Neonatology Practice Set

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Practice Set of Neonatology

1. Which is not a cause for Methemoglobinemia?
(1) Inhaled Nitric oxide
(2) Dapsone
(3) EMLA
(4) Ciprofloxcillin

2. What is not true regarding preterm immunization?
(1) The antibody response is equal to term infant.
(2) Vaccine are safe and well tolerated by them.
(3) The schedule is same as for term infants.
(4) An additional dose of hepatitis B vaccine should be given.

3. Match the following medicines and the teratogenic effect.
a. Valproate 1. Skeletal dysplasia
b. Carbamezapine 2. Tooth enamel Hypoplasia
c. Coumarin derivatives 3. Neural tube defect
d. Tetracyclins 4. Cranio facial defect
(1) a:2, b:1, c:4, d:3
(2) a:3, b:4, c:1, d:2
(3) a:4, b:1, c:3, d:2
(4) a: 1, b:4, c:2, d:3

4. Match the following structure and their embryonic counterparts.
a. Urachus 1. Connection between midgut to yolk sac
b. Vitello intestinal duct 2. Umbilical vein
c. Falciparum Ligament 3. Cloaca & Alantois
d. Round ligament liver 4. Ventricle of mesentery
(1) a:2, b:1, c:4, d:3
(2) a:3, b:1, c:4, d:2
(3) a:4, b:1, c:3, d:2
(4) a:1, b:4, c:2, d:3

5. Which is a false statement
(1) Stillbirth is a baby born with no sign of life at or after 28 weeks of gestation.
(2) The current perinatal mortality rate in India is 45 per 1000.
(3) 60% of perinatal death are stillbirths.
(4) The WHO target under Every Newborn Action Plan is to decrease stillbirth rate to 12/1000 birth by 2030.

6. Which intestinal atresia is most common?
(1) Duodenal atresia
(2) Ileal atresia
(3) Jejunal atresia
(4) Colonic atresia

7. What is not true regarding Transient Myeloproliferative Disorder?
(1) Exclusively affect newborn with Down’s syndrome
(2) Also known as Transient abnormal myelopoiesis
(3) Most definitive test is GATAI mutation
(4) Spontaneous resolution is a rule over 3-6 months

8. What conditions may make us suspect an interruption in normal transition to extrauterine breathing?
(1) Tachycardia and high systolic blood pressure
(2) Tachypnea and bradycardia
(3) Tachypnea with acrocyanosis
(4) Tachycardia and Apgar of 9

9. When resuscitating a newborn with chest compression, how much oxygen concentration should be used?
(1) 21%
(2) 30%
(3) 40%
(4) 100%

10. Which is not a valid reason to withhold resuscitation in newborn?
(1) Weight <500 grams
(2) Gestation <23 weeks
(3) Trisomy 13 or 18
(4) Anencephaly

11. Resuscitation can be discontinued if there is no heart rate and breathing for?
(1) 10min
(2) 15 min
(3) 20min
(4) 30min

12. What is false statement regarding Maternal lupus and neonatal heart blocks?
(1) Peak age of onset of bradycardia is 18-22 weeks.
(2) Maternal Dexamethasone Is a standard therapy.
(3) Babies can develop cardiomyopathy in long term.
(4) All pregnant ladies are symptomatic at the time of diagnosis.

13. Which variety of choledochal cyst is commonest?
(1) Type 1 (Extraheaptic dilatation)
(2) Type 2 (Diverticulam)
(3) Type 3 (Intrahepatic Dilataion)
(4) Type 4 (Both Intra & Extra hepatic dilatation)

14. A preterm otherwise well baby had sudden abdominal distension and bluish discolouration of abdomen wall on day 7 of life. X-ray show pneumoperitoneum. Laprotomy reveal ileal perforation and rest of gut as healthy. What is most probable diagnosis?
(1) Necrotising enterocolitis stage 3
(2) Spontaneous intestinal perforation
(3) Intestinal sepsis and septic perforation
(4) Ischemic perforation of gut

15. What is not true regarding Total Parenteral Nutrition (TPN)?
(1) SMOF oil is a better choice than only soya based fat preparations.
(2) 20% lipid formulation are better tolerated than 10% lipid formulation.
(3) Amino acids are the primary cause of TPN related hepatotoxicity.
(4) Aluminium toxicity via TPN can worsen neurodevelopment outcome.

