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82 Cards in this Set
- Front
- Back
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Normal HR for newborn
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120-160
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Normal resp for newborn
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30-60
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Normal temp for newborn
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97-100.4 (more likely to have low temp in first day; HSV- high)
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Normal BP for newborn
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70/50
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If fontanelles are greater than 4 cm, what might it suggest?
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hypothyroidism (so check for it)
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What is craniosynostosis?
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the fontanelles are closed already--> babies head will not be able to grow--> bad
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What should be noted in ENT?
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patency (make sure both nares connect to oropharynx), ear tags, cleft lips, suck reflex, and bilateral red reflex
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What is the only cancer than can kill a baby short order (born with)?
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retinal cancer
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What is checked for on neck of baby?
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ensure no ducts, cysts, or bulges; also document marks
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If there is a midline neck mass, what is the concern?
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thyroid disorder
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If there is a mass anterior to the SCM, what is the concern?
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brachial cleft cyst (brachial cleft should go away before birth..sometimes it does not)
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If there is a mass posterior to the SCM, what is the concern?
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cystic hygroma
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What do you check for on chest?
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ensure no clavicel fracture, breathing without distress; ascultate heart and lungs
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Describe murmurs in most congenital heart disorders.
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murmurs are not generally heard initially, but do present with systemic systems
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What do you check for on the abdomen?
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ensure soft and round, no masses, and examine the umbilical cord for anatomy
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If a baby has a scaphoid abdomen, what does it indicate?
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diaphragmatic hernia--> bad because the lungs may not have had room to develop (the more premature the baby is, there is more of a chance that the baby just had not put on weight yet)
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What is Barlow hip test?
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"click" when hip dislocated posteriorly
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What is Ortalani hip test?
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"clunk" when hip relocates posteriorly
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What are the Barlow and Ortalani tests specific for?
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congenital hip dysplasia--> too shallow of a hip socket
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If Barlow and Ortalani test cause concer, what do you do?
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order US
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If there are elevated pulse pressures (lower extremeties), what does that indicate?
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Patent Ductus Arteriosus
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If there is decreased pulse pressure (lower extremities), what does that indicate?
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coarctation of the aorta
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What does Asymmetry of the Transverse Glutesl Crease mean?
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assymetry of hips
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What should be noted on GU exam?
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descention of testes, ensure there is no hernia, hydrocele, hypospadias, ensure patent anus and no tracts
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What should be checked for in extremities?
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count digits, check cap refill, check for deformity or assymetry
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What should you check for on back?
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ensure spine symmetry, note lumbosacral hair tuft (Spina bifida), note gluteal pit in fold
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What should you check for on skin?
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bruising, marks, jaundice, notice vernix caseosa, lanugo in preterm
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What do tufts of hair on lumbosacral back indicate?
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hidden Spina bifida propida
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What is vernix caseosa?
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white cheesy stuff on kids skin- esp. on kids that are later--> no real clinical significance
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What do you check in neuro exam?
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general tone and reflexes
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What are the reflexes you look for in neuro exam?
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sucking, rooting, fencer reflex, Moro, and grasp
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Rooting
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touch one of cheeks, they should turn to that side, and want to suck
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when should the rooting reflex disappear?
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around 2 mths
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What is the Fencer Reflex?
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protective mechanism- gone by 4 mths
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What is the Moro Reflex?
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If you lift the chin to the chest, and then let go, the limbs should extend and then flex back in sharply
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When does the Moro Reflex disappear?
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by 4 mths
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When does the Grasp reflex disappear?
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by 4 mths
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Which reflex test is good for determining if nerve endings are healthy all the way to the distal part of the extremities?
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Grasp Reflex
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What is the Fencing Reflex?
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Turn head one direction, the arm and leg on that side will reach out and the opposite limbs will flex in
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How many arteries or veins should the umbilical cord have?
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2 arteries and one vein
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What is the risk when there is only 2 vessels in the umbilical cord?
