Prolonged rupture of the membranes, chorioamnionitis and low birthweight predispose
to this. Broad spectrum antibiotics are started early until the results of infection screen are available. a. Diaphragmatic hernia b. Persistent pulmonary hypertension of the newborn c. Pneumonia d. Transient tachypnoea of the newborn d. Meconium aspiration 2. Transmitted to the mother in food such as unpasteurised milk, soft cheeses and undercooked poultry. May lead to preterm delivery, foetal infection or spontaneous abortion. a. Chlamydia trachomatis b. Listeria monocytogenes infection c. Herpes Simplex d. Group B Streptococcal infection e. Escherichia coli 3. Infants who still have an oxygen requirement at 36 weeks are described as having. a. Hyaline membrane disease b. Bronchopulmonary dysplasia c. Respiratory Distress Syndrome d. Hyaline cartilage dysplasia e. Primary ciliary dyskenesis 4. The most common cause of prolonged unconjugated hyperbilirubinaemia a. physiological jaundice b. infection c. congenital hyperthyroidism d. Crigler-Najjar syndrome e. breast milk jaundice 5. The most common human enzyme defect. An X-linked recessive hereditary disease characterised by abnormally low levels of a metabolic enzyme involved in the pentose phosphate pathway, especially important in red blood cell metabolism. a. ABO incompatibility b. Kernicterus c. G6PD deficiency d. Spherocytosis e. Rhesus haemolytic disease 6. Surfactant is excreted by _____ of the aveolar epithelium a. type II pneumocytes b. type II glucocorticoids c. type I phospholipites d. type I pneumocytes e. type I glucocorticoids 7. Where the bowel protrudes through a defect in the anterior abdominal wall, adjacent ot the umbilicus and there is no covering sac. A, Exomphalos b. Rectal atresia c. Omphalocele d. Hirschsprung's disease e. Gastrochisis 8. SEvere HIE has a mortality of ____% and over ____% of survivors have neurodevelopmental disabilities. a. 30-40, 80 b. 2-4, 15 c. 5-10, 30 d. 20-30, 60 e. 10-20, 40 9. A very rare condition where the enzyme glucuronyl transferase is deficient or absent, which may result in high levels of unconjugated levels of bilirubin. a. Cockayne syndrome b. Conradi-Hunermann syndrome c. Coffin-Siris syndrome d. Cornelia de Lange Syndrome e. Crigler-Najjar syndrome 10. Which of the following is NOT advisable in treatment of necroitising enterocolitis? a. Circulatory support b. Artificial ventilation c. Parenteral nutrition d. Commence oral fortified formula immediately e. Broad spectrum antibiotics 11. Usually presents with a purulent discharge, together with swelling of the eyelids at 1-2 weeks of age. The organism can be identified with immunoflourescent staining. a. Chlamydia trachomatis infection b. Escherichia coli c. Herpes Simplex virus infection d. Group B Streptococcal infection e. Listeria monocytogenes infection 12. Characterized by the death of the white matter near the cerebral ventricles due to softening of the brain tissue. a. Parenchymal malacia b. Leukoparenchymal malacia c. Leukoventricular perimalacia d. Parenchymal infarction e. Periventricular leukomalacia 13. Respiratory distress syndrome is also known as a. Hyaline membrane disease b. Bronchopulmonary dysplasia c. Primary ciliary dyskenesis d. Hyaline cartilage dysplasia e. Primary hyaline dysmorphism 14. The initial breakdown product of haemoglobin a. unconjugated bilirubin b. urobilinogen c. conjugated bilirubin d. stercobilinogen e. glucuronyl 15. Babies become clinically jaundiced when bilirubin level reaches ______ umol/L a. 20-60 b. 40-100 c. 80-120 d. 100-160 e. 10-40 16. Infections are considered __________ if they first appear 48 hours or more after hospital admission or within 30 days after discharge. a. nosocomial b. noninvasive c. pervasive d. pertulent e. community acquired 17. Retinopathy of prematurity is found in about ____% of very low birthweight infants a. 60 b. 80 c. 40 d. 20 e. 5 18. Gross oedema of the whole foetal body and hepatosplenomegaly associated with severe anaemia a. Choreoatheroidosis b. Opisthotonos c. Hydrops foetalis d. Kernicterus e. Spherocytosis 19. If nerve roots lower to C5/C6 are injured this may result in weakness of the wrist extensors and intrinsic muscles of the hand. This is known as a. Chignon's palsy b. Klumpke's palsy c. Aponeurotic palsy d. Cephal's palsy e. Erb's palsy 20. An X-Ray showing loops of bowel in the chest and displacement of the mediastinum would be suggestive of a. Pneumonia b. Persistent pulmonary hypertension of the newborn c. Diaphragmatic hernia d. Co-arctation of the aorta e. Transient tachypnoea of the newborn 21. Term