Neonatology
1. Neonatal Care.
***) Which of the following
might increase fetal lung maturity in preterm delivery:
A.
Estrogen
B.
Prolactin
C.
Thyroxine
D.
Glucocorticoides
E.
Alpha fetoprotein
Answer: D* Glucocorticoides
***) The umbilical stump of the
newborn sloughs off after delivery about:
A.
2nd day
B.
5th day
C.
10th day
D.
15th day
E.
21st day
Answer: C* 10th day
***) The tidal volume of a
normal newborn is about:
A.
5 ml
B.
20 ml
C.
50 ml
D.
70 ml
E.
120 ml
Answer: B* 20 ml
***) The most common factor
associated with neonatal death is:
A.
Birth injury
B.
Prematurity
C.
Congenital malformations
D.
Metabolic diseases
E.
Intrauterine growth restrictions
Answer: B* Prematurity
***) One of the following is
associated with small infants:
A.
Mothers with untreated gestational diabetes
B.
Multipara
C.
Large parents
D.
Maternal smoking
E.
Post-date pregnancy
Answer: D* Maternal smoking
***) The fine downy hair
covering the skin of a newborn is called:
A.
Vernix caseosa
B.
Lanugo
C.
Milia
D.
Erythema toxicum
E.
Mottling
Answer: B* Lanugo
2.
APGAR score.
***) An infant at birth exhibits
pink body with blue extremities, pulse rate of 120/min, lusty cry, limp muscle
tone and irregular slow respiration. The Apgar score is:
A.
2
B.
4
C.
6
D.
8
E.
10
Answer: C* 6
***) A newborn baby delivered
with peripheral cyanosis, crying well, weak muscle tone, RR = 22/min irregular
and HR = 80/min, his Apgar score:
A.
4
B.
5
C.
6
D.
7
E.
8
Answer: C* 6
***) An infant born with good
respiration, vigorous cry, heart rate of 105, moving all extremities, body pink
and extremities blue. The Apgar score is
A.
10
B.
9
C.
8
D.
7
E.
6
Answer: B* 9
***) All are component of APGAR
score, except:
A.
Heart rate
B.
Blood pressure
C.
Respiratory effort
D.
Reflexes
E.
Skin color
Answer: B* Blood pressure
3.
Sepsis in the Neonate.
***) Beta Hemolytic streptococci
group A is responsible for all the following except:
A.
Acute glomerulonephritis
B.
Rheumatic fever
C.
Neonatal sepsis
D.
Scarlet fever
E.
Impetigo
Answer: C* Neonatal sepsis
***) All of the following are
predisposing factors of neonatal sepsis, except:
A.
Hypothermia
B.
Instrumental delivery
C.
Twins
D.
Amnionitis
E.
Umbilical infection
Answer: C* Twins
***) Predisposing factors for
neonatal septicemia include each of the following, except:
A.
Febrile maternal illness
B.
Twins
C.
Frank amnionitis
D.
Umbilical infection
E.
Endotracheal intubation
Answer: B* Twins
4.
Cyanosis.
***) All of the following can
cause cyanosis, except:
A.
Renal failure
B.
Congestive heart failure
C.
Polycythemia
D.
Cold
E.
Cor pulmonale
Answer: A* Renal failure
***) A newborn, 12 hours old,
cyanosed when he is quiet, becomes pink on crying, the most probable diagnosis
is:
A.
Respiratory distress syndrome
B.
Congenital pneumonia
C.
Diaphragmatic hernia
D.
Intracranial hemorrhage
E.
Bilateral choanal atresia
Answer: E* Bilateral choanal
atresia
5.
Respiratory Distress.
***) The most likely finding in
a neonate with asphyxia is:
A.
Alkalemia
B.
Hypoxia
C.
Hypocapnia
D.
Tachycardia
E.
Increased anal sphincter tone
Answer: C* Hypoxia
***) The features of respiratory
distress in newborn are the following, except:
A.
Tachypnea
B.
Flaring of nostrils
C.
Cyanosis
D.
Grunting on expiration
E.
Projectile vomiting
Answer: E* Projectile vomiting
***) Compliance of the lung is
increased in which of the following:
A.
Diffuse pulmonary fibrosis
B.
Pleural thickening
C.
Healed tuberculosis with scarring
D.
Emphysema
E.
Hyaline membrane disease
Answer: E* Hyaline membrane
disease
***) Regarding hyaline membrane
disease all of the following are true, except:
A.
Tachypnea is always present
B.
Affects mainly premature babies
C.
Expiratory grunting is present
D.
The clinical picture will develop within 4-6 hours
E.
Oxygen by mask is the best management
Answer: E* Oxygen by mask is the
best management
6.
Diaphragmatic Hernia.
***) The high postoperative
mortality for newborn with congenital diaphragmatic hernia is due to:
A.
Increased intra-abdominal pressure
B.
Persistent patent ductus arteriosus
C.
Failure of the collapsed lung to expand
D.
Mediastinal shift with impaired venous return
E.