16. What is the formula for Cerebroplacental ratio?
(1) Middle cerebral artery pulsatility index divided by uterine artery pulsatility index
(2) Uterine artery pulsatility index divided by Middle cerebral artery pulstality index
(3) Middle cerebral artery resistance index divided by uterine artery resistance index
(4) Uterine artery resistance index divided by Middle cerebral artery resistance index

17. Lactation has strongest preventive effect on which type of maternal cancer?
(1) Breast cancer
(2) Ovarian cancer
(3) Endometrial cancer
(4) Cervical cancer

18. All are proven benefits of oral colostrum application, except?
(1) Reaching full enteral feed volume early
(2) Earlier initiation of enteral feeding
(3) Reduced length of stay
(4) Reduced incidence of NEC

19. Which one of following is not a NEC score?
(1) NeoNEEDS
(2) GutCheck
(3) eNEC
(4) NIRS

20. Which is not an EGG finding of hyperkalemia?
(1) Tall P wave
(2) Tall T wave
(3) Wide QRS complex
(4) Increased PR interval

21. What is not true regarding adverse effects of Bicarbonate therapy in Metabolic acidosis?
(1) Increase in TVH
(2) Deteriorate cardiac function
(3) Increase myocardial injury
(4) Improve intracellular acidosis

22. What is the false statement regarding FENa?
(1) The correct formula for FENa is (urinary sodium multiplied by serum creatinine) divided by (urinary creatinine multiplied by serum sodium)
(2) FENa cutoff decreases with decreasing gestational age
(3) FENa is a direct measure of renal tubule handling of filtered sodium
(4) FENa should not be used in <28 weeks to define AKI

23. Which is not an absolute indication for renal replacement therapy?
(1) High Creatinine
(2) Severe resistant Metabolic acidosis (bicarb <12 mEq/L)
(3) Severe resistant hyperkalemia
(4) Volume overload with pulmonary oedema

24. The yield of blood culture can be increased by all, EXCEPT?
(1) Taking culture sample before starting antibiotic
(2) Increasing volume of blood for culture
(3) Using automated culture system
(4) Taking samples form central lines.

25. A newborn with Neonatal sepsis, has developed paucity of right lower limb movement during the course of treatment. His CRP has increased. What is the most probable possibility?
(1) Right Knee septic arthritis
(2) Right Hip arthritis
(3) Left cerebral abscess
(4) Complicated meningitis

26. Antenatal scan show left kidney pelvicalcyeal system AP diameter of 12 mm, normal ureter, normal amniotic fluid volume and normal bladder. Right kidney is normal. Which of the following statement is false?
(1) Postnatal ultrasound should be done after 48 hours of age.
(2) Most likely cause is Pelvi-ureteric junction obstruction.
(3) Most likely cause is Vesico ureteric reflex.
(4) No antenatal intervention is required.

27. Earliest changes of perinatal asphyxia will be picked up by?
(1) T1 weighted images of MRI
(2) T2 weighted images of MRI
(3) Diffusion weighted images of MRI
(4) T1 Inversion images of MRI

28. Upper Gastro intestinal losses should be replaced by?
(1) N/2 Saline with KCUI
(2) Normal saline with KCl
(3) Ringer lactate with KCl
(4) Isolate P 5%

29. Which of the following is not a seizure mimic?
(1) Myoclonic spasm
(2) Hyperkpalexia
(3) Motor automatism
(4) Tonic posturing