infants double their weight in a. 6 weeks b. 52 weeks c. 25 weeks d. 18 weeks e. 10 weeks 22. A life threatening condition associated with birth asphyxia, meconium aspiration, septaecaemia or RDS. Sometimes occurs as a primary disorder. There is right to left shunting within the lungs and at` atrial and ductal levels. a. Milk aspiration b. Persistent pulmonary hypertension of the newborn c. Transient tachypnoea of the newborn d. Diaphragmatic hernia e. Pneumonia 23. Abnormal twisting of the intestine causing obstruction a. inspissation b. volvulus c. exomphalos d. stenosis e. atresia 24. A type of abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac because of a defect in the development of the muscles of the abdominal wall a. volvulus b. stenosis c. inspissation d. atresia e. exomphalos 25. Diffuse, boggy swelling of the scalp which may be accompanied by serious blood loss leading to hypovolaemic shock a. Cephalhaematoma b. Caput succedaneum c. Chignon d. Subaponeurotic haemorrhage e. Erb's palsy 26. Thouht to be an effort to maintain airway patency and prevent airway collapse during expiration a. expiratory synchronization b. expiratory grunting c. expiratory wheeze d. synchronized grunting e. synchronized ventilation 27. Recent evidence suggests that blood glucose levels above _____ mmol/L are desirable for optimal neurodevelopmental outcome a. 2.6 b. 5.6 c. 3.6 d. 1.6 e. 4.6 28. Most ABO antibodies are ____ but some group ___ women have an ___ anti-A- haemolysin in the blood which can cross the placenta and haemolyse the red cells of a group A infant a. IgG, O, IgE b. IgA, A, IgG c. IgE, A, IgG d. IgG, O, IgM e. IgM, O, IgG 29. A diffuse swelling of the scalp in a newborn caused by pressure from the uterus or vaginal wall during a head-first delivery. Caused by mechanical trauma of the scalp pushing through a narrowed cervix. a. Subaponeurotic haemorrhage b. Cephalhaematoma c. Caput succedaneum d. Erb's palsy e. Chignon 30. Preterm infants born at 28 weeks double their birthweight in a. 18 weeks b. 52 weeks c. 6 weeks d. 25 weeks e. 10 weeks 31. The most widely used treatment for neonatal jaundice a. exchange transfusion b. sulphonamides c. phototherapy d. diazepam e. surgery 32. Hyperextension of the neck and back a. Opistometrius b. Opisthotonos c. Opisthonotos d. Opisthimitis e. Opisinization 33. Which of the following is mostly likely to be a cause of jaundice starting between 24h and 3 weeks of age? a. rhesus incompatibility b. ABO incompatibility c. G6PD deficiency d. Breast milk jaundice e. kinase deficiency 34. A collection of gases outside of the normal air passages and inside the connective tissue of the peribronchovascular sheaths, interlobular septa, and visceral pleura secondary to alveolar and terminal bronchiolar rupture. a. Pulmonary Interstital Emphysema b. Bronchopulmonary dysplasia c. Respiratory Distress Syndrome d. Respiratory osteopaenia e. Intraventricular emphysema 35. Oedema and bruising from ventouse delivery a. Caput succedaneum b. Erb's palsy c. Cephalhaematoma d. Subaponeurotic haemorrhage e. Chignon 36. May occur in cases of foetal hypoxia. May result in mechanical obstruction and chemical pneumonitis as well as predisposing to infection. The lungs may be over-inflated, accompanied by patches of collapse and consolidation. a. Diaphragmatic hernia b. Transient tachypnoea of the newborn c. Persistent pulmonary hypertension d. Meconium aspiration e. Pneumonia 37. Which of the following is least likely to cause small bowel obstruction? a. atresia or stenosis of the duodenum b. malrotation with volvulus c. atresia or stenosis of the jejunum or ileum d. meconium ileus e. Hirschsprungs disease 38. A monoclonal antibody to RSV a. paliperidone b. pamidronate c. palonosetron d. palivizumab e. palifermin 39. Particularily likely to occur in the first 24 hrs of life in babies who have IUGR, preterm, born to mothers with diabetes mellitus, are large for dates, hypothermic or polycythaemic. Symptoms are jitteriness, irritability, apnoea, lethargy, drowsiness and seizures. a. Cerebral infarction b. Pierre Robin sequence c. Cleft lip and palate d. Hypoglycaemia e. Oesophageal atresia 40. In rhesus haemolytic disease, kernicterus may be prevented if the bilirubin was kept below a. 340 mmol/L b. 3.4 mmol/L c. 3400 mmol/L d. 0.34 mmol/L e. 34 mmol/L 41. Poor peripheral pulses in the femoral arteries may be found in severe cases. Asynchronous radial pulses may be detected in the right and left arms. There may be a right radial-femoral delay but not a left radial-femoral delay. a. Co-arctation of the aorta b. Pneumonia