Neonatology Questions and Answers

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Questions and Answers on Neonatology

1. Which of the following is not a feature of Hemodynamic Significant Patent Ductus Arteriosus (HSPDA)?
(1) Bowing of intertribal septum to right with enlarged left atrium and left ventricle
(2) Transductal diameter >3 mm
(3) Left atrial/ aortic root width ratio > 1.6:1
(4) Retrograde diastolic flow >50% of forward flow.

2. Most common non renal cause of systemic hypertension in premature newborn is?
(1) Umbilical artery catheterisation
(2) Broncho pulmonary dysplasia
(3) Drugs
(4) Patent ductus arteriosus

3. Which of the following is not an ultrasound finding for biliary atresia?
(1) Triangular cord sign
(2) Gallbladder ghost triad
(3) Larger hepatic vein caliber
(4) Hepatic artery to portal vein diameter ratio >0.45

4. Which one is not a clinically proven strategy for primary prevention of NEC.
(1) Antenatal Glucocorticoids
(2) Standardised feeding regimen
(3) Probiotics
(4) Erythropoietin

5. Match the following, regarding Biomedical waste management.
a. Yellow 1. Non Infected Waste
b. Black 2. Syringes & Gloves
c. Blue 3. Body Parts
d. White 4. Needles & sharps
(1) a: 1, b:2, c:3, d: 4
(2) a:4, b:1, c:3, d:2
(3) a:3, b:1, c:2, d:4
(4) a:2, b:1, c:4, d:3

6. Which of the following is not a candidate for surrogacy in India as per surrogacy bill 2019.
(1) Indian married couple
(2) Indian origin married couple
(3) Indian single woman (Only widow or divorcee)
(4) Indian single man (only Widower or divorcee)

7. A baby is having Hypocalcemia, Hyperphosphatemia, low vitamin D and High PTH. What is the most probable diagnosis?
(1) Renal rickets
(2) Pseudohypoparathyroidism
(3) High phosphate feeding
(4) Hyperparathyroidism

8. Match the following :
a. Urea cycle 1. Seizure, normal defect pH, normal Ammonia
b. Organic acidemia 2. Alkalosis, Hyperammonimia, encephalopathy
c. Non Ketotic Hyperglycenimia 3. Lactic acidosis, Hypoglycemia
d. Mitoch ondriopathy 4. Metabolic acidosis, hypotonia
(1) a: 1, b:2, c:3, d:4
(2) a:4, b:1, c:3, d:2
(3) a:3, b:1, c:2, d:4
(4) a:2, b:4, c:1, d:3

9. Match the following :
a. Necrotising enterocolitis 1. Thompson scoring
b. Periventricular Leucomalacia 2. Papile staging
c. Intra ventricular haemorrhage 3. Modified Bells staging
d. Perinatal asphyxia 4. DeVries classification
(1) a: 1, b:2, c:3, d:4
(2) a:3, b:4, c:2, d: 1
(3) a:3, b:1, c:2, d:4
(4) a:2, b:4, c:1, d:3

10. A newborn baby develop shock on day 3 of life. Investigations showed hyponatremia, hyperkalemia and hypoglycaemia. Most probable diagnosis is?
(1) Renal Failure
(2) Panhypopitutarism
(3) Coaraction of aorta
(4) Congenital adrenal hyperplasia

11. Match the disease and brain area involvement.
a. Perinatal asphyxia 1. Globus pallidus and Substantia nigra
b. Kerincterus 2. Caudate and putamen
c. Hypoglycemia 3. Periventricular leucomalacia
d. Hypocarbia 4. Occipital lobe
(1) a:2, b:1, c:4, d:3
(2) a:3, b:4, c:2, d:1
(3) a:3, b:1, c:2, d:4
(4) a:2, b:4, c: 1, d:3

12. All of the following have similar tone abnormality, except?
(1) Myopathy
(2) Periventricular Leucomalacia
(3) Pradder willi syndrome
(4) Hypothyrodism

