Newborns

Question 1

When should cryptorchidism be referred to surgery?

Answer 1

If persistent for > 3 - 6 mo

Question 2

When should a newborn have passed meconium?

Answer 2

48h of life

Question 3

Name 3 sacral ulcer red flags

Answer 3

• Midline tuft of hair
• Dimple > 2.5 cm from gluteal cleft
• Overlying hemangioma
• Size > 0.5 cm

Question 4

Normal RR of a newborn

Answer 4

30 - 60

Question 5

Name 4 signs of increased WOB

Answer 5

• Nasal flaring
• Grunting
• Head bob
• Stenal retractions
• Intercostal indrawing

Question 6

Name 5 ddx of resp failure in newborns

Answer 6

• Respiratory distress syndrome (surfactant deficiency)
• Transient tachypnea of the newborn (TTN)
• Meconium aspiration syndrome
• Neonatal pneumonia / sepsis
• Congenital heart disease (e.g., duct-dependent lesion)

Question 7

Name three DDx of tachycardia in the newborn

Answer 7

• SVT
• Sepsis/fever
• HF
• Shock
• Medications (mother)

Question 8

3 ddx of delayed meconium

Answer 8

• MgSO4 exposure
• Meconium ileus
• Hirschsprung’s disease
• Functional ileus
• Hypothyroidism
• Anal atresia

Question 9

Name 3 worrisome features of hemangiomas

Answer 9

• Close to the eyes
• Segmental on the mandible
• Lumbosacral lesions

Question 10

Name 4 subtle signs of neonatal sepsis.

Answer 10

• Poor feeding
• temperature instability
• lethargy
• respiratory distress/apnea.

Question 11

What is the first step in newborn resuscitation per NRP? (3)

Answer 11

Warm, dry, stimulate, and assess breathing and heart rate.

Question 12

When is positive pressure ventilation indicated in a newborn?

Answer 12

HR <100 bpm or apnea/gasping.

Question 13

When are chest compressions started in neonatal resuscitation? (2)

Answer 13

HR <60 bpm after 30 seconds of effective ventilation.

Question 14

Jaundice in the first 24 hours suggests what?

Answer 14

Pathologic jaundice (e.g., hemolysis).

Question 15

Name 4 causes of pathologic neonatal jaundice.

Answer 15

ABO incompatibility, Rh disease, G6PD deficiency, sepsis.

Question 16

What is breastMILK jaundice and when does it appear?

Answer 16

Late unconjugated jaundice (after day 5–7) in thriving breastfed infant.

Question 17

Name 3 signs of acute bilirubin encephalopathy.

Answer 17

Lethargy, hypotonia → hypertonia, high-pitched cry.

Question 18

What determines need for phototherapy? (3)

Answer 18

Bilirubin level + age in hours + risk factors (use nomogram).

Question 19

Name 3 signs of poor latch.

Answer 19

Nipple pain, cracked nipples, clicking sound during feeding.

Question 20

What are 3 signs of adequate intake in a newborn?

Answer 20

• ≥6 wet diapers/day (after day 4)
• weight gain
• satisfied after feeds.

Question 21

When should birth weight be regained?

Answer 21

By 10–14 days.

Question 22

What infant condition may impair breastfeeding?

Answer 22

Ankyloglossia (tongue-tie).

Question 23

What is the concern with undescended testes? (2)

Answer 23

Infertility and increased testicular cancer risk.

Question 24

When should ankyloglossia (tongue-tie) be referred?

Answer 24

If causing significant breastfeeding difficulty (poor latch, maternal nipple trauma, poor weight gain).

Question 25

Which infants require hip ultrasound even if exam normal? (2)

Answer 25

Breech presentation family history of DDH (developmental dysplasia of the hip).

Question 26

When does clubfoot require referral?

Answer 26

Immediately — early casting improves outcomes.

Question 27

When should a newborn with failed hearing screen be referred?

Answer 27

Prompt audiology follow-up (ideally by 1 month).

Question 28

When should a newborn murmur be referred urgently? (3)

Answer 28

Cyanosis, poor feeding, tachypnea, weak femoral pulses.

Question 29

What physical finding suggests coarctation of the aorta? (2)

Answer 29

Radio-femoral delay or weak femoral pulses.

Question 30

What weight loss percentage is concerning in newborns?

Answer 30

> 10%

Question 31

Name **FIVE risk factors** for Sudden Infant Death Syndrome (SIDS). (5)

Answer 31

* Prone sleeping position * Soft bedding or loose objects in the crib * Maternal smoking during pregnancy * Secondhand smoke exposure * Prematurity * Low birth weight * Overheating during sleep * Bed-sharing * Young maternal age * Lack of breastfeeding ## Footnote These factors increase the likelihood of SIDS occurring.

Question 32

Name **THREE protective factors** that reduce the risk of SIDS. (3)

Answer 32

* Supine sleeping position * Breastfeeding * Room sharing without bed sharing * Pacifier use during sleep * Firm sleep surface with empty crib ## Footnote These factors help create a safer sleep environment for infants.