30. The duration of antibiotic for neonatal meningitis is?
(1) 7 days
(2) 14 days
(3) 21 Days
(4) 28 Days

31. What is the predictor of poor prognosis in MRS, in perinatal asphyxia?
(1) Elevated lactate
(2) Elevated ratio of Lactate to pyruvate
(3) Elevated ratio of Lactate to n-acetyl aspartate
(4) Elevated n acetyl aspartate

32. Abnormal sign in posterior limb of internal capsule is a poor prognostic marker for?
(1) Perinatal asphyxia
(2) Kernicterus
(3) Hypoglycemia
(4) Maple syrup Urine Diseases

33. A 28 week baby recovering from RDS, develop increased ventilatory requirement on day 3 of life. Sepsis screen is negative, ABG is showing metabolic acidosis, and murmur is present on auscultation. What is further course of action?
(1) Second dose of surfactant
(2) Upgrading antibiotic
(3) Getting ECHO and starting Paracetamol
(4) Giving a fluid bolus

34. Which of the following is not a high risk antenatal factor for Developmental Dysplasia of Hip (DDH)?
(1) Female sex
(2) Breech presentation
(3) Primigravida
(4) Polyhydroamnios

35. Which of the following is the most sensitive marker for Osteopenia Of Prematurity?
(1) Hypocalcemia and raised Alkaline phosphate
(2) Hypophosphatemia and raised Alkaline phosphate
(3) Raised Alkaline phosphate
(4) Hyperphosphatemia

36. Which of the following statement is false regarding Pulse oximeter screening?
(1) Waiting for screening until 24 hours of life will decrease false positive result
(2) Passed screening is Right hand or foot saturation 95% or greater and difference is < 3%
(3) Pulse oximeter Screening can detect majority of correction of aorta.
(4) Screen should not be repeated if right hand saturation is less than 90%.

37. Which one is a postnatal growth chart?
(1) Lubchenco
(2) Colorado
(3) Fenton
(4) Ehrancranz

38. Which one is not treatment for fetal Supraventricular tachycardia?
(1) Digoxin
(2) Flecanide
(3) Sotalol
(4) Amiodarone

39. Which is not a Quality Improvement study tool?
(1) PDSA Cycle
(2) Root cause analysis
(3) Blinding
(4) Six Sigma

40. Match the following.
a. Randomised Controlled Trial 1. PRISMA
b. Meta-analysis 2. CHOP screening checklist
c. Observational study 3. STROBE
d. Quality Improvement Projects 4. CONSORT

(1) a:1, b:2, c:3, d:4
(2) a:4, b:1, c:3, d:2
(3) a:3, b:4, c:1, d:2
(4) a:2, b:1, c:4, d:3

41. Match the following :
a. Chi Square Test 1. Compare multiple sample with single test
b. ANOVA 2. Compare categorical variable
c. T test 3. Test of normal distribution
d. Z test 4. Compare mean of two given sample

(1) a:1, b:2, c:3, d:4
(2) a:4, b:1, c:3, d:2
(3) a:3, b:4, c:1, d:2
(4) a:2, b:1, c:4, d:3

42. MTP amendment bill 2020 seeks following changes, except.
(1) Increasing upper limit for termination of a pregnancy from 20 weeks to 24 weeks.
(2) Opinion of one registered medical practitioner is required till 20 weeks of gestation.
(3) Opinion of two medical practitioner is required for termination of 20-24 weeks.
(4) For survivors of rape and incest, upper limit is 20 weeks for termination.

43. In intrauterine transfusion, blood is transfused in?
(1) Fetal peritoneal cavity
(2) Umbilicial artery
(3) Umbilical Vein
(4) Placenta

44. Which agent is used for fetal reduction?
(1) KCl
(2) CaCl2
(3) Hypertonic saline
(4) Bleomycin

45. Which one of following is not an evidence based strategy to decrease ventilatory associated pneumonia in newborn?
(1) Head of bed elevation by 30-45 degree
(2) Hand hygiene
(3) Using closed suction system for endotracheal tube suction
(4) Changing ventilator circuit if visible soiled