13. Match the following :
a. HIDA scan 1. Islet cell hyperplasia/Insulinoma
b. EC scan 2. Extra hepatic Biliary atresia
c. Fluoride DOPA scan 3. Posterior segment of eyeball
d. B scan 4. Renal function
(1) a:2, b:1, c:4, d:3
(2) a:3, b:4, c:2, d:1
(3) a:2, b:4, c:1, d:3
(4) a:1, b:4, c:2, d:3

14. Pick up the true statement.
(1) Blood pressure = Stroke volume * Heart rate
(2) Left to right shunt is normal in ductus in fetus
(3) Contractility of heart is independent of preload and after load
(4) Fetes heart doesn’t start pumping blood until 18-20 weeks

15. Which of the following action is not appropriate when caring for parents immediately after death of their baby?
(1) Autopsy discussion
(2) Allowing mother to spend time with her dead baby .
(3) Discuss about planning for future pregnancy
(4) Providing room for bereavement

16. Oligohydroamnios, pulmoary hypoplasia and bilateral echogenic kidney is suggestive of?
(1) Autosomal recessive polycystic kidney disease
(2) Autosomal dominant polycystic kidney disease
(3) Medullary cystic kidney
(4) Multicystic dysplastic kidney :

17. Interpret following ABG. : (7.23, PaO2 76, PaCo2 38, HCO3 14, Base deficit -8)
(1) Metabolic acidosis
(2) Metabolic and respiratory acidosis
(3) Respiratory acidosis
(4) Respiratory acidosis and hyperoxia

18. A baby on total parenteral nutrition is receiving 70 Kcal/kg, 4 gm/kg of protein, 6 mg/ kg/min of glucose infusion rate and 3 gm/kg of fat. What kind of biochemical abnormality is expected?
(1) Metabolic acidosis and uraemia
(2) Hypoglycaemia
(3) Respiratory alkalosis
(4) Hyperlipidemia

19. All of the following are benefits of delivery room CPAP except?
(1) Decreasing need for ventilation
(2) Decreased surfactant use
(3) Decreased incidence of BPD
(4) Decreased number of Airleak

20. Which of the following is not a prognostic factor for congenital diaphragmatic hernia outcome?
(1) Lung head ratio
(2) Liver position
(3) Total lung volume
(4) Sex of baby

21. What is not true regarding KCN gene mutation hyperinsulinemic hypoglycaemia?
(1) Usually Diazoxide resistant
(2) Lead to diffuse islet cell hyperplasia
(3) Treatment include subtotal pancreatectomy
(4) Majority of them are transient and resolve over 3 months of age

22. Which is nota side effect of Diazoxide?
(1) Hyperuricemia
(2) Hypertrichosis
(3) Fluid retention
(4) Hypocalcemia

23. Which antibiotic can be used for metallo beta lactamase producing gram negative bacilli sepsis?
(1) Piperecillin
(2) Meropenem
(3) Imipenem
(4) Colistin

24. All are essential component of kangaroo mother care, EXCEPT
(1) Developmental supportive care
(2) Skin to skin contact
(3) Early discharge
(4) Exclusive breast milk feeding

25. Which of the following condition can be diagnosed early by Stool colour card?
(1) Persistent neonatal jaundice
(2) Cow milk protein allergy
(3) Extra hepatic biliary atresia
(4) Cystic fibrosis

26. Which of the following statement is not true regarding use of Heated High Flow Nasal Cannula (HHFNC)?
(1) It is equally effective to CPAP in post extubation scenario
(2) HFNC its superior to CPAP as a primary modality in Respiratory distress syndrome
(3) HHFNC causes less trauma to newborn
(4) There is better nursing acceptance with HHFNC

27. Prerequisite for surgery in congenital diaphragmatic hernia are all except?
(1) Serum Lactate <2.5 mmol/l
(2) FiO2 <40%
(3) Urine output 2 ml/kg/hour
(4) Pre ductal saturation >95%

