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PEDIA > 1ST BM LQ1 > Flashcards

1ST BM LQ1 Flashcards

1
Q

Give at least 3 risk factors for prematurity:

A

Low socioeconomic status
Mother <16yo or >35yo
High level of maternal activity
Acute/ Chronic maternal illness
Multiple gestational births
Outcome of a previous pregnancy
Obstetrics factors: uterine malformation/trauma
Fetal conditions

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2
Q

True or False: IUGR may result in SGA BUT NOT ALL SGA are due to IUGR

A

TRUE

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3
Q

Asymmetric SGA is characterized as

A. normal birth length and head
circumference, low birthweight
B. low birth length, normal birthweight and
head circumference
C. low birthweight and birth length; normal
head circumference

A

A. normal birth length and head
circumference, low birthweight

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4
Q

LGA infants or large for gestational age is defined as:

A. weight above 85th percentile
B. weight above 90th percentile
C. weight above 95th percentile

A

B. weight above 90th percentile

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5
Q

Post term infants are considered those born:

A. 40 weeks gestation
B. 41 weeks gestation
C. 42 weeks gestation

A

C. 42 weeks gestation

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6
Q

Give at least 3 common clinical manifestations of a sick infant:

A

Abnormal movement: seizures
Altered mental status: lethargy,
irritability, hyperactive, failure to feed
Apnea, Cyanosis Congenital Anomalies
GI Disturbance: Vomiting, Diarrhea,
Abdominal Distention
Hypotension, Jaundice, Pain

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7
Q
  1. A 5-day old infant with a diagnosis of Persistent Pulmonary Hypertension remains to have
    hypoxemia despite 100% oxygen and assisted ventilation. Which is the next step in the
    management of this patient?

A. Nitric oxide
B. Indomethacin NSAIDS
C. Surfactant therapy
D. Magnesium sulfate

A

A. Nitric oxide

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8
Q

Treatment of Hyperbilirubinemia:

A. goal is to prevent neurotoxicity
B. phototherapy is done
C. exchange transfusion is the primary
treatment modality
D. all of the above

A

D. all of the above

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9
Q

The following are complications of phototherapy (“sunbathing”) EXCEPT:

A. Rashes
B. Overheating
C. Constipation
D. None of the above

A

C. Constipation

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10
Q

Major organ systems are affected because of prematurity. This is the most important
sequelae for prematures.

A. hypovolemia
B. cerebral palsy
C. hypoglycemia
D. Immature lungs

A

D. Immature lungs

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11
Q

IA was delivered term via cesarean section with good cry. Amniotic fluid is clear. Maternal
history is unremarkable. An hour after birth, she was examined tachypneic with retractions but
chest sounds are clear. The following are true of IA’s condition EXCEPT:

A. self-limited
B. treatment is oxygen inhalation, fluid
therapy
C. associated with early clearance of fetal
lung fluid
D. chest xray; prominent perihilar pulmonary
vascular markings

A

C. associated with early clearance of fetal
lung fluid

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12
Q

The following statements are TRUE of diaphragmatic hernia EXCEPT:

A. Defined as a communication between the
abdominal and thoracic cavities without
abdominal contents in the thorax.
B. Defect at the posterolateral portion of the
diaphragm is the most common
C. Reduction in the pulmonary mass and
number of bronchial divisions, respiratory
bronchioles and alveoli are the major limiting
factor for survival
D. Usually caused by trauma

A

D. Usually caused by trauma

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13
Q

The following conditions presents with normal oxygen saturation in a newborn EXCEPT:

A. fetal death
B. miscarriage
C. postterm delivery
D. intrauterine growth restriction

A

C. postterm delivery

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14
Q

This is the first manifestation of seizures in newborns.