Abnormal pulmonary microvasculature
Answer: E* Abnormal pulmonary
microvasculature
***) An infant is delivered at
full term by a spontaneous vaginal delivery to a 29 year old primigravida. At
delivery, the infant is noted to have subcostal retractions and cyanosis
despite good respiratory effort. The abdomen is scaphoid. On bag and mask
ventilation, auscultation of the lungs reveals decreased breath sounds on the
left, with heart sounds louder on the right:
A.
Dextrocardia with situs inversus
B.
Diaphragmatic hernia
C.
Pneumonia
D.
Pulmonary hypoplasia
E.
Spontaneous pneumothorax
Answer: B* Diaphragmatic hernia
7.
Hypoglycemia.
***) All the following are
associated with hypoglycemia in the newborn, except:
A.
Neonatal asphyxia
B.
Cold stress
C.
Diabetic mother
D.
Sepsis
E.
Rh-incompatibility
Answer: E* Rh-incompatibility
***) All of the following
statements are correct about hypoglycemia, except:
A.
It may associate neonatal asphyxia
B.
It may be manifestation of nesidioblastosis
C.
Glucagon and steroids may be used as treatment line
D.
Blood sugar of 45mg% is normal in full term infants
E.
Ketotic hypoglycemia is rare cause of hypoglycemia in
childhood
Answer: E* Ketotic hypoglycemia
is rare cause of hypoglycemia in childhood
8.
Jaundice.
***) Neonatal jaundice is seen
in all the following except:
A.
Breast feeding
B.
Hypothyroidism
C.
Sickle cell disease
D.
Galactosemia
E.
Septicemia
Answer: C* Sickle cell disease
***) Physiological jaundice is
characterized by all of the following, except:
A.
Onset after 36 hours of life
B.
Disappears by 10-14 days of life
C.
Associated always with anemia
D.
The total serum bilirubin does not exceed 14 mg%
E.
The direct bilirubin does not exceed 1.5 mg%
Answer: C* Associated always
with anemia
***) All of the following are
criteria for physiological jaundice, except:
A.
Starts within the first 24 hours
B.
The total serum bilirubin does not exceed 14 mg/dl
C.
The direct bilirubin does not exceed 1.5 mg/dl
D.
It will disappear within 7-10 days in full terms
E.
It does not need treatment by phototherapy
Answer: A* Starts within the
first 24 hours
***) In a 12 hours old newborn
that has jaundice the roost likely diagnosis of the following is:
A.
Erythroblastosis fetalis
B.
Physiological jaundice
C.
Biliary atresia
D.
Liver enzyme deficiency
E.
Galactosemia
Answer: A* Erythroblastosis
fetalis
***) Jaundice appearing in the
first day of life suggests one of the following:
A.
Hemolytic disease of the newborn
B.
Hypothyroidism
C.
Bile duct atresia
D.
Breast milk jaundice
E.
Liver enzyme deficiency
Answer: A* Hemolytic disease of
the newborn
***) All of the following are
causes of neonatal jaundice during the first 24 hours of life, except:
A.
ABO incompatibility
B.
Spherocytosis
C.
Biliary atresia
D.
G6PD deficiency
E.
Rh-incompatibility
Answer: C* Biliary atresia
***) A 2 months old baby is
having loose yellow motions after each breastfeeds since birth, body weight is
4.5 kg. The most appropriate action is:
A.
Stop breast feeding and give lactose free formula
B.
Stop breast milk and start WHO solution
C.
Admit to hospital for investigation
D.
Give antidiarrheal medicine
E.
Reassure the mother that her baby is well
Answer: E* Reassure the mother
that her baby is well
***) All of the fallowing
increases the risk of neonatal jaundice, except:
A.
Prematurity
B.
Trisomy 21
C.
Elective caesarean section
D.
Congenital hypothyroidism
E.
Cephalohematoma
Answer: C* Elective caesarean
section
9.
Necrotizing Enterocolitis
(NEC).
***) All of the following are
predisposing factors for developing necrotizing enterocolitis NEC, except:
A.
Prematurity
B.
Polycythemia
C.
Breast milk feeding
D.
Umbilical catheterization
E.
Perinatal asphyxia
Answer: C* Breast milk feeding
***) Concerning necrotizing
enterocolitis all are true, except:
A.
Affects mainly preterm babies
B.
Pneumatosis intestinalis is pathognomonic
C.
It has very good prognosis
D.
Exchange transfusion is a predisposing factor
E.
It may occur during the second or third week of life
Answer: C* It has very good
prognosis
10.
Neonatal Skin Conditions.
***) Epstein's pearls on the
hard palate of a newborn should be managed with:
A.
Topical antibiotics
B.
Topical steroids
C.
Excision
D.
Hydrogen peroxide
E.
No therapy
Answer: E* No therapy
***) One of the following
conditions in the newborn needs immediate management:
A.
Milia
B.
Mongolian blue spots
C.
Intact meningomyelocele
D.
Capillary hemangioma
E.
Erythema toxicum
Comments
Post a Comment