Paediatric Quiz 1

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

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

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.

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

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

Neurologic symptoms in jaundiced infants suggest acute bilirubin toxicity.

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

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

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

Immature immunity makes preterm and LBW babies especially vulnerable.

Sulfonamides displace bilirubin from albumin, increasing free bilirubin levels.

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

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

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

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

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

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

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

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

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.

Managing fluid status and thermoregulation are essential.

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

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

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

Feeding improves stool passage and bilirubin clearance.

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

Gilbert syndrome results from mildly reduced bilirubin conjugation activity.

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

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

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

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

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

Leukopenia may reflect bone marrow suppression or overwhelming infection.

Sepsis can trigger DIC, leading to low platelet counts.

Conjugated bilirubin is eliminated mainly in stool through bile.

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

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

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

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

Opisthotonos is a classic sign of kernicterus in neonates.

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

Intrapartum prophylaxis dramatically reduces neonatal GBS infections.

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

Direct overhead positioning ensures effective skin exposure.

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

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

Jaundice progresses from the face downward as bilirubin levels rise.

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

Biliblankets enable continued contact and breastfeeding during therapy.

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

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

Chest compressions are given for 60 seconds before reassessment.

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

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

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

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

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

Each breath should be delivered over about 1 second.

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

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

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

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

Beta-glucuronidase increases bilirubin reabsorption from intestines.

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

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

3.5 mm ETT is standard for term infants.

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

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

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

A poor seal prevents air entry into lungs.

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

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

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

Secondary apnea occurs after prolonged hypoxia and requires PPV.

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

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

Cooling is typically maintained for 72 hours to maximize neuroprotection.

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

Blood culture is the gold standard for confirming bloodstream infection.

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

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

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

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

Vertical transmission during delivery is the main route.

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

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

CONS is a major pathogen in hospitalized and preterm infants.

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

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

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

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

Bilirubin nomograms guide treatment thresholds by age in hours.

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

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

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

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

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

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

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