Neonatology

Question 1

What reflex is developed at 6-9 months and remains for the rest of life?

Answer 1

Parachute reflex

Question 2

What is the likely diagnosis for premature newborn with low APGARS who develop gross hematuria, flank mass, hypertension, microangiopathic hemolytic anemia, thrombocytopenia and decreased UOP?

Answer 2

rein vein thrombosis

dx: renal ultrasound with dopplar

Question 3

What is the treatment for neonatal hypoglycemia?

Answer 3

IV D10W at 2 cc/kh

Question 4

What congenital infection results in craniotabes (ping pong effect due to softened thinned flexible cranial bones?

Answer 4

Syphilis

Question 5

What is a severe/ fatal complication of twin-to- twin transfusion syndrome?

Answer 5

hydrops fetalis (either twin)

Question 6

What maternal condition results in increase risk for caudal regression syndrome (absence/ limited lower extremity movement, agenesis of lower vertebral bones)?

Answer 6

Type 1 Diabetes

Question 7

What is the most likely diagnosis (maternal condition) that results in newborn with hypertelorism, arched eyebrows, short and upturned nose, and shortened stubby digits with hypoplastic nails?

Answer 7

Phenytoin use during pregnancy

Question 8

What are the 5 components that make up an APGAR score?

Answer 8

1. color
2. reflex irritability
3. heart rate
4. respiration
5. muscle tone

(score of 0-2 for each for total of 10)

Question 9

What is the most likely diagnosis for newborn with inclusion bodies found in ocular discharge in the setting of conjunctivitis?

Answer 9

Chlamydia conjunctivitis

tx: erythromycin

Question 10

What is the most likely diagnosis for newborn with arm adducted and internal rotated, asymmetric Moro, Fluoroscopy showing ipsilateral elevated diaphragm with seesaw movement and respiratory distress?

Answer 10

Erb Palsy

brachial plexus injury resulting in phrenic nerve injury; cranial nerve 5 and 6

Question 11

What neonatal GI abnormality is associated with maternal cocaine use?

Answer 11

Gastroschisis

Question 12

What is the most likely diagnosis for neonate with displaced apical impulse, respiratory distress, bowel sounds over the left chest, and scaphoid abdomen?

Answer 12

Diaphragmatic Hernia

Question 13

What is the most likely diagnosis for child with hypoplastic long smooth philtrum, microcephaly, low weight, short stature, small upturned nose, broad nasal bridge, micrognathia, ADHD and development delays with possible cleft palate?

Answer 13

Fetal Alcohol Syndrome

Question 14

What is the most likely diagnosis for premature newborn presenting with emesis, blood stool and abdominal distention and Xray showing well defined dilated focal segment of bowel with gas accumulation in bowel wall?

Answer 14

Necrotizing Enterocolitis (NEC)

Question 15

What is the most likely diagnosis for newborn who has not passed meconium who develops bilious vomiting, abdominal distention, and Xray showing granular material in central abdomen?

Answer 15

Meconium Ileus

Question 16

How old is a neonate with areola raised but no breast tissue?

Answer 16

34-35 weeks old

Question 17

How old is a neonate with scant ear cartilage and pinna returns slowly from folding?

Answer 17

32-35 weeks

Question 18

How old is neonate who has 2-3 sole creases?

Answer 18

34-35 weeks

creases increase with age

Question 19

… sign is asymmetry of the height of the knees with hips in 90 degree flexion found in infants older than 8-10 weeks older and associated with ….

Answer 19

Galezzi; Developmental Hip dysplasia

Question 20

What is the most likely diagnosis for newborn with flatted nose and chin, wide spaced eyes, prominent epicanthal folds, spadelike flattened hands, bilateral clubfoot, pulmonary hypoplasia and renal agenesis (abnormality)?

Answer 20

Potter sequence

due to oligohydramnios

Question 21

what is the next best step in management of newborn with jaundice who is less than 20 hours of life?

