Paediatric Quiz 1

Gilbert syndrome results from mildly reduced bilirubin conjugation activity.

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

Opisthotonos is a classic sign of kernicterus in neonates.

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

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

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

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

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

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

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.

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

Blood culture is the gold standard for confirming bloodstream infection.

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

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

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

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

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

Leukopenia may reflect bone marrow suppression or overwhelming infection.

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

Chest compressions are given for 60 seconds before reassessment.

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

Secondary apnea occurs after prolonged hypoxia and requires PPV.

Direct overhead positioning ensures effective skin exposure.

CONS is a major pathogen in hospitalized and preterm infants.

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

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

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

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

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

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

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

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

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

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

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

Managing fluid status and thermoregulation are essential.

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

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

Immature immunity makes preterm and LBW babies especially vulnerable.

Neurologic symptoms in jaundiced infants suggest acute bilirubin toxicity.

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

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

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

Cooling is typically maintained for 72 hours to maximize neuroprotection.

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

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

Intrapartum prophylaxis dramatically reduces neonatal GBS infections.

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

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

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

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

Bilirubin nomograms guide treatment thresholds by age in hours.

Feeding improves stool passage and bilirubin clearance.

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

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

Biliblankets enable continued contact and breastfeeding during therapy.

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

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

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

Sulfonamides displace bilirubin from albumin, increasing free bilirubin levels.

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

A poor seal prevents air entry into lungs.

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

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

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

Conjugated bilirubin is eliminated mainly in stool through bile.

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

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

Vertical transmission during delivery is the main route.

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

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

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

Jaundice progresses from the face downward as bilirubin levels rise.

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

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

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

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

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

Each breath should be delivered over about 1 second.

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

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

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

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

3.5 mm ETT is standard for term infants.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Beta-glucuronidase increases bilirubin reabsorption from intestines.

Sepsis can trigger DIC, leading to low platelet counts.