PAEA Pediatrics
Causes for SGA - ✔️✔️maternal drug use, chromosomal abnormalities, exposure to
intrauterine viral infection, multiple gestation, advanced maternal age (>35), placental
insufficiency, lack of maternal weight gain.
When should you do a complete newborn exam? - ✔️✔️W/in 24 hrs of birth
Erythema toxicum - ✔️✔️Common; first appears 3-5 days after birth as small pustules
on erythematous bases
Spontaneous resolution w/in 1-2 wks
When is APGARs assessed? - ✔️✔️1,5, and 10 minutes (1 and 5 with Dr A)
Apgar scoring is completed in the delivery room; low serial scores alert the clinician to
the need for resuscitation efforts
New Ballad Score - ✔️✔️more complex assessment of activity, position, and tone,
which is used to evaluate neuromuscular and physical maturity. This rubric estimates
gestational age. Growth charts plot the number of weeks to birth weight to help
determine if the newborn is SGA, large for gestational age, or of normal weight.
Milia - ✔️✔️Very small, white papules concentrated on nose, cheeks, forehead, and
chin (baby acne)
Resolve w/o intervention in 1-2 mos
Miliara - ✔️✔️Caused by blockage of eccrine sweat glands, resulting in a flushed
macular appearance frequently involving neck, face, scalp, and diaper area
Light clothing and decreased humidity speed resolution of this "prickly heat" or "heat
rash" phenomenon.
Mongolion spots - ✔️✔️comon in dark skinned infants and involve small to large, blue
black macules concentrated on the back and buttocks; these macules frequently are
misdiagnosed as bruising.
Most will resolve spontaneously within 4 years, although they may persist for life
Nevus simplex (stork bite) - ✔️✔️Occur secondary to areas of surface capillary dilation
and are frequently found on the eyelids, nape of the neck, and forehead
These almost always resolve spontaneously by 2 yo although some may persist into
adolescence at which time they may be treated w laser therapy.
Vernix caseosa and lanugo - ✔️✔️greasy covering and fine hairs
, this is more abundant in perterm infants
dry, cracked, and peeling skin is more likely in postterm infants
Craniosynostosis - ✔️✔️refers to premature fusion of one or more sutures
referral to a neurologist is necessary
Fontanelles - ✔️✔️Anterior: 1 to 4 cm in size in either direction; closes around 10 to 26
months of age
Posterior: 1 cm in size on average; closes 1 to 3 months
A third fontanelle along the sagittal suture may be present and may be associated w
trisomy 21
Caput succedaneum - ✔️✔️fluid accumulation under the scalp secondary to birth
trauma. Swelling is palpable crossing the midline
Where do hematomas frequently appear? - ✔️✔️within suture lines
(cephalohematoma)
Subgaleal hemorrhages - ✔️✔️occur beneath the scalp; they are uncommon but may
result in enough blood loss to cause hemorrhagic shock
Posteriorly rotated or low set ears - ✔️✔️Prompt suspicion of other congenital
anomalies
Preauricular pits and tags - ✔️✔️common and usually are benign when they appear in
isolation. Infants w a fmhx of preauricular pits associated w deafness should be followed
serially for hearing loss.
How is hearing best assessed? - ✔️✔️During the newborn period by auditory brain
stem response or evoked otoacoustic emission testing. All infants should be screened
regularly during development.
Abnormalities or asymmetry of red reflex - ✔️✔️immediate referral to pediatric
opthalmologist. Absent red reflex in infant - congenital cataracts, glaucoma, or
retinoblastomas
Brushfield spots - ✔️✔️gray or pale yellow spots at periphery of the iris are associated
w Down Syndrome
Subconjunctival hemorrhages - ✔️✔️common benign findings associated w the trauma
of delivery. They generally resolve w time
Strabismus - ✔️✔️eye crossing, almost always is present during the newborn period
and does not represent pathology unless it is fixed or persists past 4 months
Causes for SGA - ✔️✔️maternal drug use, chromosomal abnormalities, exposure to
intrauterine viral infection, multiple gestation, advanced maternal age (>35), placental
insufficiency, lack of maternal weight gain.
