-
Question 1
Correct
-
A 2 year old girl with a history of oligohydramnios, hypotonia, and scissoring of the legs, presents with delayed walking. She was born by breech delivery. Clinical examination reveals absence of fever and no dysmorphism. Although the limbs look symmetrical and equal, the right leg seems to be shorter. The girl is otherwise healthy. Neurological examination reveals hypotonia with normal reflexes and power. The mother confirms there is no history of myelomeningocele, cerebral palsy, or birth asphyxia. What is the most likely diagnosis?
Your Answer: Congenital dislocation of the hip
Explanation:In this particular case, the symptoms and signs are suggestive for congenital dislocation of the hip. There are several risk factors present including, a breech delivery, female gender (female:male = 6:1) and oligohydramnios. It is also more common in the left hip than the right.
-
This question is part of the following fields:
- Neonatology
-
-
Question 2
Correct
-
A 37 week foetus is found to be in transverse position on ultrasound. The position has not changed despite attempting External Cephalic Version at 36 weeks and the due date is in a week. What is the preferred option of delivery for a foetus in a transverse lie?
Your Answer: Caesarean section
Explanation:A transverse lie is a common malpresentation. It occurs when the fetal longitudinal axis is perpendicular to the long axis of the uterus. The location of the spine determines if the foetus is back up (the curvature of the spine is in the upper part of the uterus) or back down (the curvature of the spine is in the lower part of the uterus).Good antenatal care, ECV, and elective caesarean section are the mainstay of the management.Spontaneous delivery of a term foetus is impossible with a persistent transverse lie and, in general, the onset of labour is an indication for the lower segment caesarean section (LSCS) in a case of a transverse lie.
-
This question is part of the following fields:
- Neonatology
-
-
Question 3
Incorrect
-
Which of the following is true of neonatal circulation?
Your Answer: The ductus venosus stays open in the foetus due to low PaO2 and circulating prostaglandins
Correct Answer: The foramen ovale closes at birth when the pressure in the left atrium is higher than the pressure in the right atrium
Explanation:In the prenatal heart, right-to-left atrial shunting of blood through the foramen ovale is essential for proper circulation. After birth, as the pulmonary circulation is established, the foramen ovale functionally closes as a result of changes in the relative pressure of the two atrial chambers, ensuring the separation of oxygen-depleted venous blood in the right atrium from the oxygenated blood entering the left atrium.
-
This question is part of the following fields:
- Neonatology
-
-
Question 4
Incorrect
-
A child presents with lymphoedema. Clinical examination reveals she has widely spaced nipples and a systolic murmur. Her femoral pulses are absent. Her mother admits she did not have any scans during gestation. What is the most probable diagnosis?
Your Answer: DiGeorge syndrome
Correct Answer: Turner syndrome
Explanation:Turner syndrome is a genetic disease that affects females. It presents with wide-spread nipples, low hairline, lymphoedema, short 4th metacarpals, high-arched palate, cardiac problems, and horseshoe kidneys.
-
This question is part of the following fields:
- Neonatology
-
-
Question 5
Correct
-
A baby is delivered at 26 weeks. Full course of antenatal steroids was administered. There was a delay in clamping the cord. No respiratory effort is observed, and the heart rate is slow. What should be the next step in management of this case?
Your Answer: 5× inflation breaths
Explanation:Most infants have a good heart rate after birth and establish breathing by about 90 s. If the infant is not breathing adequately aerate the lungs by giving 5 inflation breaths, preferably using air. Until now the infant’s lungs will have been filled with fluid.
-
This question is part of the following fields:
- Neonatology
-
-
Question 6
Correct
-
A 17-year-old girl presents to the OBGYN after having unprotected. She is found to be 5 days pregnant. The fertilized tissue is at which stage of development?
Your Answer: Blastocyst
Explanation:Time- EventWeek 1: ImplantationWeek 2: Formation of bilaminar diskWeek 3: Formation of primitive streakFormation of notochordGastrulationWeek 4: Limb buds begin to formNeural tube closesHeart begins to beatWeek 10: Genitals are differentiated
-
This question is part of the following fields:
- Neonatology
-
-
Question 7
Incorrect
-
Which of the following is associated with neonatal vitamin E deficiency?
Your Answer: Peeling skin
Correct Answer: Thrombocytosis
Explanation:Vitamin E deficiency in premature infants has been described as being associated with low haemoglobin levels in the 2nd month of life, haemolytic anaemia associated with thrombocytosis. Recently, low vitamin E concentrations were suspected as being associated with sudden death in infancy.
-
This question is part of the following fields:
- Neonatology
-
-
Question 8
Incorrect
-
What is the most common cardiac abnormality found in Noonan syndrome?
Your Answer: Hypoplastic left heart
Correct Answer: Pulmonary stenosis
Explanation:Noonan syndrome is one of the most common genetic diseases associated with congenital heart defects, being second in frequency only to Down syndrome.Pulmonary stenosis and hypertrophic cardiomyopathy are generally the most common congenital heart defects found in Noonan syndrome.Pulmonary stenosis is often associated with a thickened and dysplastic valve. It is usually difficult to obtain a satisfactory result using the transcatheter balloon dilatation of such dysplastic valves, so surgical intervention is more likely to be needed.Hypertrophic cardiomyopathy involves predominantly the ventricular septum as asymmetric septal hypertrophy, but may also affect the ventricular free walls. Left ventricular outflow tract obstruction may occasionally be produced.
-
This question is part of the following fields:
- Neonatology
-
-
Question 9
Incorrect
-
In which of the following ethnic backgrounds are Mongolian blue spots most likely to be found?
Your Answer: Asian
Correct Answer: White European
Explanation:Mongolian spots are, hyper-pigmented, non-blanching patches present on the back and gluteal region at birth. They are commonly found in African and Asian ethnic groups, and can also present in infants of Mediterranean and middle eastern descent. Though the spots usually disappear by puberty, some may persist into adulthood.
-
This question is part of the following fields:
- Neonatology
-
-
Question 10
Incorrect
-
A nuchal translucency measurement is taken from the nape of the foetus' neck to screen for Down's syndrome.Which of these is the embryological origin of this tissue?
Your Answer: Mesoderm
Correct Answer: Ectoderm
Explanation:The origins of the neural tube and the nape of the neck where nuchal translucency measurements are taken are from embryonic ectoderm.The structural development of the head and neck occurs between the third and eighth weeks of gestation. The 5 pairs of branchial arches, corresponding to the primitive vertebrae gill bars, that form on either side of the pharyngeal foregut on day 22 are the embryologic basis of all the differentiated structures of the head and neck. Each arch consists of 3 layers: an outer covering of ectoderm, an inner covering of endoderm, and a middle core of mesenchyme. These arches are separated further into external, ectoderm-lined pharyngeal clefts and internal, endoderm-lined pharyngeal pouchesA population of ectodermal cells adjacent to the neural fold and not included in the overlying surface (somatic) ectoderm gives rise to the formation of the neural crest. These neuroectodermal crest cells are believed to migrate widely throughout the developing embryo in a relatively cell-free enriched extracellular matrix and differentiate into a wide array of cell and tissue types, influenced by the local environment. Most connective and skeletal tissues of the cranium and face ultimately come from the derivatives of neural crest cells.
-
This question is part of the following fields:
- Neonatology
-
SESSION STATS - PERFORMANCE PER SPECIALTY
