Newborn Care Quiz
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Questions and Answers

What is the recommended room temperature for newborn care?

  • 30-32°C
  • 25-28°C (correct)
  • 22-24°C
  • 20-22°C
  • What is the target temperature range for newborns?

  • 36-37°C
  • 37-38°C
  • 35-36°C
  • 36.5-37.5°C (correct)
  • Which of the following is NOT an effect of early skin-to-skin contact in newborn care?

  • Prevents anemia (correct)
  • Encourages breastfeeding
  • Prevents hypothermia
  • Bonding
  • In newborn care, what is the significance of maintaining a temperature of 25-28°C?

    <p>It helps in thermoregulation</p> Signup and view all the answers

    Which specialty would most likely address issues related to hypothermia in newborns?

    <p>Pediatrics</p> Signup and view all the answers

    Which condition is NOT associated with intrahepatic cholestasis?

    <p>Biliary atresia</p> Signup and view all the answers

    What is a common risk factor that can lead to intrahepatic cholestasis in newborns?

    <p>Prolonged use of TPN</p> Signup and view all the answers

    Which test result is expected for alpha-1-antitrypsin deficiency in the context of intrahepatic cholestasis?

    <p>Coombs test negative with normal Hb</p> Signup and view all the answers

    Which of the following is a feature of extrahepatic cholestasis?

    <p>Increased enterohepatic circulation</p> Signup and view all the answers

    What underlying mechanism might contribute to extrahepatic cholestasis related to biliary atresia?

    <p>Paucity of bile ducts</p> Signup and view all the answers

    What is the duration of the neonatal period?

    <p>Birth up to 1 month old</p> Signup and view all the answers

    Which of the following is included in essential newborn care?

    <p>Immediate drying</p> Signup and view all the answers

    Why is uninterrupted skin-to-skin contact important after birth?

    <p>It prevents hypothermia and promotes breastfeeding</p> Signup and view all the answers

    What is the purpose of delayed cord clamping?

    <p>It reduces the likelihood of anemia in the infant</p> Signup and view all the answers

    What condition in the neonate is most likely associated with jaundice spreading to the mid abdomen?

    <p>Hepatosplenomegaly</p> Signup and view all the answers

    Which factor is NOT commonly examined in a neonate with suspected TORCH infections?

    <p>Bone density</p> Signup and view all the answers

    What is the likely bilirubin level if jaundice is noted in a neonate with hepatosplenomegaly and other symptoms?

    <p>15mg/dL</p> Signup and view all the answers

    What sign of respiratory distress is characterized by the indrawing of the chest wall during breathing?

    <p>Retractions</p> Signup and view all the answers

    Which symptom is associated with severe respiratory distress in neonates?

    <p>Tachypnea</p> Signup and view all the answers

    Which of the following is not a common sign of respiratory distress in newborns?

    <p>Hyperthermia</p> Signup and view all the answers

    Which of the following congenital infections is least likely to cause chorioretinitis?

    <p>Syphilis</p> Signup and view all the answers

    What is a potential complication of hydrocephalus observed in neonates?

    <p>Delayed speech development</p> Signup and view all the answers

    What is the most appropriate reason to administer phenobarbital in this case?

    <p>To reduce bilirubin levels in the infant</p> Signup and view all the answers

    Which diagnostic test is best suited to confirm jaundice related to breastfeeding?

    <p>Indirect Coombs Test</p> Signup and view all the answers

    What symptom is most likely associated with inadequate nursing in this infant?

    <p>Coombs Test Positive</p> Signup and view all the answers

    What condition is likely to occur if the breastfeeding continues without addressing caloric intake?

    <p>Prolonged jaundice</p> Signup and view all the answers

    What is the expected duration of jaundice in infants who are not breastfed?

    <p>3 weeks to 3 months</p> Signup and view all the answers

    Which factor is associated with decreased caloric intake in breastfed infants?

    <p>Infrequent breastfeeding sessions</p> Signup and view all the answers

    What is a likely intervention when improper breastfeeding leads to jaundice?

