Newborn

Question 1

A normal newborn respiratory rate is how many breaths per min?

Answer 1

30-60 breaths per minute

Question 2

Absence of _____ causes the closure of the ductus venous.

Answer 2

Placental circulation

Question 3

Increased pressure in the _____ causes the functional closure of the foramen ovale.

Answer 3

left atrium

Question 4

Blood glucose in the neonate is lowest _____ hours after delivery and stabilizes at _____ hours.

Answer 4

1-5 hours and 3-4 hours

Question 5

By 4-24hours of age, blood glucose levels should remain greater than or equal to _____ mg/dL.

Answer 5

45

Question 6

Which maternal immunoglobulin crosses the placenta to provide passive immunity to baby to viruses that the mother has encountered?

Answer 6

IgG

Question 7

What does the mnemonic APGAR stand for?

Answer 7

Activity, Pulse, Grimace, Appearance, Respirations

Question 8

During the first 60 seconds of life also termed _____, the following five initial resuscitation steps are taken: ________.

Answer 8

“The Golden Minute”; provide warmth, position airway, clear secretions, dry infant, provide tactile stimulation

Question 9

You should initiate resuscitation medications when HR is ____ after 45-60sec of coordinated chest compressions and PPV.

Answer 9

<60bpm

Question 10

After the Golden Minute, if there are no respirations or HR is _____, initiate PPV within 30-60sec and monitor O2.

Answer 10

<100

Question 11

If HR is less than ____ after 30sec of effective PPV then you should _____ and continue PPV as well as initiate chest compressions.

Answer 11

60bpm; intubate

Question 12

After 30sec of effective PPV, if HR is _____, continue PPV without chest compressions.

Answer 12

60bpm

Question 13

With meconium stained fluid- if baby is not vigorous with depressed respirations, tone, or HR <100 then you should: initiate PPV or suction with ET tube?

Answer 13

initiate PPV, suctioning with ET tube is no longer recommended for meconium stained fluid due to lack of evidence

Question 14

Murmur in a newborn a few hours after birth is a normal finding and is due to what?

Answer 14

incomplete closure of the ductus arteriosus

Question 15

Which form of jaundice occurs in 50% of newborns, peaks at 3-4 days, total billi peaks at <13, is NOT visible in the first 24hours, is primarily unconjugated/indirect, and is temporary.

Answer 15

Physiologic

Question 16

A newborn with NAS should be asymptomatic for how many hours before discharge?

Answer 16

48-72 hours

Question 17

Which form of jaundice is visible in the first 24hours, rises quickly to total bill >13, is primarily conjugated, and persists after 1 week?

Answer 17

Pathologic

Question 18

What are the criteria for early neonatal discharge?

Answer 18

uncomplicated vaginal delivery, full term, normal exam, thermal homeostasis, ability to feed, normal labs(if done)

Question 19

What is the normal weight for a term newborn infant?

Answer 19

2501-4000g

Question 20

Infants typically lose ____ - ____ of birth weight in first 3 days of life.

Answer 20

10%-15%

Question 21

Infants should regain back to birth weight by ____ to ____ days of life.

Answer 21

10-14 days

Question 22

The _____ reflex is when the newborn grasps an object or finger placed in the palm and typically disappears by ___ months of age.

Answer 22

Palmar grasp; 2 months

Question 23

The ____ is elicited by ration of the head to one side and the newborn will extend arm on the side to which the head is rotated and will flex the opposite arm. This disappears by ___ months of age.

Answer 23

Tonic neck response; 7 months

Question 24

The ____ reflex is known as the

“startle” response, elicited by jarring motions or loud noises and typically disappears by ___ months of age.

Answer 24

Moro; 6 months

Question 25

The ____ reflex is elicited by placing infants soles of feet in contact with a flat surface or table edge and typically disappears by ___ weeks of age.

Answer 25

Placing and stepping or "walking"; 4 weeks

Question 26

Newborn metabolic screening is generally done after ___ hours of age but is preferred at ___-___ hours of age.

Answer 26

24 hours; 48-72hours

Question 27

What presents as purulent discharge, swelling, and tenderness adjacent to thinner cnthus of the eye that is treated by gentle pressure in a circular motion with a warm and moist cotton ball?

