Neonatology 👶🏻

Question 1

Which is cause of jaundice in first day of life
A. Physiological
B. ABO hemolysis
C. SCA
D. Hypothyroidism

Answer 1

B. ABO hemolysis

Question 2

14 days old FTVD you noticed he is jaundice, he is feeding and growing well:

A. Breast milk jaundice
B. Hypothyroidism
C. Hemolysis
D. Sepsis

Answer 2

A. Breast milk jaundice 🍼🤱🏻

Within 7 days: Breast feeding jaundice
Within 14 days: Breast milk jaundice

Question 3

The rooting reflex disappears by […] months

Answer 3

4 months 👄

Question 4

Stepping reflex disappears by […] months

Answer 4

2 months 👣

Question 5

Moro reflex […]
Palmar grasp […]
Plantar grasp […]

Answer 5

👼🏻6
✊🏻3
🦶🏻6

Question 6

Large hemangioma over the eyelid:
A. Referral to opthalmo
B. Reassure as it disappears by 5 years
C. Tell mother it’ll get worse
D. Steroid

Answer 6

A. Referral to opthalmo
1st line tx: Propranolol

Question 7

Pregnant at 39 weeks now in labor, during delivery you noticed the amniotic fluid is mixed with dark black-green. What is the cause of this color?

A. Fetal aspiration
B. Fetal distress
C. Placenta abruption
D. Preterm pabor

Answer 7

B. Fetal distress

Question 8

Newborn with poor feeding. Which is a risk factor for neonatal sepsis?
A. Positive swap for staph epidermis
B. ROM for 12 hrs
C. Preterm babies
D. Cessation section

Answer 8

C. Preterm babies

🚨Risk for neonatal sepsis
Preterm • IUGR • ROM >18 hrs • Swap +ve GBS • Maternal fever • Chorioaminionitis

Question 9

Baby born by CS He is preterm 27 weeker. Now has Respiratory distress. Etiology:
A. Hyaline membrane disease
B. Meconium aspiration
C. Transient tachypnea of newborn
D. Congenital heart disease

Answer 9

A. Hyaline membrane disease

Preterm
Surfactant deficiency
L/S <2 or baby of DM mom
CXR: ground glass

Question 10

38 weeks CS baby with tachycardia, tachypnea, and grunting
CXR: fluid on lung fissure. Etiology:
A. Transient tachypnea of newborn
B. Meconium aspiration
C. Sepsis
D. ARDS

Answer 10

A. Transient tachypnea of newborn

Question 11

A baby delivered with meconium aspiration and admitted to PICU
Pre-ductal oxygen (hands) 85% , post-ductal oxygen (legs) 74%. Best action

A. Nitric oxide
B. Surfactant
C. Bicarbonate
D. Antibiotics

Answer 11

A. Nitric oxide

10% difference O2 sat = Pulmonary HTN
Tx: Nitric oxide / Sildenafil
Meconium aspiration suppress surgactant » Tx: O2 & Surfactant

Question 12

Which of the following most common type of CP in preterm babies:
A. Quaderplegia
B. Diplegia
C. Monoplegia
D. Hemiplegia

Answer 12

B. Diplegia
Both arms or both legs

Question 13

A baby born with low APGAR not responding to initial resuscitation. Best way to prevent CP:

A. Mechanical ventilation
B. Hypothermia
C. Antibiotics
D. Steroid

Answer 13

B. Hypothermia

Question 14

FTVD newborn of DM mom with Respiratory distress and desating. Mx:

A. Intubation & MV
B. ICU, monitor RBS & observation
C. Cardiac echo
D. Oxygen 100%

Answer 14

B. ICU, monitor RBS & observation

Question 15

When to give anti-D for baby as prophylaxis
A. Within 72 hrs after delivery
B. During delivery
C. After 7 days of birth
D. Last 2 weeks of pregnancy

Answer 15

A. Within 72 hrs after delivery

Anti-D Ig
☑️ GA week 28
☑️ 72 hrs postpartum

Question 16

Newborn with microcephaly & hepatosplenomegaly. Best investigation:
A. Chromosomal
B. Congenital infection screening
C. Metabolic screening
D. Culture

Answer 16

B. Congenital infection screening

TOURCH
🔹Micocephaly
🔹Cataract (rubella)
🔹Hepatosplenomegaly
🔹Brain calcification (CMV / Toxo)
🔹Jaundice
🔹Congenital heart disease
🔹Congenital nephrotic syndrome

Question 17

NICU child suddenly developed distress with absent breath sounds. Where to place the butterfly needle?

