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91 Cards in this Set
- Front
- Back
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What is oligohydramnios?
What abnormalities is it a risk factor for (3)? |
Too little amniotic fluid
Severe renal abnormalities, pulmonary hypoplasia, limb abnormalities |
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Labor at how far along in gestation qualifies as preterm labor?
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Before 37 weeks gestation
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How long qualifies as prolonged rupture of membranes?
What is prolonged rupture a risk factor for (2)? |
> 24 hours
Chorioamnionitis, Neonatal infection |
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Treating a mother with Mg may result in what for the fetus?
What are the signs? |
Hypermagnesemia
CNS depression, respiratory depression, hypotonia |
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What is a nuchal cord?
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Cord wrapped around the neck
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When do variable fetal decelerations occur?
What are they associated with? |
Occur and end with contraction
Assoc. w/ cord compression during contraction |
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When do late fetal decelerations occur?
What are they associated with? |
Occur repetitively after a contraction
Assoc. w/ fetal hypoxia |
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At what times after birth are Apgar scores calculated?
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1 minute, 5 minutes, 10 minutes
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What does an Apgar score of 0-3 suggest?
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Asphyxia
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Breakdown of the mnemonic APGAR
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A -- appearance
P -- pulse G -- grimace A -- activity R -- respiratory effort |
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What is the average weight of newborns?
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3.4 kg -- 7.5 lbs
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How long after birth should newborns return to birth weight?
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About 2 weeks
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Whay do babies lose weight the first few weeks after birth?
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Loss of excess extravascular fluid
Poor intake |
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What is the definition of Small for Gestational Age?
What are some causes? |
Being below 10th percentile for gestational age
Maternal causes often due to decreased uterine blood flow (HTN, diabetes, cardiac/renal disease) Fetal causes include multiple gestation, infection, chromosomal, etc. |
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What is the definition of Large for Gestational Age?
What maternal issue is it associated with? |
Being above 90th percentile for gestational age
Associated with maternal diabetes |
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What is the average length of newborns?
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50 cm -- 20 in
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What is the average head circumference of newborns?
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35 cm -- 14 in
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What does the Dubowitz(Ballard) exam assess?
What is the optimal age for it being done? |
Gestational age of the infant
(uses physical and neuro criteria) 12 - 48 hours old |
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What is the normal range for respiratory rate in newborns?
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30 - 60 breaths/min
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What is the normal range for HR in newborns?
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90 - 180 beats/min
(average is 120 - 160) |
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What does plethoric skin in a newborn suggest?
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Possibility of polycythemia
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What is lanugo?
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Fine, soft, immature hair of scalp/brow
(often seen in premature babies) |
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Comparison of skin between premies and post-date infants
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Premature -- thin, transparent skin
Post-date -- leathery, dry, cracking |
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What are milia?
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White papules on nose/chin
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What is erythema toxicum neonatorum?
What does it contain? Is it benign or malignant? |
Red splotch w/ whitish/yellow papule in center
(may last one week) Contains eosinophils Benign |
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What is transient neonatal pustular melanosis?
What group of infants is it common in? |
Vesiculopustular lesions on back, chin, neck, extremities, palms, soles
(lasts 2-3 days) Common in African american infants |
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How do salmon patches present?
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"stork bite" on nape of neck
"angel kisses" on eyelids Often symmetric BENIGN |
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What is dermal melanosis?
What groups of infants is it commmon in? |
Blue-gray pigmentation usually on lower back and buttock
(fade during 1st year) More common in pigmented babies |
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What is caput succedaneum?
What causes it? |
Boggy, edematous subcutaenous tissues
CROSSES SUTURE LINES Results from pressure against maternal pelvic bones |
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What is cephalohematoma?
How is it differentiated from caput succedaneum? |
Subperiosteal bleeding
DOES NOT CROSS SUTURE LINES |
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What bone do cephalohematomas typically involve?
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Parietal bone
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What is hypertelorism?
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Increased distance between orbits
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What is leukokoria?
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Absence of the red reflex
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Dull gray tympanic membranes are a sign of what?
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Serious otitis media
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What are Epstein's pearls?
What groups of infants are they found in? |
White inclusion cysts around midline of hard palate
Found in most newborns |
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What is torticollis?
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A "positioning defect"
Shortening of the SCM causes head to tilt unnaturally |
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What do widely shaped nipples on a shield-shaped chest suggest?
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Turner's syndrome
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What is transient tachypnea of the newborn due to?
What factors predispose infants for this (3)? |
Due to residual amniotic fluid
Diabetic mothers, precipitous delivery, C-section |
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How long after birth does the PDA murmur usually resolve?
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1 - 2 days
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What does a small VSD sound like on chest exam?
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Harsh systolic murmur at LLSB
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What is a scaphoid abdomen?
What is it suggestive of? |
"Boat-shaped" abdomen
Suggests diaphragmatic hernia |
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How many vessels does the umbilical cord normally have?
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3
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What groups of infants are umbilical hernias common in?
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African american and low birthweight infants
NOTE: most resolve within 1 yr of birth |
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What is omphalitis?
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Serious infection/cellulitis aroudn the umbilicus
NOTE: can proceed to life-threatening sepsis (treat w/ anti-biotics) |
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What is the definition of gastroschisis?
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Defects lateral to the umbilicus
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Inguinal hernias are common in what type of infants?
