Paediatric Quiz 1

3.5 mm ETT is standard for term infants.

The priority is to open the airway and provide effective ventilation, especially if the baby is apneic or bradycardic.

Septic neonates often appear lethargic, poorly perfused, and hypotonic.

PDA is a cardiac condition and does not directly affect bilirubin metabolism.

Feeding improves stool passage and bilirubin clearance.

Developmental milestones (especially motor and cognitive) are interpreted using corrected age until about 2 years.

Follow-up is essential to detect late-onset hyperbilirubinemia after early discharge.

Most neonates require 10–14 days of antibiotics for bloodstream infections.

Corticosteroids accelerate surfactant production in fetal lungs and reduce incidence of RDS.

Symmetrical movement of all limbs is a normal finding, suggesting intact motor pathways and healthy tone.

Fever often signals infection like chorioamnionitis, a major risk factor.

TTN typically improves quickly without need for surfactant; RDS is more severe and persistent.

Delay in management may lead to irreversible brain injury such as cerebral palsy or cognitive delay.

CRP is a sensitive inflammatory marker used to support the diagnosis.

Leukopenia may reflect bone marrow suppression or overwhelming infection.

Observation and good feeding are adequate when bilirubin is below treatment level.

Jaundice progresses from the face downward as bilirubin levels rise.

Birth asphyxia results from failure of gas exchange causing low oxygen and high carbon dioxide levels.

Rh incompatibility arises when an Rh-negative mother carries an Rh-positive fetus.

Cooling is typically maintained for 72 hours to maximize neuroprotection.

Prolonged resuscitation beyond 10 minutes is associated with poor neurological outcomes.

Caffeine is a respiratory stimulant used to treat and reduce apnea episodes in preterm neonates.

Healthy weight gain in preterms is approximately 15–20 g/kg/day to mimic intrauterine growth rates.

Human milk reduces NEC, improves immunity, and supports neurodevelopment.

Secondary apnea occurs after prolonged hypoxia and requires PPV.

Resuscitation is ideally done by a team of at least 3–4 trained members.

Direct overhead positioning ensures effective skin exposure.

A blood glucose level of more than 45 mg/dL after 24 hours of life is considered normal for a term neonate.

Term infants typically have smooth, pink skin, possibly with traces of lanugo, and minimal vernix.

Large gastric residuals and bloating are warning signs for NEC or poor tolerance to enteral feeds.

Vertical transmission during delivery is the main route.

Hip assessments (Barlow/Ortolani maneuvers) are done with the baby supine, hips and knees flexed to evaluate for instability.

Shock presents with signs of poor circulation like prolonged CRT and low BP.

An Apgar score of 4–6 at 1 and 5 minutes suggests moderate asphyxia.

Managing fluid status and thermoregulation are essential.

Gasping is ineffective breathing and warrants PPV, regardless of heart rate.

Cranial ultrasound is the preferred non-invasive tool to detect intraventricular hemorrhage in preterm neonates.

Immature immunity makes preterm and LBW babies especially vulnerable.

Group B Streptococcus is the most common cause of early-onset neonatal sepsis, acquired during delivery.

Grunting is a sign of respiratory distress and should prompt evaluation for pulmonary or cardiac pathology.

A cephalohematoma is a subperiosteal bleed that does not cross suture lines and may take weeks to resolve.

Delayed umbilical stump separation beyond 3 weeks may suggest leukocyte adhesion defect or other immunodeficiencies.

Jitteriness is a common and early sign of hypoglycemia in neonates, especially in infants of diabetic mothers or those small for gestational age.

The “Pulse” component of the Apgar score measures heart rate.

LP helps identify CNS infection, especially if neurological signs are present.

Oxygen saturation is carefully titrated to avoid both hypoxia and hyperoxia; 90–95% is ideal in most stable preterms.

Beta-glucuronidase increases bilirubin reabsorption from intestines.

Due to anaerobic metabolism, metabolic acidosis is common in asphyxiated neonates.

Early surfactant therapy reduces RDS severity and improves survival in extremely preterm infants.

Therapeutic hypothermia is most effective when started within the first 6 hours of life.

Neurologic symptoms in jaundiced infants suggest acute bilirubin toxicity.