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slightly higher risk of other anomalies so do deatiled exam---no special tests usually
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Overriding sutures
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sutures that overlap (so that baby could fit through the birth canal)
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Capet Succedaneum
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common--> swelling that crosses suture lines and resolves in days--> asymptomatic
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Cephalohematoma
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less common--> bleeding under the periosteum (creates natural pressure to contain bleeding0--> does not cross suture lines
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How long does it take cephalohematoma to resolve?
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weeks to months
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Condition that may result from cephalohematoma
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jaundice due to breakdown of blood
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What is a subgaleal hemorrhage?
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bleeding between bone and skin that does not cross suture lines--> seen when vacuum device is used--> there is no direct pressure so they may lose a lot of blood (emergency- ABCs and surgery!)
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Tx for subgaleal hemorrhage
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compression and resuscitation
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Condition that pushes ears anteriorly
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subgaleal hemorrhage
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What is hydrocephalus?
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fluid pressure inside third ventricle--. Can cause cranial nerve palsy
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What is anencephaly?
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"no brain"--> born with brain stem and some measure of brain matter (look normal but head is filled with fluid)
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What is Dandy-Walker Malformation?
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congenital brain malformation of cerebellum and 4th ventricle
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subcinjunctival hemorrhage
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no big deal!
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What can cause no corneal reflex or cloduiness?
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glaucoma
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When there is a missing red reflex, what condition might be present (leukochorea)?
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retinal blastoma
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Pussy eyes
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chlamydia or gonorrhea
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Epstein Pearls
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No clinical significance--inside mouth- go away in a few weeks
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ear tags and ear pits
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growths or tracts that open---should have disappeared before birth but did not--> may be mucous producing cells in there so ENT doc may do surgery so that they do not get infected
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Low Ears--what genetic disorder?
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Down Syndrome
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Hernias
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muscle defects with intestine poking through--> umbilical hernias common in Afr. Am. Babies- go away by a year of life
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Periumbilical hernia
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line is actually intact muscle tissue and should prob. Be surgically corrected--> like to incarcerate
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Ambiguous genitalia
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must determine if boy/girl with chromosome testing--> medical emergency from birth--> usually very sick due to adrenal issues
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This neurologic abnormaility is associated with forceps delivery
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facial nerve palsy
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MC Brachial plexus injury
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Erb's palsy
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Where is the lesion (nerve root) in Erb's palsy?
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C5, C6
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Which reflexes will be present/absent with Erb's Palsy?
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grasp reflex present, but biceps reflex absent
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Which reflexes will be present/absent with Klumpe's plasy?
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grasp reflex absent, biceps reflex present
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Which brachial plexus lesion is associated with phrenic nerve lesion?
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Erb's palsy
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Which brachial plexus lesion is associated with ipsilateral Horner's syndrome?
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Klumpke's plasy
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These are pustules with pigmented bases present at birth
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transient pustular melanosis
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How long does it take for pustules in transient pustular melanosis to resolve?
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24-48 hours
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How long does it take for pigmented macules to resolve?
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1-3 months
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What does microscopic eval of contents of transient pustular melanosis show?
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neutrophils, but lesions are sterile
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When do the pustules with erythematous base of Erythem atoxicum Neonatorum appear?
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within 24-48 hours post birth
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What parts of body is ETN on?
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back and trunk
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What does microscopic evaluation of ETN show?
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eosinophils
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Milia
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sebaecous glands
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Miliaria Crystaline
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no clinical significance
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Miliaria Rubia
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Neonatal acne
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some born with it--> pustules on red base in places that are hormone sensitive- back and shoulders, face, labia--> response to estrogen
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Cutis Marmorata/Mottling
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thin skin where when it is cold you see a reticular pattern--> likely in preterm babies
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Strawberry Hemangioma
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Collection of blood vessels--? Auto infarct usually within one year
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