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Preterm infants
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What is a hydrocele?
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Fluid-filled sac in scrotum
Due to remnants of proccessus vaginalis |
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What is Erb-Duchenne Palsy due to?
What is the prognosis? |
Excessive lateral traction on the brachial plexus
Generally, palsy resolves spontaneously |
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What is the Moro reflex?
It is absent in what condition? |
Head extension causes extension and then flexion of extremities
Absent on affected side in Erb-Duchenne palsy |
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What types of infants is developmental dysplasia of the hip more common in (3)?
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Females, First-born, Breech delivery
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What is a breech delivery?
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"Butt first" pregnancy
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What is metatarsus adductus?
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In-toeing of the forefoot due to intrauterine positioning
Foot is kidney bean shaped |
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What is talipes equinovarus?
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Clubfoot deformity due to contractures in utero
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What is the difference between metatarsus adductus and talipes equinovarus?
(with regards to therapy) |
Metatarsus adductus -- foot can easily be put into neutral position
Talipes equinovarus -- Foot cannot be put into a neutral position |
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What is calcaneovagus?
Can this be easily repaired? |
Thin, "banana-shaped" foot
Able to fold onto anterior tibia Yes |
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What does absence of the Moro reflex imply?
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Significant CNS abnormality
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When does the root/suck reflex go away?
How about the palmar grasp? The Moro? The stepping? |
Root/suck -- 4-6 months
Palmar grasp -- 4 months Moro -- 6 months Stepping -- 2 months |
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How does the infant Babinski compare to the adult?
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It is the opposite
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How many calories do infants typically need by the end of the 1st week?
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100 - 120 kcal/kg/day
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How may calories per ounce do breast milk and formula contain?
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20 kcal/oz.
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Describe breast milk stools
How do they compare to formula stools? |
Loose, mustard colored
Formula -- darker, firmer, smellier, less frequent |
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What disease is meconium ileus assoc. w/?
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Cystic Fibrosis
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Deficiency of what enzyme causes physiologic jaundice?
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Glucuronyl transferase
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How long after birth do signs of kernicterus typically show up?
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2 - 5 days
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How long is the lifespan of RBCs in infants?
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70 - 90 days
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When does breast feeding jaundice occur?
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First week of life
Managed by more frequent breast feeding |
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When does breast milk jaundice occur?
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Develops AFTER day 7
May persist for 2-3 weeks |
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When does physiologic jaundice occur?
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Between days 3-6 of life
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What is the most common cause of hemolytic disease of the newborn?
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ABO incompatibility
Mother is usually O and infant A or B |
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What type of hyperbilirubinemia is assoc. w/ kernicterus?
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UNCONJUGATED hyperbilirubinemia
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What is the most common cause of neonatal conjuctivitis?
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Chlamydia
Treated w/ ORAL erythromycin |
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What is erythromycin ophthalmic ointment given for?
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Prevention of gonococcal ophthalmia neonatorum
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Why are newborns more susceptible to hemorrhage?
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Transient vitamin K deficiency
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Supplementation of which vitamin is recommended for breast-fed infants?
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Vitamin D
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Date range for term neonate?
For infant? For toddler? For pre-schooler? |
Neonate -- 0-28 days
Infant -- 1-12 months Toddler -- 1-3 years Pre-schooler -- 3-5 years |
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Normal range of BP for a newborn infant
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(50-70) / (30-50)
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When is the diagnosis of failure to thrive given?
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If child's growth drops across 2 percentile curves
OR, if growth is less than 3rd percentile |
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What is the classical pattern of growth "fall-off" in failure to thrive?
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First drop in percentile for weight
Then, drop in percentile for height Finally, drop in percentile for head circumference |
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What is the most common cause of failure to thrive?
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Caregiver is giving insufficient calories
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What is the best test to determine etiology of failure to thrive?
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Thorough H&P
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What are the five domains used in assessing development?
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Gross Motor
Fine Motor Language Problem-solving Social |
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What is global developmental delay?
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Scores at least 2 s.d's below mean in at least 2 of 5 domains
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What is Rett syndrome?
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X-linked dominant disorder of girls (boys die @ birth)
Presents as regression at age 1-2 years |
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What is the best predictor of intelligence?
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Language
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Who is at more risk for speech development delays, boys or girls?
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Boys (3x higher risk)
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Most likely causes of newborn meningitis?
Of child > 4 months old? |
Newborn -- Group B strep, gram-negatives
> 4 months -- Strep pneumo, H. influenzae, N. meningitidis |
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What sleeping position is thought to help prevent SIDS?
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Supine sleeping position
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Significant milestones hit by 6 months of life?
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Able to lift chest and head while on stomach
Able to sit high in a chair w/ straight back Able to roll from back onto abdomen Able to pick up dropped object Beginning of teething Starts to imitate sounds Begins to fear strangers |
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Significant milestones hit by 9 months of life?
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Is able to crawl
Can pull self to standing position Has a pincer grip between thumb and index finger Develops depth perception Develops "object constancy" Can respond to simple commands (understands "no") |
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Significant milestones hit by 12 months of life?
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Nearly-closed anterior fontanel
No longer have a Babinski Can often walk independently Can say momma, poppa, and at least 2 other words Experiences separation anxiety |
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When do the fontanelles usually close by?
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Posterior -- often by 6 weeks of age
Anterior -- often by 18 months of age |
