Paediatric Neonatology

Question 1

What criteria does the APGAR score test?

Answer 1

Activity (muscle tone)
Pulse (should be above 100)
Grimace (reflex response) 
Appearance (skin colour)
Respiratory effort (cry)

Question 2

What is the milestone age for pincer grip?

Answer 2

Approximately 10 months

Question 3

What is the normal respiratory rate for a neonate?

Answer 3

40 to 60 breaths per minute

Question 4

When is the MMR vaccine given?

Answer 4

Twice

Approximately 13 months and 3.5 years old

Question 5

What chromosomal abnormality characteristically presents with microcephaly, cleft lip, and polydactyly?

Answer 5

Trisomy 13, Patau’s syndrome

Question 6

What causes respiratory distress syndrome in neonates?

Answer 6

Insufficient surfactant production leads to alveolar collapse, typically in preterm infants <32 weeks gestation

Question 7

A ground glass appearance of the lungs on chest x-ray is characteristic of what?

Answer 7

Respiratory distress syndrome of the newborn

Question 8

Chronic lung disease or prematurity is defined as what?

Answer 8

Oxygen requirements beyond 36 weeks of post menstrual age

Question 9

Apnea is a pause in respiration that lasts for how long?

Answer 9

20 seconds or more

Question 10

What drugs can be used in the treatment for apnoea of prematurity?

Answer 10

Theophylline

Caffeine

Question 11

What is transient tachypnoea of the newborn and what will it show on CXR?

Answer 11

Delayed resorption of fluid in the lungs leads to respiratory distress in the newborn
Can show as ling hyperinflation and fluid in the horizontal fissure
Usually settles sighing a day

Question 12

Rocker bottom feet is a feature of which chromosomal abnormality?

Answer 12

Trisomy 18

Question 13

What is the mainstay of treatment for neonatal jaundice?

Answer 13

Phototherapy (according to bilirubin threshold graphs)
If severe: exchange transfusion

For phototherapy, baby must be exposed and have eyes covered and have extra fluids and regular breaks for feeds with mum

Question 14

What are some causes of neonatal jaundice with conjugated bilirubin?

Answer 14

Biliary atresia
Hepatitis

(Pale stools and dark urine)

Question 15

What are causes of neonatal jaundice that will present within the first day of life?

Answer 15

ABO/ Rh incompatibility
Haemolysis (spherocytosis, elliptocytosis, GPDH/ pyruvate kinase deficiency)
TORCH infections