21q: The number of fontanelles present in newborn are
a. 1
b. 2
c. 3
d. 6
22q: At birth the normal heart rate is
a. 60-80/min
b. 80-110/min
c. 70-120/min
d. 110-150/min
23q: For neonate, lower limit of poor perfusion, in terms of systolic BP is
a. Less than 60 mm Hg
b. Less than 70 mm Hg
c. Less than 80 mm Hg
d. Less than 90 mm Hg
24q: In neonate, chest compression:ventilation relationship is
a. 3:1
b. 5:1
c. 2:1
d. 4:1
25q: Characteristics of caput succedaneum include all of the following except
a. Crosses midline
b. Crosses suture line
c. It does not disappear within 2-3 days
d. It is a diffuse oedematous swelling of soft tissues of scalp
26q: Umbilical cord usually falls after
a. 5-10 days
b. 15-20 days
c. 1-5 days
d. None of the above
27q: 99% of neonates void within
a. 24 hours
b. 48 hours
c. 8 hours
d. 12 hours
28q: Transition stools in neonate
a. Stool passed in first 2-3 days
b. Stool passed on 4th-5th day
c. Stool passed after 7 days of birth
d. Stool passed in first 24 hours
29q: Radiologically gas is demonstrated in colon after how many hours of birth
a. Half hour
b. One hour
c. Two hours
d. Three hours
30q: Low birth weight baby is defined as
a. BW less than anticipated from period of gestation
b. Gestation of less than 37 weeks
c. BW less than average of country
d. BW less than 2.5 kg
Saturday, March 6, 2010
45 - Neonatology Mcqs - part 2
11q: What should be measured in a newborn who presents with hyperbilirubinemia?
a. Total and direct bilirubin
b. Total bilirubin
c. Direct bilirubin
d. Conjugated bilirubin only
12q: Following features may be seen in cold injury of neonate except
a. Bradycardia
b. Uncontrolled shivering
c. Sclerema
d. Metabolic acidosis
13q: Commonest cause of neonatal death in India is
a. Prematurity
b. Congenital malformations
c. Metabolic diseases
d. Birth injury
14q: All are criteria for perinatal mortality rate except
a. Late foetal deaths + early neonatal deaths
b. Gestational age of 28 weeks or more
c. Birth weight 1000 grams or more
d. Body length between 25 and 35 cms
15q: Still birth constitutes
a. Early foetal death
b. Late foetal death
c. Early + Intermediate foetal death
d. Intermediate + Late foetal death
16q: Abortus means
a. Early foetal deaths
b. Intermediate foetal deaths
c. Late foetal deaths
d. Early + intermediate deaths
17q: Extended perinatal mortality includes
a. Late foetal death + early neonatal deaths
b. Late foetal death + early neonatal deaths + Intermediate stillbirth
c. Early + Intermediate foetal death
d. Intermediate + late foetal death
18q: Capacity of stomach of newborn is
a. 20 mL
b. 30 mL
c. 50 mL
d. 100 mL
19q: Post-term babies are those with
a. 294 days
b. 294 days or more
c. 259-293 days
d. None of the above
20q: Foetal scalp blood pH is abnormal when
a. pH less than 7.25
b. pH less than 7.3
c. pH less than 7.35
d. pH less than 7.4
a. Total and direct bilirubin
b. Total bilirubin
c. Direct bilirubin
d. Conjugated bilirubin only
12q: Following features may be seen in cold injury of neonate except
a. Bradycardia
b. Uncontrolled shivering
c. Sclerema
d. Metabolic acidosis
13q: Commonest cause of neonatal death in India is
a. Prematurity
b. Congenital malformations
c. Metabolic diseases
d. Birth injury
14q: All are criteria for perinatal mortality rate except
a. Late foetal deaths + early neonatal deaths
b. Gestational age of 28 weeks or more
c. Birth weight 1000 grams or more
d. Body length between 25 and 35 cms
15q: Still birth constitutes
a. Early foetal death
b. Late foetal death
c. Early + Intermediate foetal death
d. Intermediate + Late foetal death
16q: Abortus means
a. Early foetal deaths
b. Intermediate foetal deaths
c. Late foetal deaths
d. Early + intermediate deaths