Answer 27

Dacryocystitis

Question 28

Diaper dermatitis is most commonly caused by the microorganism ____ ____.

Answer 28

Candida albicans

Question 29

Zinc oxide, 1% topical hydrocortisone, and Nystatin can be used to treat severe cases of _____.

Answer 29

Diaper dermatitis

Question 30

Thrush is most common around the second week of life and is medically treated with what?

Answer 30

Oral Nystatin four times a day for 1 week

Question 31

What is the most common pathogen in neonatal infections?

Answer 31

GBS

Question 32

What are early signs of neonatal infection?

Answer 32

Lethargy, refusal to feed, vomiting, temperature instability

Question 33

Early onset GBS develops within the first ____ hours of life and is likely or rarely fatal?

Answer 33

24 hours | Likely fatal

Question 34

Late onset GBS develops after the ____ week of life and is likely or rarely fatal?

Answer 34

2nd week | Rarely fatal

Question 35

Diffuse papular rash on trunk and pharynx, respiratory distress, cyanosis and sepsis are all signs of which infection in a neonate?

Answer 35

Listeria

Question 36

Signs of microencephaly, cerebral calcifications, hepato-splenomegaly and jaundice are all signs of which viral infection in a neonate?

Answer 36

Toxoplasmosis

Question 37

Which plexus injury accounts for 90% of all plexus injuries and involves C5-C7 (occasionally C4) with the shoulder and arm being affected?

Answer 37

Erb's palsy

Question 38

Which plexus injury accounts for 8-9% of all plexus injuries, involves C5-T1 and affects the upper arm, lower arm and hand?

Answer 38

Total palsy

Question 39

Which plexus injury involves C8-T1 and affects the lower arm and hand?

Answer 39

Klumpke paralysis

Question 40

Destruction of RBC's, resulting in hyper-bilirubinemia and jaundice is what disease in an infant?

Answer 40

Hemolytic disease

Question 41

Encephalopathy caused by deposition of bilirubin in brain cells causing lethargy, diminished reflexes, hypotonia and seizures is which condition?

Answer 41

Kernicterus

Question 42

Absent or incomplete closure of one or more vertebral arches with a dimple or hair tuft over site is which CNS anomaly?

Answer 42

Spina bifida occulta

Question 43

Extrusion of meninges and CSF through defect in vertebral column is which CNS anomaly?

Answer 43

Meningocele

Question 44

A myelomeningocele is a meningocele with extrusion of what?

Answer 44

Spinal cord

Question 45

Abnormal accumulation of CSF in ventricles of the brain is which CNS anomaly?

Answer 45

Hydrocephalus

Question 46

Respiratory distress and a scaphoid abdomen that is apparent at birth could by which respiratory anamoly?

Answer 46

Diagphragmatic hernia

Question 47

Highest prevalence of SIDS occurs between months ___ and ___.

Answer 47

2 and 4

Question 48

What are the high risk zones for jaundice at 24, 36 and 48 hours?

Answer 48

24 >8 36 >11 48 >13

Question 49

Limpness, low blood pressure and cyanosis are symptom clusters for which neonatal condition?

Answer 49

Meconium aspiration

Question 50

Cyanosis, tachypnea, grunting/flaring and resolution in 24 hours is c/w which neonatal condition?

Answer 50

TTN

Question 51

pH normal or low, pCO2 high, bicarb normal is which acid base imbalance?

Answer 51

Respiratory acidosis

Question 52

low pH, co2 normal, bicarb low is which acid base imbalance?

Answer 52

Metabolic acidosis

Question 53

Increased oxygenation of circulating blood causes constriction and closure of what?

Answer 53

Ductus arterioisis

Question 54

Normal pH in an umbilical arterial cord gas is?

Answer 54

7.26 +/- 0.7

Question 55

Normal PCO2 in an umbilical arterial cord gas is?

Answer 55

53 +/- 10

Question 56

Normal Bicarb (HCO3) in an umbilical arterial cord gas is?

Answer 56

22.0 +/- 3.6

Question 57

Normal base deficit in an umbilical arterial cord gas is?

Answer 57

4 +/- 3

Question 58

Low pH, high PCO2 and low bicarb is which acid base imabalnce?

Answer 58

Mixed acidemia