A. apnea
B. cyanosis
C. chewing
D. upward gaze

A

A. Apnea

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15
Q

The following are complications of newborns weighing 4.3 kgs at birth EXCEPT:

A. polycythemia
B. hyperglycemia
C. shoulder dystocia
D. clavicular fracture

A

B. hyperglycemia

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16
Q

The following are characteristics of jitteriness in the newborn EXCEPT:

A. with upward gaze
B. occurs in active state
C. depends on the tactile stimuli
D.occurs in polycythemic neonates

A

A. with upward gaze

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17
Q

The following is/are TRUE of caput succedaneum EXCEPT:
A. Requires no treatment
B. May extend across the midline and suture
lines.
C. molding of the head with overriding of
frontal bones
D. Diffuse ecchymotic, edematous swelling of
the soft tissues of the scalp.

A

C. molding of the head with overriding of
frontal bones

overriding parietal bones

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18
Q

The following are correctly described EXCEPT:

A. Jaundice from deposition of indirect
bilirubin in the skin appears bright yellow.
B. Jaundice of the obstructive type appears
muddy yellow.
C.Pathologic jaundice appears at birth or
within the first 24 hours of life.
D. Physiologic jaundice appears at 2nd-3rd
day of life
E. NONE OF THE ABOVE

A

E. NONE OF THE ABOVE

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19
Q

Vacuum extraction or forceps-assisted delivery would sometimes lead to:

A. hydrocephaly
B. anencephaly
C. cerebral palsy
D.intracranial hemorrhage

A

D.intracranial hemorrhage

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20
Q

Common problem/s encountered in small for gestational age newborns:

A. hyperglycemia
B. hypercalcemia
C. hyperthermia
D. respiratory distress syndrome

A

A. hyperglycemia

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21
Q

The following are true in Infant of diabetic mothers EXCEPT:

A. cardiomegaly but with heart
B. can have anencephaly, hypoplastic left
heart and hydronephrosis
C. high incidence of respiratory distress syndrome
D. can be jittery, tremulous and
hyperexcitable or hypotonic, lethargic and poor sucking
E. None of the above
F. All of the above

A

E. None of the above

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22
Q

A 3.5 kg, 42 weeks old neonate was referred to you for tachypnea, retractions , cyanosis.
You noted meconium nails and cord. However, neonate was vigorous. Management in general
for these kind of patients involves the following, EXCEPT:

A. antibiotic coverage
B.intubate to aspirate the lungs
C. for mild disease, it only requires 30%
oxygen up to 2 days
D. Extracorporeal membrane oxygenation as
the final rescue therapy

A

B.intubate to aspirate the lungs

unless patient is in respiratory distress;
take note: neonate was in vigorous state

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23
Q

A perinatal history should include the following EXCEPT:

A. age of the mother
B. intake of medications
C. outcome of previous pregnancies
D. mode of delivery
E. none of the above

A

E. none of the above

24
Q

The following are features/characteristics of infant of diabetic mothers EXCEPT:

A. large and plump with puffy, plethoric facies
B. can be with normal or low birth weight
C. high risk of brachial plexus injury
D. none of the above

A

D. none of the above

25
Q

Use of assisted reproductive technology is one of the risk factors for high risk pregnancy.
One of the complications for using such are the following EXCEPT:

A. prematurity
B. cerebral palsy
C.very low birthweight newborns
D. large for gestational age newborns

A

D. large for gestational age newborns

26
Q

The following are TRUE of Bronchopulmonary Dysplasia EXCEPT:

A. Chest radiographs would show “Bubbly
lungs
B. moderate BPD needs 30% only of oxygen
inhalation
C. ventilatory and nutritional support are the
mainstay of treatment
D. worsening respiratory status with
decreasing work of breathing

A

D. worsening respiratory status with
decreasing work of breathin

27
Q

Conditions associated with oligohydramnios include EXCEPT:

A. fetal anomalies
B. pulmonary hypoplasia
C. intrauterine growth restriction
D. congenital diaphragmatic hernia

A

D. congenital diaphragmatic hernia

28
Q

T OR F: Asymmetric SGA infants with decreased growth potential have a poorer outcome than
symmetric SGA infants whose brain growth is not impaired.

