Family Medicine Clerkship - Newborn Examination Part I

Front 1

Infants with chest abnormalities need to be evaluated for?

Back 1

poland's syndrome

turner's syndrome

Front 2

What are 4-6 things that can account for abnormal small size of an infant?

Back 2

1. smoking or drugs
2. trisomy 13, 18, or 21
3. turner's syndrome
4. TORCH complex
5. bacterial ( TB, syphilis)
6. PKU

Front 3

What is considered to be a small sized infant?

Back 3

birth weight below the 10th percentile

Front 4

Define TORCH:

Back 4

toxoplasmosis, other viruses, rubella, cytomegalovirus, and herpes simplex viruses

Front 5

What is the etiology of having a baby with a high birth weight?

Back 5

maternal diabetes

Front 6

Babies with a high birth weight typically have which features? (4)

Back 6

increased incidence of perinatal asphyxia and birth injuries, respiratory distress syndrome, and hypoglycemia

Front 7

What are two major causes of conjugated hyperbilirubinemia?

Back 7

1) hepatobiliary disorders

2) ductal disturbances in bilirubin excretion

Front 8

What are the 4 major causes of unconjugated hyperbilirubinemia?

Back 8

1) physiologic hyperbilirubinemia

2) breastfeeding and breastmilk jaundice

3) increased production of bilirubin

4) decreased hepatic uptake or conjugation

Front 9

(2) should be measured in newborns with jaundice, and various causes of this should be considered.

Back 9

1) total bilirubin levels

2) direct bilirubin levels

Front 10

Babies with a high birth weight typically have which features? (4)

Back 10

increased incidence of perinatal asphyxia and birth injuries, respiratory distress syndrome, and hypoglycemia

Front 11

Name the possible genetic characteristics of each:

Macrocephaly?

Microcephaly?

Large fontanelles?

Back 11

Macrocephaly: autosomal dominant inheritance

Microcephaly: can be familial with either autosomal rec or dominant

Large fontanelles: trisomy 13, 18, and 21 syndromes

Front 12

(?) should be obtained in newborns with a pallor or ruddy complexion.

Back 12

CBC

Front 13

Other than genetics, macrocephaly can be associated with?

Back 13

hydrocephalus and achondroplasia

Front 14

Other than genetics, microcephaly can be associated with?

Back 14

fetal alcohol syndrome
prader willi

Front 15

Other than genetics, large fontanelles may be associated with? (3)

Back 15

hypothyroidism
bone disorders: cleidocranial dysostosis or hypophosphatasia

Front 16

Congenital exophytic scalp nodes should always be evaluated further because of which reason?

Back 16

because a significant percentage of these lesions connect to the underlying central nervous system

Front 17

Define craniosynostosis:

This condition is associated with which two diseases?

Back 17

premature fusion of the cranial sutures, resulting in growth restriction perpendicular to the affected sutures and compensastory overgrowth in unrestricted regions.

disease 1: Apert's syndrome
disease 2: crouzon's disease

Front 18

When craniosynostosis is associated with ? you need to consider neurosurgery.

Back 18

restricted brain growth.

Front 19

What are the three clinical signs of cranial dysraphism?

Back 19

*the hair collar sign (darker coarser hair surrounding the scalp nodule)

*vascular malformations

*cutaneous dimples and sinuses

Front 20

What is cranial dysraphism?

Back 20

Incomplete raphe closure which results in cranial bifidum

Front 21

What are the three common types of neck masses found in infants? (4)

Back 21

vascular malformations
abnormal lymphatic tissue
teratomas
dermoid cysts

Front 22

Define Apert's Syndrome.

Back 22

congenital disorder characterized by malformations of the skull, face, hands and feet. It is classified as a branchial arch syndrome. Affects the first branchial arch.

Front 23

Define crouzon's disease

Back 23

genetic disorder known as a branchial arch syndrome. Specifically, this syndrome affects the first branchial (or pharyngeal) arch

Front 24

What is caput succedaneum?

What is it caused by?

Back 24

poorly demarcated tissue swelling that crosses suture lines; accompanying pitting edema and overlying petechiae, ecchymoses and purpura

CAUSE: secondary to accumulation of blood or serum ABOVE the periosteum

Front 25

What is cephalhematoma?

What is it caused by?

Back 25

well demarcated swelling that does not cross suture lines

rupture of blood vessels that TRASVERSE skull to periosteum

Front 26

What is the treatment of caput seccedaneum?

What is the treatment of cephalhematoma?

