NIPE OSCE

• What does NIPE stand for?

  Newborn and Infant Physical Examination
• The NIPE is performed on every newborn baby within the first 72 hours of life.
• The NIPE is a screening tool used to identify congenital anomalies in babies.
• Which areas does the NIPE primarily focus on?

  Eyes, heart, hips, testicles
• Every baby has a NIPE performed either in hospital before discharge or at home by a community midwife.
• The NIPE cannot be performed on preterm babies.

  False
• What is the minimum gestational age for a preterm baby to have their hips checked during the NIPE?

  34+0 weeks
• Steps in performing the NIPE

  1️⃣ Obtain parental consent

  2️⃣ Ask screening questions

  3️⃣ Examine the baby top-to-toe

  4️⃣ Document findings

  5️⃣ Refer as needed
• Parents are asked screening questions about heart problems, eye problems, and hip problems in first-degree relatives.
• What is the most commonly inherited cardiac anomaly that parents are asked about in the screening questions?

  Aortic coarctation
• Parents are asked if the baby was head down presentation from 36 weeks onwards.
• What are other important questions to ask parents during the NIPE screening?

  Feeding, urine, bowel movements
• The maternal medical notes should be checked for any conditions or medications that could affect the baby's health.
• The NIPE must always be performed in a strict top-to-toe order.

  False
• What environmental conditions are necessary for performing the NIPE?

  Well-lit, warm environment
• Poor tone in a baby could be a sign of infection, brain damage, or a syndrome.
• Cyanosis in a newborn baby first manifests with bluish discoloration around the fingertips and mouth.
• What is erythema neonatorum commonly known as?

  Newborn rash
• Vernix is commonly found in the creases around the neck, axilla, and groin.
• Match the birthmark with its description:

  Stork marks ↔️ Red or pink patches on the skin

  Strawberry marks ↔️ Raised red lumps formed from blood vessels

  Port wine stains ↔️ Purple marks commonly on the face

  Slate grey naevus ↔️ Blue/grey marks on darker skin tones
• Large birthmarks near the eyes, nose, or mouth should be referred to Dermatology.
• How is head circumference measured in a newborn baby?

  Above ears and eyebrows
• Cephalohematoma crosses the suture lines of the skull.

  False
• A boggy swelling under the galeal aponeurosis of the scalp is called a subgaleal haemorrhage.
• What does a sunken fontanelle indicate in a newborn baby?

  Dehydration
• Premature fusion of sutures is called craniosynostosis.
• What is a possible cause of facial asymmetry in a newborn after an instrumental delivery?

  Facial nerve palsy
• Low-set ears may be a sign of an underlying genetic syndrome.
• Pre-auricular skin tags or pits are always associated with congenital renal anomalies.

  False
• What instrument is used to examine the mouth during the NIPE?

  Tongue depressor
• A bifid uvula may be related to a cleft palate.
• What team is a newborn with teeth referred to?

  Maxillofacial team
• Subconjunctival haemorrhages are harmless and caused by increased pressure during birth.
• The 'red reflex' in the eye is a reflection of light from the cornea.
• What may a pale pink or orange red reflex indicate in a baby with darker skin tone?

  Normal variation
• What are subconjunctival haemorrhages in the eyes of a newborn typically caused by?

  Increased pressure during birth
• When examining a newborn's eyes with an ophthalmoscope, you are looking for the red reflex.
• The red reflex in a newborn's eyes may appear pale pink or orange, which is considered normal.
• What are two conditions that may obscure the red reflex in a newborn's eye?

  Congenital cataract and retinoblastoma
• Surgery for congenital cataracts in newborns typically occurs between 1 and 2 months of age.