A

FALSE

symmetric SGA infants with decreased growth potential have a poorer outcome than asymmetric SGA infants whose brain growth is not impaired

29
Q

.The following are factors in considering infants as high risk for morbidity or mortality
during the neonatal period EXCEPT:

A. Birthweight 2 kgs or 5 kgs
B. 36 weeks or 43 weeks of gestation
C. Apgar score of 6 @ 5 mins.
D. Premature labor @ 37 weeks AOG

A

D. Premature labor @ 37 weeks AOG

30
Q

TRUE of Pathologic jaundice EXCEPT:

A. occurs on the 20 hours of life
B. direct bilirubin of 1.5 mg/dL
C. persists beyond 2 weeks after birth
D. total bilirubin level is at 15 mg/dL in term infants

A

B. direct bilirubin of 1.5 mg/dL

> 2mg/dL

31
Q

Minor causes of apnea in prematures may be caused by the following EXCEPT:
A. severe infection
B. neck extension
C. metabolic imbalance
D. vasovagal reflex after OGT insertio

A

B. neck extension

32
Q

A 900 gms , 26th weeks, neonate was referred to you for tachypnea, cyanosis, grunting.
On PE, breath sounds are decreased both lung fields. Management of this kind of patients
involves: EXCEPT ;

A. surfactant therapy
B. antibiotic therapy is needed
C. CPAP is the mainstay treatment
D. Betamethasone therapy to mother prior to delivery
E. Dexamethasone is given to neonate shortly after birth

A

E. Dexamethasone is given to neonate shortly after birth

GIVEN TO THE MOTHER NOT THE BABY

33
Q

Characteristics of preterms that increase their risk for morbidity and mortality are the
following EXCEPT:

A. easily loses heat
B. large surface area
C. diminished fat reserves
D. diminished drive to breath
due to immaturity of the lungs

A

D. diminished drive to breath
due to immaturity of the lungs

34
Q

The following statement(s) about Persistent Pulmonary Hypertension is/are correct
EXCEPT:

A. There is persistence of the fetal circulatory pattern
of left-to-right shunting through the PDA and
foramen ovale after birth is a result of excessively
high pulmonary vascular resistance
B. Hypoxemia is universal and intermittently
unresponsive to 100% oxygen given by oxygen hood.
C. Therapy is directed toward correcting predisposing
condition and improving poor tissue oxygenation.
D. None of the above

A

A. There is persistence of the fetal circulatory pattern
of left-to-right shunting through the PDA and
foramen ovale after birth is a result of excessively
high pulmonary vascular resistance

must be right-to-left shunting

35
Q

WHAT STAGE?

Dry, cracked, peeling, loose and wrinkled skin,
malnourished

A

STAGE 1

36
Q

WHAT STAGE?

Dry, cracked, peeling, meconium stained nails

A

STAGE 3

37
Q

WHAT STAGE?

Dry cracked, peeling, meconium stained amniotic fluid

A

STAGE 2

38
Q

WHAT STAGE?

Dry, cracked, peeling, meconium stained cord

A

STAGE 3

39
Q

WHAT STAGE?

“too big for a baby” , perinatal depression, greenish
amniotic fluid

A

STAGE 2

40
Q

Asymmetric SGA is characterized as:

A. normal birth length and head
circumference, low birthweight
B. low birth length, normal birthweight and
head circumference
C. low birthweight and birthlength; normal
head circumference
D. normal birthweight, low head
circumference, low birth length

A

A. normal birth length and head
circumference, low birthweight

41
Q

KM was delivered term, cephalic and thickly meconium stained. At 4 hours of life, she
was noted to be tachypneic. There was also a note of overdistention of the chest. The
following are true of her condition:

A. Condition usually improves after 24 hours.
B. Low risk for persistent pulmonary hypertension.
C. Chest radiograph: patchy infiltrates, coarse
streaking of both lung fields, increased
anteroposterior diameter and flattening of the
diaphragm
D. None of the above

A

C. Chest radiograph: patchy infiltrates, coarse
streaking of both lung fields, increased
anteroposterior diameter and flattening of the
diaphragm