Answer 21

work-up for non-physiologic jaundice (CBC, retic count, coombs test, blood culture, total and direct bilirubin)

Question 22

What is the initial management for Erb’s palsy?

Answer 22

Physical therapy and observation

Question 23

What is the most likely diagnosis for newborn (less than 2 hours of life) presenting with cyanosis, grunting, tachypnea, retractions, normal lung fields and CXR showing flattened diaphragms and prominent pulmonary vasculature?

Answer 23

Transient Tachypnea of Newborn
(due to inadequate lung field clearance- i.e. C-section)
(tx: supportive care)

Question 24

What is the most likely diagnosis for newborn with microcephaly, microphthalmia, cataracts, chorioretinitis, limb atrophy, cicatrical scarring (hypopigmentation in dermatomal distribution)?

Answer 24

Congenital Varicella

due to maternal infection during 1st 20 weeks

Question 25

What is the cause of physiologic jaundice?

Answer 25

1. decreased fetal RBC lifespan

2. inactivity of liver conjugation

Question 26

When should neonatal cardiac compression being administered during birth?

Answer 26

if heart rate below 60 despite PPV

Question 27

When should PPV be initiated during newborn resuscitation?

Answer 27

Heart rate less than 100

Question 28

What electrolyte/ metabolic abnormality is associated with small left colon syndrome?

Answer 28

hypoglycemia

Question 29

What maternal condition is associated with small left colon syndrome?

Answer 29

Maternal diabetes

Question 30

What condition can be associated with hand paralysis, clavicular fracture especially if damage to cranial nerves C8-T1 occurs and had miosis (constricted pupil), ptosis, anisocoria and anhidrosis?

Answer 30

Horner’s syndrome due to Klumpke palsy

Question 31

What is the most likely diagnosis and treatment for a translucent bluish, nonblanching fluctuant swelling laterally located in lower mouth that has belly of frog appearance?

Answer 31

Ranula; surgical excision

Question 32

What is the most likely diagnosis for severe unconjugated (indirect) hyperbiliruinemia that is non-hemolytic and non-obstructive in newborn?

Answer 32

Crigler Najjar syndrome

Question 33

What treatment other than phototherapy can be used for Crigler Najjar syndrome?

Answer 33

Phenobarbital

Question 34

What maternal anti-hypertensive medication is correlated with major congenital abnormalities?

Answer 34

ACE inhibitors

Question 35

What is the most likely diagnosis for newborn with apnea, respiratory distress, generalized hypotonia, and GI hypomotility after treatment of hypertensive mother?

Answer 35

Hypermagnesium (elevated Mg level- transient)

Question 36

What is the most likely diagnosis for newborn presenting with nasal hypoplasia and stippled epiphysis?

Answer 36

Fetal Warfarin Syndrome

Question 37

What does an elevated alpha fetoprotein during prenatal screening suggest?

Answer 37

Neural Tube Defect (like meningomyelocele)

Question 38

What electrolyte abnormality is associated with subcutaneous fat necrosis (indurated, flesh colored nodules and plaques on lower back/ buttocks)?

Answer 38

Hypercalcemia (can develop up to 6 months)

Question 39

What is the initial step in management for neonate with pneumothorax (less than 20 percent) who is asymptomatic with normal blood pressure?

Answer 39

100 percent inhaled oxygen

Question 40

What disorder is associated with Necrotizing enterocolitis (NEC)?

Answer 40

Cystic fibrosis (pancreatic insufficiency)

Question 41

What is the most likely diagnosis of newborn with bilateral cryptorchidism, hypoplasia of abdominal muscles (umbilical hernia), lung hypoplasia (due to oligohydramnios from renal disorder) and renal dysplasia?

Answer 41

Prune belly (Eagle-Barrett syndrome)

Question 42

What maternal medication is associated with persistent pulmonary HTN in neonate?

Answer 42

SSRIs

Question 43

What are the two benefits of cirumcision?

Answer 43

1. decreased risk for UTI in 1st year of life

2. decreased risk of HIV transmission