PANCE Pediatrics Exam review Test Bank Answered
What does examination at birth begin with?
- Observation, auscultation of heart and lungs and inspection for birth trauma/deformities
How often is Apgar score assessed?
- At 1, 5 and 10 minutes
What does APGAR stand for?
- A: Activity ...
What does examination at birth begin with?
- Observation, auscultation of heart and lungs and inspection for birth
trauma/deformities
How often is Apgar score assessed?
- At 1, 5 and 10 minutes
What does APGAR stand for?
- A: Activity like muscle tone
P: Pulse:
G: Grimace which is reflex irritability
A: Appearance which is skin color
R: Respiration
Apgar score of < 3 indicates? - Immediate resuscitation required
Apgar score of 4-7 indicates? - May require some resuscitation
Apgar score of 7-10 indicates? - Normal
To get 2 points in each category of Apgar, what will baby look like? - Active movement
> 100 bpm
Sneezes, coughs, pulls away
Pink all over
Good respiration, crying
If baby gets all 1 points in each category of Apgar, what will baby look like? - Arms and
legs flexed
< 100 bpm
Grimace
Pink, except extremities
Slow, irregular respirations
If baby gets 0 points in each category of Apgar, what will baby look like? - No activity or
muscle tone
No pulse
No grimace response
Blue-gray, pale all over
Absent respirations :(
What are possible causes of a child being small for gestational age, sga? - Maternal
drug use, chromosomal abnormalities, exposure to intrauterine viral infection, multiple
,gestation, advanced maternal age as in over 35 years, placental insufficiency, lack of
maternal weight gain.
What is Most commonly the cause of large for gestational age, lga? - Maternal diabetes
What should be completed within 24 hours of birth? - Complete newborn examination
The Newborn skin exam should evaluate for? - Color, temperature, rashes or lesions,
edema, hair distribution
What are 6 common skin conditions we may find on a newborn during skin exam? - 1.
Erythema Toxicum
2. Milia
3. Miliaria
4. Mongolian spots
5. Nevus simplex aka stork bite
6. Vernix caseosa aka greasy covering and lanugo aka fine hairs
Which skin condition is common, first appears 3-5 days after birth as small pustules on
erythematous bases and spontaneously resolves in 1-2 weeks? - Erythema Toxicum
Which skin condition occurs secondary to areas of surface capillary dilation and is
frequently found on eyelids, nape of neck and forehead? - Nevus Simplex aka stork bite
How long till Nevus Simplex will resolve? - Almost always by age 2, but some may
persist into adolescence and need laser therapy
Which skin condition is caused by blockage of eccrine sweat glands, resulting in a
flushed macular appearance frequently involving neck, face, scalp and diaper area? -
Miliaria
What helps speed resolution of Miliaria, a prickly heat or heat rash phenomenon? - Light
clothing and decreased humidity
What skin condition is very small, white papules concentrated on nose, cheeks,
forehead and chin and resolves without intervention in 1-2 months? - Milia
What skin condition is more abudnant in preterm infants? - Vernix caseosa and lanugo
What skin condition(s) are more likely in postterm infants? - Dry, cracked and peeling
skin
What skin condition is common in dark-skinned infants and involve small to large, blue-
black macules concentrated on the back and buttocks; often misdiagnosed as bruising.?
- Mongolian spots
, How long does it take to resolve mongolian spots? - Most resolve spontaneously within
4 years, although they may persist for life
During head & face exam of newborn, what is craniosynostosis? - Premature fusion of
one or more sutures.
Referral to neurologist is necessary
Which fontanelle is approximately 1-4 cm in size and closes around 10-26 months of
age? - Anterior
Which fontanelle is 1 cm in size and closes around 1-3 months of age? - Posterior
Which fontanelle is associated with trisomy 21? - Fontanelle along the sagittal suture
During head and face exam we may find Caput succedaneum which is what? - Fluid
accumulation under scalp secondary to birth trauma.
Can Caput Succedaneum be palpated? - Yes the swelling is palpable crossing the
midline
Where do hematomas frequently appear? - Within suture lines called cephalohematoma
Where do subgaleal hemorrhages occur? - Beneath scalp
Why are subgaleal hemorrhages serious? - Can result in enough blood loss to cause
hemorrhagic shock, but luckily is rare.
If odd facies beyond edema and bruising secondary to delivery persist what does this
suggest? - Underlying syndrome may be going on
In infant if we notice this about the ears we should be suspicious of congenital
anomalies? - Rotated or low set ears
Infants with pre-auricular pits should be followed for what? - Hearing loss if there is a
family history of deafness
What is best way to asses newborn hearing? - Auditory brain stem response or evoked
otoacoustic emission testing.
If infant does not have red reflex in eyes, what conditions should we be concerned
about and what should we do? - Congenital cataracts, glaucoma, retinoblastomas all
present as an absent red reflex.
Make immediate pediatric ophthalmologist visit
Describe what Brushfield spots are and what condition they are associated with? - Gray
or pale yellow spots at periphery of iris
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