    <p>Stop breastfeeding for 2 days</p> Signup and view all the answers

    What substance in breastmilk is linked to decreased caloric intake in jaundice cases?

    <p>Glucuronidase</p> Signup and view all the answers

    What is the primary purpose of injecting anti-D gamma globulin (RhoGAM) after the delivery of an Rh+ infant?

    <p>To reduce Rh hemolytic disease</p> Signup and view all the answers

    Which of the following results is typically associated with Rh incompatibility before treatment?

    <p>Positive Direct Coombs test</p> Signup and view all the answers

    In evaluating hyperbilirubinemia, what is the first test to check according to the guide referenced?

    <p>Direct Coombs test</p> Signup and view all the answers

    What condition is indicated by a Direct Coombs test that is negative with an increase in hemoglobin?

    <p>Polycythemia</p> Signup and view all the answers

    What defines direct hyperbilirubinemia in neonates?

    <p>Indicates cholestasis and is considered pathologic</p> Signup and view all the answers

    What is generally the first observation regarding bilirubin levels in the first six hours of life for a newborn?

    <p>B1 rises rapidly</p> Signup and view all the answers

    What clinical finding may suggest physiologic hyperbilirubinemia in a newborn?

    <p>Negative Coombs test with normal hemoglobin and reticulocyte count</p> Signup and view all the answers

    What does an increased reticulocyte count in a newborn indicate?

    <p>Possible hemolytic anemia</p> Signup and view all the answers

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    Neonatology

    • Neonatal Period: birth to 1 month.
    • Essential Newborn Care: a series of time-bound standard procedures.
    • Immediate drying: prevents hypothermia.
    • Uninterrupted skin-to-skin contact: prevents hypothermia, improves breastfeeding.
    • Delayed cord clamping (1-3 minutes): decreases anemia, prevents brain hemorrhage.
    • Non-separation of mother and baby, breastfeeding within the first hour prevents neonatal deaths.
    • Optimal method for maintaining neonatal temperature: skin-to-skin contact.
    • Room temperature: 25-28°C.
    • Target temperature for newborns: 36.5-37.5°C.
    • Common mechanisms of heat loss in newborns: Convection, conduction, radiation, evaporation.

    Classification of Prematurity

    • Based on birth weight and gestational age.
    • Low birth weight (<2,500 grams).
    • Very low birth weight (<1,500 grams).
    • Extremely low birth weight (<1,000 grams).
    • Late preterm birth (equal/ >34 weeks and <37 weeks).
    • Very preterm birth (<32 weeks).
    • Extremely preterm birth (<28 weeks).
    • Low birth weight: based on weight alone, regardless of gestational age.
    • SGA (small for gestational age): compares birth weight to gestational age.

    Newborn Screening

    • Ideally performed at 48 hours of age.
    • Repeat at 2 weeks old if blood collected <24 hours old.
    • Preterm babies: 5-7 days old.
    • Can be done until 1 month old (sick babies).
    • Expanded NBS covers 28 diseases.
    • Examples of conditions screened include: congenital hypothyroidism, congenital adrenal hyperplasia, galactosemia, phenylketonuria, glucose-6-phosphate dehydrogenase deficiency, and MSUD.

    Congenital Adrenal Hyperplasia

    • Autosomal recessive disorders of cortisol biosynthesis.
    • Deficiency in cortisol biosynthesis.
    • Depending on the deficient enzyme: mineralocorticoid deficiency/excess, or virilization.
    • 90% of cases are due to 21-hydroxylase deficiency.
    • Manifestations may appear in the first 6 months of life, with signs of sexual and somatic precocity.
    • Treatment usually involves glucocorticoid replacement (e.g., hydrocortisone) and sometimes mineralocorticoid replacement (e.g., fludrocortisone).

