Question | Answer |
Most common fracture resulting from birth trauma is to the: | clavicle |
Epstein pearls = | benign white beady papules on the hard palate (keratin cysts) |
Cloudy cornea from cataracts or glaucoma | Leukocoria |
Tachypnea in an infant is a rate >__ | 60 |
What are signs of respiratory distress in an infant | Tachypnea, retractions, grunting |
Transient tachypnea of the newborn is from retained secretions, and usually resolves within: | 24-36 hours |
Murmurs heard at birth should be considered __ in etiology until proven otherwise | Valvular |
Congenital heart disease is present in what percent of infants? | 0.8% |
__ due to PACs is not uncommon in the first few days of life | Irregular heart rate |
Newborn has excessive drooling and choking with attempted feeding. Dx by CXR after placement of NG tube. Surgical tx required. Dx = | Tracheo-esophageal fistula |
Abdominal wall defect to right of umbilicus. Intestines/stomach/bladder/liver are outside the peritoneal cavity | Gastroschisis |
Liver and stomach covered by peritoneum at the umbilical orifice | Omphalocele |
Umbilical hernias are found in up to what percent of black infants? | 40 |
Umbilical hernias less than what size usually close by age 5? | 1.5 cm |
What are signs that an umbilical hernia needs surgical repair? | >1.5 cm at 2 years of age, or signs of incarceration |
Congenital absence of intramural colonic ganglion cells in rectosigmoid. Inability of bowel complex to relax causes functional bowel obstruction. In first 24-48 hrs, failure to pass meconium, abdominal distention, bilious vomiting = | Hirschsprung disease. Dx requires rectal biopsy |
How is hypoglycemia defined in the infant? | <35-40 mg/dL |
What are the symptoms of infant hypoglycemia? | Lethargy, poor feeding, irritability, jitteriness, seizures |
What is the treatment for infant hypoglycemia? | IV glucose D10W @ 2ml/kg |
Neonatal mortality: | from birth to 28th day |
Perinatal mortality: | 20th week of gestation to 7th day after birth |
Low Birth Weight = | <2500 gm. 7% live births & 70% neonatal mortality |
Very Low Birth Weight | <1500 gm |
Fetal scalp ABG of ____ indicates fetal hypoxic compromise | <7.20 |
Fetal scalp ABG of ____ is borderline & needs repeat test | 7.20 - 7.25 |
Soft creamy layer on skin in preterm infants = | vernix caseosa; also often see lanugo in preterm |
transient blue/black macules on lower back/buttocks in 90% AA, Indian, Asian infants | Mongolian spots |
Salmon patch = | Nevus simplex: pink macular hemangiomas; neck, eyelids, forehead |
With portwine stain (AKA _____), consider: | AKA nevus flammeus; Sturge Weber syndrome |
White eye, cat eye: | retinoblastoma |
Most common congenital anomaly of nose | choanal atresia (stenosis). Possible respiratory distress/apnea at birth. Sx: cyanosis that improves with crying |
Micrognathia, cleft palate, airway obstruction are features of: | Pierre Robin syndrome |
Persistence or aggravation of pulmonary vasoconstriction results in: | persistent pulmonary hypertension of the newborn (PPHN) |
Transient tachypnea of the newborn (TTN) = | Failure to replace pulmonary alveolar fluid completely with air can lead to respiratory distress; retained secretions; usually resolves in 24-36 hrs |
Periodic breathing | normal crescendo breathing followed by a brief apneic period |
Capillary vs cavernous hemangiomas | capillary: raised, red lesions; cav: deep blue masses; Both enlarge after birth & resolve at 1-4 yo; may produce high-output heart failure or plt trapping/ hemorrhage |
Erythema toxicum: | erythematous, papular-vesicular rash; common in neonates; involves eosinophils in the vesicular fluid |
Pustular melanosis: | more common in AA; small, dry vesicle on a pigmented brown macular base |
Bacterial infections in newborn | sepsis, pneumonia, meningitis, UTIs, omphalitis |
Perinatal viral infections: | HSV, hepatitis B, C |
Congenital infections in newborn | CMV, rubella, varicella, toxoplasmosis, syphilis, TB |
Observe infants born to GPS-positive moms for how long? | 48 hrs |
Severe cardiac defects & infection present in: | 6 hours |
More common in AA; small, dry vesicle on a pigmented brown macular base | pustular melanosis |
To what nursery level do healthy infants go? | Level 1 |
What is a level 3 nursery? | Regional center for critical infants |
Infant conjunctivitis is common or uncommon? | Common |
Hematoma contained in skull suture lines | Cephalohematoma |
Hematoma that crosses skull suture lines | Caput succedaneum |
Premature fusion of the cranial sutures is called: | Craniosynostosis |
Intermittent strabismus is normal up to: | 3-6 months |
Cloudy cornea from cataracts or glaucoma | Leukocoria |
Macroglossia is associated with: | Trisomy 21, Beckwith-Wiedemann |
Where is a branchial cleft cyst located? | Anterior to SCM |
Where is a thyroglossal duct cyst located? | Neck midline |
Where is a cystic hygroma located? | Posterior to SCM |
Common neck masses | Branchial cleft cyst, thyroglossal duct cyst, cystic hygroma |
Large fontanelles may signify: | hypothyroidism; trisomy 13, 18, or 21; or bone disease |
What nursery level will an infant >30 weeks and 1200 gm not requiring ventilation or circulatory support go to? | Level 2 |
Premature birth, fetal maturity: mgmt | Give corticosteroids |
Meconium-stained amniotic fluids | Fetal distress |
SIDS epidemiology | 1/1000 live births. Peak at 2-4 months old; 90% are <6 months. 40% reduction since Back to Sleep. 2-10% may be undiagnosed abuse |