Fetus And Neonatal Infant

Question 1

Newborn male born term to a 36 y/o G3P2 (2002) mother via NSD, ruptured BOW x20 hrs, with difficulty delivering the right shoulder during delivery. On physical exam, he is limp, apneic with no palpable pulse appreciated, (+)caput and meconium-stained skin. What is the initial step of management?
(ch 121 p926)

A. Observe for 1 minute to determine the initial Apgar score which will guide you succeeding managent
B. Vigorous drying and stimulation
C. Intubate
D. Start PPV

Answer 1

B. Vigorous drying and stimulation

Question 2

A NB female was resusciated because she was apneic, limp, cyanotic with HR of 40s upon birth. She was intubated because of persistent bradycardia after 60s of PPV. If you are to follow the NRP, what is the proper way of delivering ventilation and compression in a neonate after an alternative airway has been established?
(ch 121 p927)

A. The ratio of compression and ventilation is still 3:1 with or without an alternative airway
B. Once the airway is established, the compression:ventilation ratio is 15:2
C. The compression:ventilation is still 30:2
D. You may give continuous ventilation while performing compression. Recheck pulse every 2 mins.

Answer 2

A. The ratio of compression and ventilation is still 3:1 with or without an alternative airway

Question 3

What is the characteristic position of the involved arm in patients with erb-duchenne palsy?
(ch 121 p924)

A. Involved arm is adducted from the shoulder, arm is rotated externally and forearm is supinated
B. Involved arm is adducted from the shoulder, arm is rotated internally and forearm is supinated
C. Involved arm is adducted from the shoulder, arm is rotated internally and forearm is pronated
D. Involved arm is adducted from the shoulder, arm is rotated externally and forearm is pronated

Answer 3

C. Involved arm is adducted from the shoulder, arm is rotated internally and forearm is pronated

Question 4

An asphyxiated newborn who was diagnosed with HIE and shows hyperactive tendon reflexes, bilateral miosis, hypotonic and flexed extremities is in what stage?
(ch 120 table 120.7 p920)

A. 1
B. 2
C. 3
D. None of the above

Answer 4

B. 2

Question 5

The following are indicative of poor neurologic ourcome in HIE except?
(ch 120 p923)
A. Initial blood cord pH< 6.7
B. Base deficit >20
C. Decorticate posturing
D. Lack of neurologic improvement on PE after 72 hrs

Answer 5

C. Decorticate posturing

Question 6

Medical treatment of seizures in HIE includes the ff except:
(ch 120 p 920)

A. Diazepam
B. Phenytoin
C. Levetiracetam
D. Phenobarbital

Answer 6

A. Diazepam

Question 7

What is the first step in rescucitating a newborn with thickly MSAF who is initially apneic, with HR 80, limp and cyanotic upon birth?
(ch 122 p 926-928)

A. Suction secretions
B. Give PPV
C. Tactile stimulation
D. Intubate

Answer 7

A. Suction secretions (part of the procedure for establishing airway)