branchial cleft abnormalities, such as cleft lip/palate

56

What is cortical thumb, and what does it indicate?

Having thumb enclosed within the palm--can be normal and resolve by 7 months, or represent an UMN lesion

57

How can you differentiate cortical thumb that is a sign of UMN lesions, vs a benign, and solitary finding?

Look for other s/sx of UMN lesions such as muscle tone, tendon reflexes etc

58

What is the most common etiology of bowing of the legs?

Delivery trauma--assess for motor/sensory problems

59

What is the normal position of the legs in utero?

Hips-Flexed, abducted, and externally rotated
Knees-flexed and internally rotated

60

What happens to the number of creases on the sole of the foot with increasing gestational age?

Increases--none before 28 weeks, 37 weeks decent amount, and term cover entire surface

61

What is metatarsus varus (metatarsus adductus)? Prognosis/treatment?

Adduction and supination of the foot from molding during birth

Corrective treatment, but not surgery

62

What are cavus feet? Prognosis/treatment?

Exaggeration in the medial longitudinal arch, associated with hindfoot varus that appears later in childhood. Associated with spinal cord disease

May lead to compromised foot function, thus surgery is usually indicated.

63

What are flexible (pronated) flatfeet? Prognosis/treatment?

Benign and common finding of feet d/t bone laxity in the arches. Usually will improve by 6 years.

Can give arch support if does not resolve, but special shoes have not been shown to alter outcomes.

64

What is genu recurvatum? Prognosis/treatment?

Congenital hyperextension of the knees d/t molding in utero.

Responses to conservative treatment.

65

What is tibial torsion? Prognosis/treatment?

Internal (or external) tibial torsion causing intoeing. 2/2 normal uterine positioning. Usually appears in the second year of life.

Usually self limited and resolves with growth

66

What is femoral torsion? Prognosis/treatment?

Internal torsion of the femur that leads to gait abnormalities of unknown etiology.

Correct sitting posture if needed, but usually resolves on its own

67

What is developmental dysplasia of the hip? Prognosis/treatment?

"Dislocatable" hip (not truly dislocated) that are postnatal in origin, usually a result of breech presentation. May be a sign of neuromuscular disorder.

Splints and harnesses are used to correct this.

68

What is the Ortolani test?

Checking for laxity in the femoral head by lifting legs anteriorly

69

What is the most important test in assessing for developmental dysplasia of the hip?

Barlow Test

70

What are annular bands? Prognosis/treatment?

Constriction rings that involve one or more of the extremities, usually associated with LAD.

Treatment involves observation, unless there is a risk of amputation.

71

What is talipes equinovarus? Prognosis/treatment?

"clubfoot" where the foot is inverted and internally rotated. Can be an isolated abnormality, or indicative of neuromuscular disorders

Conservative treatment is indicated, but may require surgery.

72

What are calcaneovalgus feet? Is it usually unilateral, or bilateral? Prognosis/treatment?

Hyperdorsiflexed foot with forefoot abduction 2/2 in utero positioning. Usually unilateral.

Usually self limiting, with resolution in the first 6 months