42
Q

DH was diagnosed with diaphragmatic hernia and the following can be seen EXCEPT:

A. can be stable up to 48hours
B. respiratory distress is a cardinal sign
C. scaphoid abdomen with decreased chest
wall diameter
D. bowel sounds can be heard in the chest
with decreased breath sounds

A

C. scaphoid abdomen with decreased chest
wall diametera

43
Q

The following metabolic disorders can be seen in infant of diabetic mothers:
A. hyperglycemia, hypocalcemia and
hypermagnesemia
B. hypoglycemia, hypocalcemia, and
hypomagnesemia
C.hyperglycemia, hypercalcemia and
hypomagnesemia
D. none of the above

A

B. hypoglycemia, hypocalcemia, and
hypomagnesemia

44
Q

The following is/ are TRUE of apnea of prematurity:

A. Cessation of breathing for >= 20 secs
B. Cessation of breathing for any duration
with cyanosis
C.Treatment includes gentle tactile
stimulation, supplemental oxygen,
methylxanthines
D. A and C only

A

D. A and C only (Rationalization
answer)

45
Q

True of Respiratory Distress Syndrome:

A. Incidence is directly related to gestational
weight and birthweight
B. Decreased production and secretion of
surfactant is the primary cause
C. Mature levels of pulmonary surfactant are
present after 32 weeks gestation.
D. All of the above

A

B. Decreased production and secretion of
surfactant is the primary cause

46
Q

The following are TRUE of APnea of Prematurity EXCEPT

A. Surfactant deficiency
B. pulmonary hgge
C. occurs shortly after birth
D. inversely correlated with age
E. occurs in those with the birthweight of 900 gms

A

C. occurs shortly after birth

2nd-7th DOL

47
Q

The following is/are TRUE of cephalhematoma EXCEPT:

A. resorbed in 2 months
B. subgaleal hemorrhage
C. limited to the surface of one cranial bone
D. does not cross the midline and suture lines

A

B. subgaleal hemorrhage

subperiosteal hemorrhage

48
Q
  1. Conditions associated with polyhydramnios include EXCEPT:

A. anencephaly
B. tracheoesophageal fistula
C. twin-to-twin transfusion (donor)
D. twin-to-twin transfusion (recipient)

A

C. twin-to-twin transfusion (donor)

associated with oligohydramnios

49
Q

Hyperactivity in a neonate usually results from several factors. One of the following is
NOT included:

A. hypoxia
B.hypoglycemia
C. hypocalcemia
D. discomfort from warm environment

A

D. discomfort from warm environment

50
Q

Postterm newborns are characterized as the following characteristics EXCEPT:

A. abundant lanugo
B. decreased vernix
C. abundant scalp hairfeeding
D. desquamating skin

A

A. abundant lanugo

51
Q

True of jaundice associated with breastfeeding :

A. Breastfeeding jaundice occurs after 7 days of
life.
B. No therapy needed if serum bilirubin is 250
umol/L
C. Breastmilk jaundice occurs in the first 7 days
after birth
D. Breastmilk jaundice is also called Lactation
Failure Jaundice

A

B. No therapy needed if serum bilirubin is 250
umol/L

52
Q

Why is it important to identify a high risk pregnancy?

A. prevent fetal complications
B. initiate treatment early
C. reduce morbidity and mortality
D. all of the above

A

D. all of the above

53
Q

Lethargic newborns shortly after birth may be secondary to:
A. infections
B. maternal medications
C.inborn errors of metabolism
D. mild hypoxic ischemic encephalopathy

A

B. maternal medications

54
Q

Vomiting normally occurs in the following situations EXCEPT:

A. overfeeding
B. milk allergy
C. a normal phenomenon
D. inexperienced feeding technique

A

B. milk allergy

55
Q

This is the prompt and parcel in the management of premature infants upon delivery
EXCEPT

A. thorough drying
B. formula milk feeding
C.giving of antibiotics
D. adequate supply of oxygen

A

B. formula milk feeding

PEDIA (3 decks)

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