Back 26

none needed, resolves within days

none if uncomplicated, for depression, you need immediate neurosurgerical intervention

Front 27

Caput seccedaneum and cephalohematomas are what?

Back 27

common forms of head trauma in newborns

Front 28

Which fractures are the most common in newborns?

What type of break is it usually?

What symptoms, if any?

Back 28

clavicular fractures

greenstick fracture

crepitus over the broken bone, and bruising above the bone.

Front 29

Clavicular injuries are common in which type of baby?

What is the treatment?

Back 29

a large baby

minimizing newborn's pain or discomfort.

Front 30

When does a cranial nerve 7 paralysis need intervention?

Which additional testing should be done?

Back 30

if there are no changes within 7-10 days, do electrodiagnostic testing

Front 31

Newborns with a cleft lip require which two interventions?

Back 31

genetic testing and plastic surgery

Front 32

CLEFT LIP is seen in which syndromes?

Back 32

trisomy 13, holoprosencephaly, amnion rupture sequence

Front 33

___ ___ are more often found in patients (NEWBORNS) with cleft palate

Back 33

newborns with erupted teeth!

Front 34

What is coloboma?

Back 34

absence or a defect in some ocular tissue.

Front 35

What is the CHARGE association?

Back 35

coloboma
heart disease
choanal Atresia
postnatal growth Retardation
Genital hypoplasia
Ear abnormalities

Front 36

Is aniridia usually bilateral or unilateral?

Back 36

bilateral

Front 37

What is aniridia usually associated with?

Back 37

poor vision and nystsagmus

Front 38

newborns with erupted teeth often have which syndrome?

Back 38

cleft palate

Front 39

A white pupil can mean three things:

Back 39

abnormality of the lens, vitreous, or fundus

Front 40

Newborns with cataracts should be tested for what?

Back 40

TORCH infections

Front 41

Newborns with monocular congenital or dense cataracts are at risk of developing what?

Back 41

deprivation amblyopia: lazy eye, is a disorder of the visual system that is characterized by poor or indistinct vision in an eye that is otherwise physically normal, or out of proportion to associated structural abnormalities

Front 42

Newborn with corneal cloudiness and enlargement, tearing, blepharospasm, photophobia.... diagnosis?

Back 42

congenital glaucoma

Front 43

Chemical conjunctivitis occurs within which time frame? (after birth)

How about gonorrheal conjunctivitis?

Back 43

24 hours

24-48 hours

Front 44

What is the difference between the time frames of gonorrhea and chlamydia after birth?

Treatments of both?

Back 44

g- occurs within 24-48 hours
c- 7-14 days after birth

g- penicillin or cefoxatime
c- erythromycin

Front 45

What is the timeframe of HSV conjunctivitis of newborns?

What is the treatment?

Back 45

2 weeks after birth

acyclovir

Front 46

What are the implications of pectus carinatum and pectus excavatum?

Back 46

they are relatively benign

Front 47

What is Poland's syndrome?

What are 3-4 associated findings of this syndrome?

Back 47

unilateral absence or hypoplasia of the pectoralis major

1. rib defects
2. hypoplasia of upper extremities
3. syndactyly

Front 48

(3) are associations with turner's syndrome (clinical findings)

Back 48

widely spaced nipples
excessive nuchal skin
lymphedema

Front 49

How would you evaluate for turner's syndrome ?

Back 49

genetic consultation
chromosomal analysis
echocardiography to detect lesions of the heart

Front 50

A small thorax in a newborn suggests what?

Back 50

pulmonary hypoplasia

Front 51

A ___ thorax of newborns suggests dwarfism.

Back 51

bell shaped.

Front 52

What is the normal range of a newborn's heart beat?

Back 52

120-160

Front 53

Diagnosis? Newborn presents with cyanosis that is relieved with crying.

How can you confirm this in the hospital?

Back 53

choanal atresia

the nasal tube cannot go through the nostril deeply

Front 54

If a newborn's heart rate does not increase with stimulation, evaluate the kid for what?

Back 54

evaluate for EKG and electrolyte levels

EKG to rule out heart block

Front 55

Diminished pulses in extremities indicate two things in newborns:

Back 55

1. peripheral vasoconstriction

2. poor cardiac output

Front 56

Absent or diminished femoral pulses indicate what?

Back 56

coarctation of the aorta

Front 57

although hypertension is rare in newborns, it is RARELY ___

Back 57

idiopathic

Front 58

What are the most common murmurs of newborns? (what is it due to)

Back 58

flow murmurs that represent a transition from fetal to neonatal circulation