CONS is a major pathogen in hospitalized and preterm infants.

Each breath should be delivered over about 1 second.

PROM (>18 hours) allows ascending bacteria from the genital tract to infect the neonate.

Initial resuscitation begins with room air (21% O₂); supplemental oxygen is added only if necessary.

A bulging anterior fontanelle when the baby is calm is concerning for increased intracranial pressure, such as from hydrocephalus or meningitis.

Too much oxygen causes oxidative damage, increasing risk of ROP and chronic lung disease.

Sepsis occurring after 72 hours is categorized as late-onset.

Placental insufficiency leads to chronic fetal hypoxia, making it a leading cause of birth asphyxia. Acute events like cord prolapse are less common.

Testicular torsion is a surgical emergency characterized by acute swelling, redness, and pain in the scrotum.

Chest compressions are given for 60 seconds before reassessment.

Most maternal IgG is transferred in the third trimester, which preterm babies miss — making them more vulnerable to infections.

Intrapartum antibiotics reduce group B streptococcus and other bacterial transmission during delivery.

Crepitus and tenderness over the clavicle, along with asymmetric Moro reflex, strongly suggest a clavicle fracture.

A 28-week preterm infant typically has thin skin, absent breast tissue, and minimal cartilage in the ears.

This combo provides broad coverage including GBS and gram-negative organisms.

Serum bilirubin measured in the lab is the most accurate method.

Lethargy and poor feeding are early neurological signs of HIE due to brain hypoxia.

Preterm babies lack insulating fat and have immature skin, making them prone to hypothermia.

Cranial ultrasound or MRI can detect brain injury due to hypoxia, such as periventricular leukomalacia.

Sulfonamides displace bilirubin from albumin, increasing free bilirubin levels.

Post-term neonates often have peeling or cracked skin, meconium staining, and reduced vernix.

Therapeutic hypothermia (33–34°C) slows brain metabolism, reducing damage from hypoxic-ischemic events.

Due to anaerobic metabolism, lactic acid accumulates, resulting in metabolic acidosis.

Bilirubin nomograms guide treatment thresholds by age in hours.

Conjugated bilirubin is eliminated mainly in stool through bile.

Biliblankets enable continued contact and breastfeeding during therapy.

Prolonged or obstructed labor can compromise fetal oxygenation and lead to birth asphyxia.

EEG helps monitor seizure activity and brain function in neonates undergoing therapeutic hypothermia.

HIE can cause long-term neurological damage including cerebral palsy.

Anti-D prevents maternal sensitization against Rh-positive fetal cells.

Warmth is part of the initial steps for all at-risk infants.

Sepsis can trigger DIC, leading to low platelet counts.

Blood culture is the gold standard for confirming bloodstream infection.

Listeria can cause in utero infection via hematogenous spread across placenta.

Opisthotonos is a classic sign of kernicterus in neonates.

Patent ductus arteriosus causes a continuous murmur due to flow from aorta to pulmonary artery.

A murmur associated with clinical signs like poor feeding warrants urgent evaluation with echocardiography to rule out congenital heart disease.

At 10 minutes, target preductal SpO₂ is 85–95%.

Cerebral palsy is the most frequent long-term complication from hypoxic brain injury.

Bradycardia >120 bpm is not a clinical concern; severe asphyxia causes heart rates below 100 or 60 bpm.

Prompt antibiotic therapy is life-saving in suspected sepsis; don’t wait for labs.

A poor suck reflex may indicate neurologic or muscular dysfunction and requires immediate evaluation.

Post-conceptional (or corrected) age is calculated by adding the age at birth to the number of weeks since birth — used to assess developmental milestones in preterms.

A poor seal prevents air entry into lungs.

Gilbert syndrome results from mildly reduced bilirubin conjugation activity.

Intrapartum prophylaxis dramatically reduces neonatal GBS infections.

Preterm babies lose heat easily due to their large surface area, limited fat stores, and immature skin.

Turner syndrome (45,XO) presents with features like webbed neck, lymphedema, and widely spaced nipples.

A failed newborn hearing screen should be followed up with repeat testing and referral to audiology to ensure early intervention for hearing loss.