Paediatric Quiz 1

Blood culture is the gold standard for confirming bloodstream infection.

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

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

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

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

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

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

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

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

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

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

Sulfonamides displace bilirubin from albumin, increasing free bilirubin levels.

Chest compressions are given for 60 seconds before reassessment.

Vertical transmission during delivery is the main route.

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

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

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

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

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

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

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

Gilbert syndrome results from mildly reduced bilirubin conjugation activity.

Beta-glucuronidase increases bilirubin reabsorption from intestines.

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

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

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

Each breath should be delivered over about 1 second.

Opisthotonos is a classic sign of kernicterus in neonates.

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

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

Immature immunity makes preterm and LBW babies especially vulnerable.

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

A poor seal prevents air entry into lungs.

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

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

Sepsis can trigger DIC, leading to low platelet counts.

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

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

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

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

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

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

Cooling is typically maintained for 72 hours to maximize neuroprotection.

Neurologic symptoms in jaundiced infants suggest acute bilirubin toxicity.

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

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

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

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

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

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.

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

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

3.5 mm ETT is standard for term infants.

Jaundice progresses from the face downward as bilirubin levels rise.

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

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

Secondary apnea occurs after prolonged hypoxia and requires PPV.

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

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

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

CONS is a major pathogen in hospitalized and preterm infants.

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

Biliblankets enable continued contact and breastfeeding during therapy.

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

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

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

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

Direct overhead positioning ensures effective skin exposure.

Leukopenia may reflect bone marrow suppression or overwhelming infection.

Bilirubin nomograms guide treatment thresholds by age in hours.

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

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

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

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

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

Feeding improves stool passage and bilirubin clearance.

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

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

Intrapartum prophylaxis dramatically reduces neonatal GBS infections.

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

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

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

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

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

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

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

Managing fluid status and thermoregulation are essential.

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

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

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

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

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

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

Conjugated bilirubin is eliminated mainly in stool through bile.

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

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

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

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

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

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