A. 2nd intercostal space
B. 3rd intercostal space
C. 4th intercostal space
D. 5th intercostal space

Answer 17

A. 2nd intercostal space
“Tension Pneumothorax”

Question 18

Pediatric newborn with purulent eye discharge, Culture showed G -ve diploccoci. Tx:
A. Topical antibiotics
B. Observation
C. IV cephalosporin
D. IV doxycyclin

Answer 18

C. IV cephalosporin

Day 1 : silver nitrate
Day 1-5: Nesseria » Ceftriaxone
Day 5-14 : Chlamydia » erythromycin

Question 19

Premature newborn present with abdominal distention and air in bowel wall. Dx:
A. Intussception
B. Necrotizing Enterocolitis
C. Duodenal atresia
D. Pyloric stenosis

Answer 19

B. Necrotizing Enterocolitis

Question 20

Cyanotic newborn with scaphoid abdomen. Heart sounds identified in the right side only. Most likely Dx:
A. Dextocardia with sinus inversus
B. TGA
C. Diaphragmatic hernia
D. Hiatal hernia

Answer 20

C. Diaphragmatic hernia

Question 21

Treatment of G+ meningitis in newborn:
A. Ampicillin
B. Doxycyclin
C. Ceftriaxone
D. Vancomycin

Answer 21

A. Ampicillin

Ampi + Genta + Cefotaxime
“Ampicillin” cover GBS + Listeria
“Gentamycin & Cefotaxime” cover G-

Question 22

Prevent infection for small babies during examination by:
A. Wear gloves
B. Gown
C. Hand wash
D. Mask

Answer 22

C. Hand wash

Question 23

Treatment of neonate with APGAR 3:
A. Chest expansion
B. Ventilation
C. IVF
D. No need for intervention

Answer 23

B. Ventilation

Question 24

In neonate what causative organism of meningitis?
A. Listeria
B. S. pneumo
C. Staph aureus
D. N. meningitidis

Answer 24

A. Listeria

Meningitis in pediatrics
<3 mo: Listeria, E.coli, group D strep
>3 mo: S.pneumo, H.influenza, Neisseria

Question 25

Calculate APGAR
HR 120, breath irregular & gasping, acrocyanotic, cough & grimace, only flexing limbs: […]

Answer 25

7

Appearance 2: 🩷 1: acrocyanosis 0: 🩵
Pulse 2: >100 1: <100 0: 🚫
Grimace 2: cough/sneeze 1: grimace 0: 🚫
Activity (tone) 2: Active 1: flexed 0: 🚫
Resp 2: crying 1: irregular 0: 🚫

Question 26

In multiple gestation what increase mortality & morbidity?
A. Prematurity
B. Instrumental delivery
C. Cessarian
D. Jaundice

Answer 26

A. Prematurity

Question 27

Infant has congenital heart block, mild PDA, platelets low. His mother has:
A. Rubella
B. SLE
C. Metabolic disease
D. Sepsis

Answer 27

B. SLE

Rubella: PDA
SLE: heart block +/- PDA, rash, low plt

Question 28

Infant of Diabetic mother advised to be on a high concentration glucose (20%) what is the expected route of glucose delivery?
A. NGT
B. OGT
C. Central line
D. Peripheral line

Answer 28

C. Central line

Maximum glc concentration can be given in peripheral line is 12.5%

Question 29

10 days old neonate I/E: tuft of hair in his lower back. What investigation you should order now?
A. US
B. CT
C. MRI
D. CSF

Answer 29

C. MRI
“Spina bifida”

Question 30

4 days old neonate with cyanosis.
His Hbg: 214 Hct: 75% .. management:

A. Partial exchange transfusion
B. Oxygenation
C. Hydration & monitoring
D. No treatment needed

Answer 30

C. Hydration & monitoring

Neonatal polycythemia
#1: Hydration
#2: partial ExTx
# definitive: treat the cause

Question 31

A neonate found to have generalized petechial rash & intracranial hemorrhage immediately after delivery. His Hb low, Plt 4, all other labs are normal. Mother’s plt normal. Most likely diagnosis:

A. ITP
B. Alloimmune thrombocytopenia (NAIT)
C. Congenital thrombocytopenia
D. Congenital CMV infection

Answer 31

B. Alloimmune thrombocytopenia (NAIT)

Tx: platelet
Subsequent pregnancies give mother IVIG & steroid

Question 32

Finding of nasal depress on newborn examination. Next step :
A. Chromosomal test
B. TORCH test
C. Blood culture
D. C1

Answer 32

A. Chromosomal test

Dysmorphic features » Chromosomal test
Hypoglc / Met Acid » Metabolic screen
Hepatosplenomegaly / Cataract » TORCH

Question 33

Case of neonate after venus there is bulging in head under periosteum within line of head sutures. Dx:

A. Cephalohematoma
B. Subgleal bleeding
C. Interventricular hemorrhage
D. Subarachnoid hemorrhage

Answer 33

A. Cephalohematoma

• Do not cross sutures = Cephalohematoma
• Cross suture lines= Caput succedaneum
• Subgleal hematoma : severe, cross suture, + shock !!