17q: Extended perinatal mortality includes
a. Late foetal death + early neonatal deaths
b. Late foetal death + early neonatal deaths + Intermediate stillbirth
c. Early + Intermediate foetal death
d. Intermediate + late foetal death
18q: Capacity of stomach of newborn is
a. 20 mL
b. 30 mL
c. 50 mL
d. 100 mL
19q: Post-term babies are those with
a. 294 days
b. 294 days or more
c. 259-293 days
d. None of the above
20q: Foetal scalp blood pH is abnormal when
a. pH less than 7.25
b. pH less than 7.3
c. pH less than 7.35
d. pH less than 7.4
Friday, March 5, 2010
44 - Neonatology Mcqs - part 1
1q: All of the following are features of prematurity in a neonate except
a. No creases on sole
b. Abundant lanugo
c. Thick ear cartilage
d. Empty scrotum
2q: All of the following therapies may be required in one hour old infant with severe birth asphyxia except
a. Glucose
b. Dexamethasone
c. Calcium gluconate
d. Normal saline
3q: Appropriate therapy for neonate wiith vaginal bleeding on 4th day of life
a. Administration of vitamin K
b. Investigate the case for bleeding disorder
c. Use of FFP
d. No specific therapy
4q: In unconjugated hyperbilirubinemia, kernicterus increases with the use of
a. Ceftriaxone
b. Phenobarbitone
c. Ampicillin
d. Sulphonamides
5q: A 25 year old woman had premature rupture of membrane and delivered male child who was lethargic and apneoic on first day of birth and went into shock. The mother had previous history of abortion 1 year back. On vaginal swab culture, growth of beta haemolytic colonies on blood agar was found. On staining these were found to be gram positive cocci. Which of the following is most likely diagnosis?
a. Streptococcus pyogenes
b. Streptococcus agalactiae
c. Peptostreptococci
d. E.faecium
6q: Neonate presents with jaundice and clay white stools. On liver biopsy giant cells are seen. Most likely diagnosis is
a. Physiological jaundice
b. Neonatal hepatitis with extrabiliary atresia
c. Neonatal hepatitis with physiological jaundice
d. Extrabiliary atresia
7q: Most common cause of cholestatic jaundice of newborn is
a. Hypoplasia of biliary tract
b. Neonatal hepatitis
c. Choledochal cyst
d. Physiological jaundice
8q: A newborn has drooling after feeds. He has respiratory distress and froth at mouth. Diagnosis is
a. Tracheo-oesophageal fistula
b. TOF
c. Respiratory distress syndrome
d. None of the above
9q: Full term small for date babies are at high risk for
a. Hypoglycemia
b. IVH
c. Bronchopulmonary dysplasia
d. Hyperthermia
10q: True statement regarding IUGR babies is
a. Hepatomegaly is due to fatty infiltration
b. Head circumference is 3 cm greater than chest circumference
c. HMD is common
d. Hypothermia does not occur due to good shivering mechanism
a. No creases on sole
b. Abundant lanugo
c. Thick ear cartilage
d. Empty scrotum
2q: All of the following therapies may be required in one hour old infant with severe birth asphyxia except
a. Glucose
b. Dexamethasone
c. Calcium gluconate
d. Normal saline
3q: Appropriate therapy for neonate wiith vaginal bleeding on 4th day of life
a. Administration of vitamin K
b. Investigate the case for bleeding disorder
c. Use of FFP
d. No specific therapy
4q: In unconjugated hyperbilirubinemia, kernicterus increases with the use of
a. Ceftriaxone
b. Phenobarbitone
c. Ampicillin
d. Sulphonamides
5q: A 25 year old woman had premature rupture of membrane and delivered male child who was lethargic and apneoic on first day of birth and went into shock. The mother had previous history of abortion 1 year back. On vaginal swab culture, growth of beta haemolytic colonies on blood agar was found. On staining these were found to be gram positive cocci. Which of the following is most likely diagnosis?
