Pedia: Neonatology

Question 1

At what week of gestation is surfactant first synthesized? First appears in amniotic fluid? Reach mature levels?

Answer 1

20W
28-32W
35W

Question 2

Serious apnea is defined as cessation of breathing _____

Answer 2

Longer than 20s

Of any duration accompanied by cyanosis and bradycardia

Question 3

Idiopathic apnea of prematurity resolves by ___

Answer 3

36W PCA

Question 4

How does one differentiate CHD from pulmonary diseases as the underlying cause of cyanosis?

Answer 4

Hyperopia test.

PaO2 increases with pulmonary disease; not increased in cyanotic.

Question 5

Management of biliary atresia

Answer 5

Kasai procedure

Do it before 8W (90% success)

Question 6

Abdominal UTZ finding in biliary atresia

Answer 6

Triangular cord sign

Question 7

How does one differentiate neonatal hepatitis from biliary atresia?

Answer 7

Neonatal hepatitis more common in premature; with a familial tendency.
Consistently pigmented stools rule against biliary atresia

Question 8

Most common syndrome with intrahepatic duct paucity

Answer 8

Alagile syndrome

Question 9

Kernicterus occurs in infants with a bilirubin level ___

Answer 9

20mg/dL

Question 10

Jaundice is observed in how many % of term infants? Preterm infants?

Answer 10

60% of term;

80% of preterm

Question 11

Indicators of pathologic jaundice

Answer 11

Appear within 1st 24 hours
Normal rate of increase 12 in full term; >14 in preterm
Persists after 10-14 days
Direct bilirubin fraction >2mg/dL

Question 12

Most common location of Bochdalek’s hernia? Morgagni?

Answer 12

Bochdalek: posterolateral, left
Morgagni: antermedial, right

Question 13

Triad of necrotizing enterocolitis:

Answer 13

• Intestinal ischemia
• Bacterial translocation
• Enteral nutrition

Question 14

Indications for surgery in necrotizing enterocolitis:

Answer 14

• Evidence of perforation on X-ray

- positive result of abdominal paracentesis

Question 15

Most common cause of nosocomial infections in neonates

Answer 15

Coagulase negative staphylococcus

Question 16

What is the most common cause of neonatal hepatitis?

Answer 16

Group B streptococcus

Question 17

Small salmon pink papules in neonates suggest infection with

Answer 17

Listeria monocytogenes

Question 18

Drug of choice for neonatal meningitis caused by enterovirus

Answer 18

Pleconaril

Question 19

What do you give in neonatal resuscitation if mother received narcotic within 4 hours of delivery

Answer 19

Naloxone

Question 20

Treatment for recurrent apnea of prematurity

Answer 20

Theophylline or caffeine

Lowers threshold of response to hypercapnia;
Enhances diaphragmatic contractility;
Prevents diaphragm fatigue