Neonatal Neurological Assessment and Care Flashcards

Hypoxic-ischemic encephalopathy (HIE) is graded using the Sarnat classification. Grade II (moderate) HIE is characterized by:

Answer: Lethargy, hypotonia, absent Moro reflex, and possible seizures

Sarnat Grade II HIE presents with lethargy, hypotonia, suppressed primitive reflexes, and seizures occurring within 24 hours of birth.

The anterior fontanelle normally closes at approximately:

Answer: 12–18 months of age

The anterior fontanelle closes between 12–18 months as the frontal and parietal bones complete ossification.

A bulging anterior fontanelle in a febrile neonate is a sign of:

Answer: Increased intracranial pressure (e.g., meningitis)

A tense, bulging fontanelle indicates elevated intracranial pressure, which in a febrile neonate is a warning sign of meningitis.

Intraventricular hemorrhage (IVH) in preterm infants is most commonly associated with:

Answer: Gestational age under 32 weeks and respiratory distress

IVH risk is highest in the most immature neonates; fragile germinal matrix capillaries rupture under hemodynamic and hypoxic stress.

Neonatal seizures most commonly manifest as:

Answer: Subtle seizures (eye deviation, lip smacking, cycling limb movements)

Due to immature cortical organization, neonatal seizures most often present as subtle signs rather than classic tonic-clonic activity.

Grade III IVH is distinguished from Grade II by the presence of:

Answer: Blood filling and distending the ventricles (intraventricular clot with ventricular dilation)

Grade III IVH involves blood filling and distending the ventricles, increasing risk of post-hemorrhagic hydrocephalus.