28. For routine in between patient contact, which is best hand hygiene strategy?
(1) Hand wash by liquid soap
(2) Alcohol based hand rub
(3) Hand rub followed by gloves
(4) Hand wash by chlorhexidine based scrub

29. What is not to be used in severe PPHN ”
(1) Dopamine
(2) Sildenefil
(3) Inhaled nitric oxide
(4) PGE

30. What is true regarding CSF protein in ventricular fluid versus lumbar puncture?
(1) Ventricular CSF protein is higher than Lumbar CSF
(2) Ventricular CSF protein is lower than lumbar CSF
(3) CSF protein is equal in both Ventricular and lumbar fluid
(4) There is no relation in both fluids

31. Which is not a benefit of delayed cord clamping in preterm babies?
(1) Decreased need for blood transfusion.
(2) Decreased incidence of necrotising enterocolitis
(3) Decreased incidence of intraventricular haemorrhage
(4) Decreased mortality

32. Neonatal cholestasis, significantly elevated alpha fetoprotein and coagulopathy suggest:
(1) Neonatal Hemochromatosis
(2) Neonatal Tyrosinemia
(3) Cystic fibrosis
(4) Galactosemia

33. Best way for umbilical cord care to promote easy falling is?
(1) Keeping umbilical cord dry
(2) Applying antibiotic powder
(3) Cleaning umbilical cord with spirit
(4) Applying betadine on umbilical cord

34. Which is not a direct benefit of antenatal corticosteroid?
(1) Decreased incidence of Respiratory distress syndrome
(2) Decreased incidence of Bronchopulmonary dysplasia
(3) Decreased Mortality
(4) Decreased Intraventricular haemorrhage

35. Column movement in intercostal drainage tube (ICDT) indicates?
(1) ICDT is in pleural space
(2) Air leak its still present and not sealed
(3) ICDT is in lung parenchyma
(4) ICDT is in mediastinum

36. What is the formula for dissociation coefficient for Co2 in high frequency ventilation?
(1) DCO2 = VThf 2 * Fhf
(2) DCO2 = VThf3 * Fhf
(3) DCO2 = MAP * Fhf
(4) DCO2 = VThf * Fhf2

37. What is the traumatic parameter to induce Ventilator Induced Lung Injury (VILI)?
(1) Volumrauma
(2) Barotrauma
(3) Differences in regional mechanics of lung
(4) All of the above

38. What is the treatment of seizure, occurring during hypernatremia correction?
(1) Phenobarbitone
(2) Hypertonic saline
(3) Hypotonic saline
(4) Dextrose infusion

39. Which test is recommended to pick deletion and duplications of chromosomal material?
(1) Karyotyping
(2) Clinical Exam sequencing
(3) Microarray
(4) Methylation analysis

40. What kind of data is Gender?
(1) Nominal
(2) Ordinal
(3) Interval
(4) Discrete

41. Which of the following suggest highest correlation between variables?
(1) r=+0.25
(2) r=+0.5
(3) r= -0.75
(4) r=+2

42. Best measure for central tendency in a highly skewed distribution is?
(1) Mean
(2) Median
(3) Mode
(4) Range

43. What is false about Increased nuchal translucency with normal karyotype?
(1) Associated with cardiac anomalies
(2) Associated with renal anomalies
(3) Have higher chance of miscarriages
(4) Always an abnormal finding

44. A newborn born limp was started on bag and mask ventilation after initial steps. After 5 breaths, you notice that the baby has no chest rise. Which of the following steps is not important in managing the baby’s condition?
(1) Ensure adequate seal
(2) Clear the airway if secretions are present
(3) Increase the oxygen concentration by adding a reservoir
(4) Position the baby’s neck so that it is not overflexed or hyperextended

45. If a new-born does not begin breathing in response to stimulation, you should assume he is in ___________ apnea.
(1) Primary
(2) Secondary
(3) Terminal
(4) None of above