a. Streptococcus pyogenes
b. Streptococcus agalactiae
c. Peptostreptococci
d. E.faecium
6q: Neonate presents with jaundice and clay white stools. On liver biopsy giant cells are seen. Most likely diagnosis is
a. Physiological jaundice
b. Neonatal hepatitis with extrabiliary atresia
c. Neonatal hepatitis with physiological jaundice
d. Extrabiliary atresia
7q: Most common cause of cholestatic jaundice of newborn is
a. Hypoplasia of biliary tract
b. Neonatal hepatitis
c. Choledochal cyst
d. Physiological jaundice
8q: A newborn has drooling after feeds. He has respiratory distress and froth at mouth. Diagnosis is
a. Tracheo-oesophageal fistula
b. TOF
c. Respiratory distress syndrome
d. None of the above
9q: Full term small for date babies are at high risk for
a. Hypoglycemia
b. IVH
c. Bronchopulmonary dysplasia
d. Hyperthermia
10q: True statement regarding IUGR babies is
a. Hepatomegaly is due to fatty infiltration
b. Head circumference is 3 cm greater than chest circumference
c. HMD is common
d. Hypothermia does not occur due to good shivering mechanism
43 - Features of Prematurity
*Premature babies are those babies who are born before 37 completed weeks.
*Physical criteria of prematurity :
- Skin texture : Shiny gelatinous, thin, plethoric skin.
- Lanugo : abundant.
- Plantar creases : Single deep crease over anterior 1/3rd of sole or no deep creases. Sole may be full of superficial creases.
- Genitals : Males : Both testes are at external inguinal ring or above. Empty scrotum with scanty rugosities.
- Genitals : Females : Labia majora are widely separated with labia minora fully exposed with hypertrophied clitoris.
- Breast nodules : Lesser than 5 mm and nipple is small or absent.
- Ear cartilage : Cartilage is deficient or absent with poor recoil.
- Hair : Brownish-black, fuzzy or woolly.
*Neurological criteria :
- Posture : Hypotonic, arms and legs extended.
- Arm recoil : No recoil or returns to incomplete flexion.
- Popliteal angle : Usually greater than 90 degrees. (120-180 degrees).
- Scarf sign : Elbow usually crosses the midline of chest. (video below)
- Square window : Degree of flexion at wrist limited.
- Head lag
- Various neonatal reflexes absent or incomplete.
*Video of SCARF sign:
*Physical criteria of prematurity :
- Skin texture : Shiny gelatinous, thin, plethoric skin.
- Lanugo : abundant.
- Plantar creases : Single deep crease over anterior 1/3rd of sole or no deep creases. Sole may be full of superficial creases.
- Genitals : Males : Both testes are at external inguinal ring or above. Empty scrotum with scanty rugosities.
- Genitals : Females : Labia majora are widely separated with labia minora fully exposed with hypertrophied clitoris.
- Breast nodules : Lesser than 5 mm and nipple is small or absent.
- Ear cartilage : Cartilage is deficient or absent with poor recoil.
- Hair : Brownish-black, fuzzy or woolly.
*Neurological criteria :
- Posture : Hypotonic, arms and legs extended.
- Arm recoil : No recoil or returns to incomplete flexion.
- Popliteal angle : Usually greater than 90 degrees. (120-180 degrees).
- Scarf sign : Elbow usually crosses the midline of chest. (video below)
- Square window : Degree of flexion at wrist limited.
- Head lag
- Various neonatal reflexes absent or incomplete.
*Video of SCARF sign:
Tuesday, March 2, 2010
42 - Brachycephaly
Brachycephaly, also known as flat-head syndrome, is a type of cephalic disorder. This occurs when the coronal suture fuses prematurely, causing a shortened front-to-back diameter of the skull. The coronal suture is the fibrous joint that unites the frontal bone with the two parietal bones of the skull. The parietal bones form the top and sides of the skull. This feature can be seen in Down Syndrome.
The incidence of brachycephaly has increased dramatically since the advent of Sudden Infant Death Syndrome recommendations for parents to keep their babies on their backs. Many pediatricians remain unaware of the issue and possible treatments.
Treatments range from a simple repositioning of babies below the age of 5 months or more involved treatment with a helmet for children under the age of 18 months.
Brachycephaly also describes a developmentally normal type of skull with a low cephalic index, such as in snub-nosed breeds of dog.
McQs in Paediatrics (Pocket MCQs)
Paediatric McQs for Postgraduate Examinations: Practice Examinations
McQs in Paediatrics: With a Tactical Guide on How to Approach Clinical Examinations (PMCQ)
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