Quiz 14: Congenital Disorders

Question 1

How many infants are born with a congenital disorder?

1%
3%
5%
10%

Answer 1

3%

Question 2

Which infants should be examined after delivery for a congenital disorder?

Postterm infants

Infants with 3 vessels in their umbilical cord
Infants that have a low

Apgar score

All infants

Answer 2

All infants

Question 3

When should you anticipate the birth of an infant with a congenital disorder?

In patients younger than 35 years

In patients who received penicillin during early pregnancy

In patients with poorly controlled diabetes

In patients who smoked cigarettes during their pregnancy

Answer 3

In patients with poorly controlled diabetes

Question 4

How should you manage an infant with a clubbed foot?

Refer the infant to an orthopaedic clinic within the first 72 hours after delivery.

Refer the infant to a level 3 hospital for surgical correction.

Ask the mother to bring the infant back at 2 weeks for a further examination.

A clubbed foot corrects spontaneously and, therefore, does not need to be treated.

Answer 4

Refer the infant to an orthopaedic clinic within the first 72 hours after delivery.

Question 5

Dislocation of the hip should be diagnosed by:

Taking an X-ray of the hips of all infants

By inspecting the infant for a mass in the groin

By performing an Apt test on all infants before discharge

By doing a Barlow’s test on all infants after delivery

Answer 5

By doing a Barlow’s test on all infants after delivery

Question 6

How should you manage an infant with a dislocated hip?

Nurse the infant in double nappies.

Refer the infant as soon as possible to an orthopaedic clinic for splinting.

Examine the infant again in 2 weeks to determine whether the hip has returned to normal.

Strap the hip to prevent pain.

Answer 6

Refer the infant as soon as possible to an orthopaedic clinic for splinting.

Question 7

An undescended testis in a term infant:

Is normal.

Often descends spontaneously by 3 months.

Needs urgent surgical correction.

Indicates that the infant has ambiguous genitalia.

Answer 7

Often descends spontaneously by 3 months.

Question 8

Infants with a hypospadias should be:

Circumcised

Referred to a level 3 hospital for urgent surgery

Referred to a urology clinic

Booked for a follow-up examination at 5 years

Answer 8

Referred to a urology clinic

Question 9

Infants with ambiguous genitalia:

Should all be brought up as females

Should be referred to a plastic surgery clinic when they are 1 month old

Should be seen again at 6 months when it is easier to decide whether they are male or female

Should be referred urgently to a level 3 hospital for further investigation

Answer 9

Should be referred urgently to a level 3 hospital for further investigation

Question 10

An inguinal hernia:

Is common in preterm infants.

Transilluminates well.

Should be referred for surgical correction when the infant is 3 months old.

Is usually seen in girls.

Answer 10

Is common in preterm infants.

Question 11

Infants that appear normal but have a single umbilical artery:

Have Down syndrome.

Should be carefully examined for other abnormalities.

Can be discharged as these are common minor abnormalities that cause no problem.

Should be referred urgently to a genetics clinic for chromosome analysis.

Answer 11

Should be carefully examined for other abnormalities.

Question 12

How should infants with a cleft lip be managed?

These infants should be referred to a plastic surgeon.

The cleft lip can be stitched closed at 6?months by a medical officer at a level 2 hospital.

The cleft lip closes spontaneously and, therefore, does not need treatment.

Nothing can be done and most of these infants die in the first few months.

Answer 12

These infants should be referred to a plastic surgeon.

Question 13

Oesophageal atresia should be suspected if:

Intra-uterine growth restriction is diagnosed

Oligohydramnios was present during the pregnancy

Polyhydramnios was present during the pregnancy

The mother develops hypertension during pregnancy

Answer 13

Polyhydramnios was present during the pregnancy

Question 14

How does oesophageal atresia often present in the newborn infant?

A distended abdomen and a double bubble on X-ray

The infant dribbles saliva and a nasogastric tube cannot be passed into the stomach.

An infant vomits bile.

The infant has a hoarse cry.

Answer 14

The infant dribbles saliva and a nasogastric tube cannot be passed into the stomach.

Question 15

Vomiting green bile after delivery suggests a diagnosis of:

Oesophageal atresia
Duodenal atresia
An absent anus Meningomyelocoele

Answer 15

Duodenal atresia

Question 16

What is the immediate management of a meningomyelocoele?

Cover it with sterile gauze.
Leave it exposed.
Paint it with gentian violet.
Apply surgical spirits.

Answer 16

Cover it with sterile gauze.

Question 17

Down syndrome is due to:

An extra chromosome 13
An extra chromosome 18
An extra chromosome 21
A missing chromosome 22

Answer 17

An extra chromosome 21

Question 18

Which of the following is a sign of Down syndrome?

Small eyes
No anus
Convulsions
Hypotonia (floppy)

Answer 18

Hypotonia (floppy)

Question 19

Infants born with the fetal alcohol syndrome often have:

An upward slant of the eyes
A long, smooth upper lip
Hydrocephalus
Single palmar creases

Answer 19

A long, smooth upper lip

Question 20

When speaking to parents of an infant with congenital disorders, it is best:

To tell them as soon as possible

To wait until all the results of the special investigations are available

Not to allow them to see the infant until they have had a chance to get over the shock

To let them discover for themselves that their infant is abnormal

Answer 20

To tell them as soon as possible