    Galactosemia

    • Three enzyme deficiencies can result in galactosemia: Galactose-1-phosphate uridyltransferase (GALT), galactokinase (GALK), and galactose-4-epimerase (GALE).
    • GALT deficiency (classic form): In infants, feeding intolerance, vomiting, jaundice, convulsions, lethargy, and hypotonia appear in weeks after birth;
    • GALK deficiency: cataracts
    • GALE deficiency (benign): healthy individuals, but the severe form resembles GALT deficiency.
    • Treatment involves a lactose-free diet.

    G6PD Deficiency

    • Presents with episodic or chronic hemolytic anemia.
    • Symptoms typically develop 1-2 days after exposure to oxidant substances (e.g., certain medications, some foods).

    Phenylketonuria (PKU)

    • Deficiency of phenylalanine hydroxylase leads to hyperphenylalaninemia.
    • Accumulation of phenylalanine can disrupt metabolism and damage the brain.
    • Manifestations include developmental delay & intellectual disability if untreated.
    • Treatment involves a diet low in phenylalanine.

    Maple Syrup Urine Disease (MSUD)

    • Genetic disorder resulting from defective branched-chain α-keto acid dehydrogenase complex activity.
    • Toxic accumulation of branched-chain keto acids in the brain.
    • Signs of irritability, poor feeding, maple syrup odor, and encephalopathy.
    • Treatment involves dietary restriction of leucine, isoleucine, and valine.

    Caput Succedaneum

    • Swelling at the site of contact; crosses sutures.
    • Edematous and pits with gravity.
    • Maximum size & firmness at birth and resolves in 48-72 hours.
    • Minimal blood volume.

    Cephalohematoma

    • Over parietal bones; does not cross the sutures.
    • Initially firm, becomes more fluctuant later.
    • Increases after birth for 12-24 hours; resolves over 2-3 weeks.
    • Significant blood volume.

    Subgaleal Hemorrhage

    • Beneath the epicranial aponeurosis; may extend.
    • Firm to fluctuant; ill-defined borders; may have crepitus or fluid waves.
    • Progressive after birth; resolutions over 2-3 weeks.
    • May be massive if associated with coagulopathy.

    Esophageal Atresia with Tracheoesophageal Fistula (EA with TEF)

    • Congenital anomaly of the esophagus.
    • Associated TEF in most cases.
    • Manifests as frothing at the mouth, regurgitation, and respiratory distress after feeding.
    • Diagnosis might be indicated if the infant is unable to pass an NG tube.

    Congenital Diaphragmatic Hernia

    • Most common type: Bochdalek hernia.
    • Herniated abdominal contents into the chest cavity.
    • Usually compresses the left lung.
    • Presents with respiratory distress shortly after birth
    • Xray: mediastinal shift

    Necrotizing Enterocolitis (NEC)

    • Preterm neonates with a stormy clinical course.
    • Triad of pathophysiology : intestinal ischemia, enteral nutrition, and pathologic organisms (e.g., Clostridium, E. coli).
    • Usually in the first week.

    Omphalocele vs. Gastroschisis

    • Omphalocele:
      • Defect below or at the umbilicus.
      • Covered with a membranous sac.
      • Commonly associated with other congenital anomalies.
    • Gastroschisis:
      • Defect to the left or right of the umbilicus, usually on the right side.
      • Exposed bowel.
      • Less frequently associated with other congenital anomalies.

    Pediatric Nutrition

    • Colostrum - first 2 days of lactation, high protein low fat & lactose; rich in Ig (especially IgA)

    Stages of Lactation

    • First 7 days: Colostrum, watery, high protein, low fat & lactose.
    • Transitional milk: in between colostrum and mature milk, macronutrients increase.
    • Mature milk: contains high fat and lactose.
    • Involuntary milk: reverts to colostrum like composition.
    • Exclusive breastfeeding up to 6 months.
    • Breastfeeding is best for 2 years and beyond.
    • Feeding schedule: self-regulated by infant.

    Integrated Management of Childhood Illnesses (IMCI)

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    Description

    Test your knowledge on essential aspects of newborn care including optimal room temperature, skin-to-skin contact, and conditions like cholestasis. This quiz covers important topics that impact the health and well-being of newborns. Perfect for healthcare students and professionals in pediatrics.

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