When should you do a complete newborn exam? - ✔️✔️W/in 24 hrs of birth
Erythema toxicum - ✔️✔️Common; first appears 3-5 days after birth as small pustules
on erythematous bases
Spontaneous resolution w/in 1-2 wks
When is APGARs assessed? - ✔️✔️1,5, and 10 minutes (1 and 5 with Dr A)
Apgar scoring is completed in the delivery room; low serial scores alert the clinician to
the need for resuscitation efforts
New Ballad Score - ✔️✔️more complex assessment of activity, position, and tone,
which is used to evaluate neuromuscular and physical maturity. This rubric estimates
gestational age. Growth charts plot the number of weeks to birth weight to help
determine if the newborn is SGA, large for gestational age, or of normal weight.
Milia - ✔️✔️Very small, white papules concentrated on nose, cheeks, forehead, and
chin (baby acne)
Resolve w/o intervention in 1-2 mos
Miliara - ✔️✔️Caused by blockage of eccrine sweat glands, resulting in a flushed
macular appearance frequently involving neck, face, scalp, and diaper area
Light clothing and decreased humidity speed resolution of this "prickly heat" or "heat
rash" phenomenon.
Mongolion spots - ✔️✔️comon in dark skinned infants and involve small to large, blue
black macules concentrated on the back and buttocks; these macules frequently are
misdiagnosed as bruising.
Most will resolve spontaneously within 4 years, although they may persist for life
Nevus simplex (stork bite) - ✔️✔️Occur secondary to areas of surface capillary dilation
and are frequently found on the eyelids, nape of the neck, and forehead
These almost always resolve spontaneously by 2 yo although some may persist into
adolescence at which time they may be treated w laser therapy.
Vernix caseosa and lanugo - ✔️✔️greasy covering and fine hairs
, this is more abundant in perterm infants
dry, cracked, and peeling skin is more likely in postterm infants
Craniosynostosis - ✔️✔️refers to premature fusion of one or more sutures
referral to a neurologist is necessary
Fontanelles - ✔️✔️Anterior: 1 to 4 cm in size in either direction; closes around 10 to 26
months of age
Posterior: 1 cm in size on average; closes 1 to 3 months
A third fontanelle along the sagittal suture may be present and may be associated w
trisomy 21
Caput succedaneum - ✔️✔️fluid accumulation under the scalp secondary to birth
trauma. Swelling is palpable crossing the midline
Where do hematomas frequently appear? - ✔️✔️within suture lines
(cephalohematoma)
Subgaleal hemorrhages - ✔️✔️occur beneath the scalp; they are uncommon but may
result in enough blood loss to cause hemorrhagic shock
Posteriorly rotated or low set ears - ✔️✔️Prompt suspicion of other congenital
anomalies
Preauricular pits and tags - ✔️✔️common and usually are benign when they appear in
isolation. Infants w a fmhx of preauricular pits associated w deafness should be followed
serially for hearing loss.
How is hearing best assessed? - ✔️✔️During the newborn period by auditory brain
stem response or evoked otoacoustic emission testing. All infants should be screened
regularly during development.
Abnormalities or asymmetry of red reflex - ✔️✔️immediate referral to pediatric
opthalmologist. Absent red reflex in infant - congenital cataracts, glaucoma, or
retinoblastomas
Brushfield spots - ✔️✔️gray or pale yellow spots at periphery of the iris are associated
w Down Syndrome
Subconjunctival hemorrhages - ✔️✔️common benign findings associated w the trauma
of delivery. They generally resolve w time
Strabismus - ✔️✔️eye crossing, almost always is present during the newborn period
and does not represent pathology unless it is fixed or persists past 4 months