c. Transient tachypnoea of the newborn d. Diaphragmatic hernia e. Persistent pulmonary hypertension of the newborn 42. Usually presents in the newborn with failure to responsd to resuscitation or as respiratory distress. The diagnosis is confirmed by chest and abdo X-ray. a. Transient tachypnoea of the newborn b. Pneumonia c. Diaphragmatic hernia d. Persistent pulmonary hypertension of the newborn e. Milk aspiration 43. Insoluble in water but soluble in lipids a. unconjugated bilirubin b. vitamin B c. vitamin C d. stercobilinogen e. conjugated bilirubin 44. Haemorraghes in the brain occur in ____% of very low birthweight infants a. 75 b. 5 c. 50 d. 10 e. 25 45. A double bubble on abdominal X-Ray is suggestive of this a. Gastroschisis b. Hirschsprungs disease c. Pierre Robin sequence d. Small bowel obstruction e. Rectal atresia 46. Results from C5/C6 nerve root injury, sometimes occuring from breech deliveries or shoulder dystocia a. Cephalhaematoma b. Caput succedaneum c. Erb's palsy d. Chignon e. Subaponeurotic haemorrhage 47. Absence of a natural opening a. volvulus b. inspissation c. atresia d. exomphalos e. stenosis 48. An association of micrognathia, posterior displacement of the tongue (glossoptosis) and midlines cleft of the soft plate a, Cerebral infarction b. Pierre Robin sequence c. Cleft lip and palate d. Hypoglycaemia e. Oesophageal atresia 49. Encephalopathy resulting from the deposition of unconjugated bilirubin in the basal ganglia and brainstem nuclei a. Kawasaki disease b. Kernicterus c. Kaposi's sarcoma d. Kussmaul's sign e. Kleinfelter syndrome 50. Which of the following is mostly likely to be a cause of jaundice starting after 3 weeks of age? a. Crigler-Najjar syndrome b. Rhesus incompatibility c. Hypothryoidism d. Congenital infection e. ABO incompatibility 51. Administered intravenously or by injection a. parenteral b. nonenteral c. enteral d. postenteral e. pre-enteral 52. A serious illness mainly affecting preterm infants in the first few weeks of life. Preterm infants fed cow's milk formula are 6 times more likely to develop this condition. a. Dysplastic entercolitis b. Necrotising enterocolitis c. Periventricular leukomalacia d. Pyloric stenosis e. Entercolising dysplasia 53. Used to close a patent ductus arteriosus A. Indomethacin B. Ibuoprofen C. Warfarin D. A or B E. A or C 54. A common cause of early onset sepsis in the UK. Early onset diease typically presents on day 1 with pneumonia, septaecaemia and occasionally meningitis. Mortality is up to 10% a. Group B Streptococcal infection b. Herpes Simplex c. Chlamydia trachomatis infection d. Listeria monocytogenes infection e. Escherichia coli 55. Bleeding below the periosteum, confined within the margins of the skull sutures. Usually involves the parietal bone. Occasionally accompanied by a linear skull fracture. a. Subaponeurotic haemorrhage b. Chignon c. Erb's palsy d. Caput succedaneum e. Cephalhaematoma 56. Out of the following, which is least likely to be required by an infant with HIE? a. fluid restriction b. respiratory support c. treatment for electrolyte imbalance d. treatment of hypertension e. anticonvulsant therapy 57. Occurs in 1 in 3500 live births and is associated with polyhydramnios during pregnancy. Almost half of the babies have other congenital malformations. a. Pierre Robin sequence b. Oesophageal atresia c. Hypoglycaemia d. Cerebral infarction e. Cleft lip and palate 58. Which of the following is mostly likely to be a cause of jaundice starting between 24h and 3 weeks of age? a. kinase deficiency b. ABO incompatibility c. Breast milk jaundice d. rhesus incompatibility e. G6PD deficiency 59. Sometimes associated with maternal anticonvulsant therapy. Infants with this condition are prone to acute otitis media. a. Hypoglycaemia b. Cleft lip and palate c. Noonans syndrome d. Cerebral infarction e. Oesophageal atresia 60. thickened or dried a. exomphalos b. inspissated c. atresia d. volvulus e. stenosis 61. A condition that affects the large intestine causing problems with passing faeces. It is congenital and results from missing nerve cells in the muscles of a portion of the baby's rectum or colon. a. Gastrochisis b. Hirschsprung's disease c. Exomphalos d. Rectal atresia e. Omphalocele Key 1. C 2. B 3. B 4. E 5. C 6. A 7. E 8. A 9. E 10. D 11. A 12. E 13. A 14. A 15. C 16. A 17. D 18. C 19. B 20. C 21. D 22. B 23. B 24. E 25. D 26. B 27. A 28. E 29. C 30. C 31. C 32. B 33. D 34. A 35. E 36. D 37. E 38. D 39. D 40. A 41. A 42. C 43. A 44. E 45. D 46. C 47. C 48. B 49. B 50. C 51. A 52. B 53. D 54. A 55. E 56. D 57. B 58. C 59. B 60. B 61. B