100 MCQs in NeonatologyByAyman Abu Mehrem, MDAssistant ConsultantDepartment of PediatricsKing Abdulaziz Hospital, Al-Ahsa

Question 1

An infant has the following findings at 5 minutes of life: pulse 130 bpm, cyanotic hands and feet, good muscle tone, and a strong cry and grimace. This infant Apgar score is:678910

Question 2

Jaundice is most likely to be physiologic in a term infant in which of the following situations:Jaundice at 12 hours of ageSerum bilirubin level increasing less than 5 mg/dL/24 hours in the first 2-4 daysDirect serum bilirubin greater than 2 mg/dLJaundice at 13 days of ageSerum bilirubin level 15 mg/dL at 7 days of age

Question 3

Which of the following is most appropriate for treating hyperbilirubinemia (11.2 mg/dL) in a 3-week-old, breast-fed infant with normal growth and development?PhototherapyExchange transfusionPhenobarbitalReplace breast milk by formula for 48 hoursNone of the above

Question 4

Newborns are obligate nasal breathers for the first few months after birth. Of the following, the most common cause of neonatal nasal obstruction is: Choanal atresiaCraniofacial malformationsIntranasal encephaloceleLacrymal cystMucosal inflammation

Question 5

A term newborn appears dusky at rest, but becomes pink with crying. Attempts to pass a catheter through each nostril have failed. Physical examination of the infant reveals other congenital anomalies. Of the following, the most likely clinical syndrome in this infant is:Apert syndromeCHARGE associationCrouzon syndromePfeiffer syndromeTreacher-Collins syndrome

Question 6

The following are accepted definitions ExceptThe neonatal period is the first 28 days of life of a newborn of any gestational age

Small for gestation infants have a birth weight less than 10th centile

Infancy refers to the 1st year of life

The fetal period is from the 12th week of gestation to delivery

The perinatal mortality rate is the number of stillbirths and neonatal deaths per 1000 total births

Question 7

The maternal serum screening test or quadruple test is done between 14 and 22 weeks gestation. It includes all of the following ExceptAlpha-fetoprotein-hCGUnconjugated pregninoloneInhibinAUnconjugated esteriol

Question 8

Neonatal hypercalcemia is associated with all of the following ExceptWilliams syndromeSubcutaneous fat necrosisBlue diaper syndromeFamilial hypercalciuric hypercalcemiaPrimary hyperparathyroidism

Question 9

The single greatest risk factor for necrotizing enterocolitis isPrematurityPatent ductus arteriosusIndomethacin therapyPolycythemiaHypoxic-ischemic insult

Question 10

You are called to the delivery of a boy at 42 weeks GA with thick meconium-stained fluid and type II decelerations. The obstetrician rapidly delivers the baby and hands him to you. The boy hypotonic, cyanotic, apneic, and bradycardic. The most appropriate action is toStimulate the infant to breathAdminister epinephrineProvide positive-pressure bag-and-mask ventilationIntubate and provide positive-pressure ventilationIntubate and apply negative-pressure suction

Question 11

You are called to see one-hour-old term baby in normal newborn nursery with ambiguous genitalia. Your plan includes all the following ExceptInform the parents that their babys genitalia are incompletely developed, and you need to do some investigation to identify their babys genderAdvise the parents to use unigender nameUrgent chromosomal analysisPelvic ultrasoundSerum electrolytes with daily monitoring

Question 12

Incidence of respiratory distress syndrome increases with all of the following ExceptPrematurityMaternal diabetesBlack raceMale genderCesarean section delivery

Question 13

Normal findings in a newborn baby includes all of the following ExceptA mongolian blue spotA strawberry nevusVaginal blood lossLanugo hairErythema toxicum

Question 14

The pharmacologic effects of caffeine in the treatment of apnea of prematurity include stimulation of the medullary respiratory center, increased sensitivity to carbon dioxide, and enhanced diaphragmatic contractility. Of the following, caffeine exerts most of its effects byAntagonism of prostaglandin activityBlockage of adenosine receptorsEnhancement of catecholamine secretionStimulation of phosphodiesteraseUpregulation of gamma-amino-butyric acid receptors

Question 15

When clinical zinc deficiency occurs in term and preterm infants, almost all affected infants areexclusively breastfed and receiving breast milk that has substantially lower-than-average zinc content. Of the following, the most common clinical manifestation of zinc deficiency in infants isAlopeciaDiarrheaFailure to thriveIrritabilityRash

Question 16

Assisted reproductive technology is associated with significant risks to the fetus and the mother. Of the following, the greatest risk to the fetus is related toCesarean sectionGestational diabetesMaternal pre-eclampsiaMultiple gestationsPlacental abruption

Question 17

A term male newborn has severe intrauterine growth restriction, triangular face with broad forehead and pointed chin, leg length asymmetry, fifth finger clinodactyly, and cryptorchidism. Of the following, the most likely genomic imprinting disorder in this infant isAlbright hereditary osteodystrophyAngelman syndromeBeckwith-Wiedemann syndromePrader-Willi syndromeSilver-Russell syndrome

Question 18

A preterm newborn has multiple fractures of long bones, wormian skull, dark blue sclera, and beaked nose. Osteogenesis imperfecta type II is suspected. Genetic molecular tests are ordered for confirmation of the diagnosis. Of the following, the genetic mutation in this infant is most likely to involve theADAMTS2 geneCollagen 1A1 geneFibrillin-1 geneFilamin B geneTransforming growth factor receptor 1 gene

Question 19

Of the following, the nasal maldevelopment most likely to be associated with holoprosencephaly is:CepocephalyChoanal atresiaNasal agenesisPiriform aperture stenosisProboscis lateralis

Question 20

Regarding the head of a newborn infant(multiple choices)A cephalohematoma will resolve within the first 24 hours of lifeCaput is due to edema of the presenting part of the headA cephalohematoma is due to bleeding into the skinOverlapping of the skull bones is a normal findingA cephalohematoma should be drained

Question 21

The most prevalent clinical manifestation of late-onset group B Streptococcus disease isArthritisCellulitisMeningitisOsteomyelitisPneumonia

Question 22

In contrast to classic bronchopulmonary dysplasia (BPD), the new BPD in the more contemporary clinical setting is characterized by different histopathologic findings on examination of the lung tissue. The most striking abnormality in the lungs of infants who have new BPD isDecrease in alveolar septationDiffuse leukocytic infiltrationEpithelial squamous metaplasiaHypertrophy of airway smooth muscleLung parenchymal fibrosis

Question 23

Several risk factors during prenatal, perinatal, and postnatal development have been proposed as predictors of cerebral palsy in preterm infants. Of the following, the highest rate of cerebral palsy among preterm infants is associated withBronchopulmonary dysplasiaNecrotizing enterocolitis requiring surgeryParenchymal brain injurySepsis or meningitisSevere retinopathy of prematurity

Question 24

A 1700-g infant is born at 36 weeks gestation complicated by severe oligohydramnios. The Apgar scores are 3 and 5 at 1 and 5 min respectively. The baby required intubation as part of the resuscitation and continued MV to improve the ABGs. At 1 hour of age, the baby showed acute deterioration with cyanosis, bradycardia, and hypotension. The most likely diagnosis of this acute change isPatent ductus arteriosusIntraventricular hemorrhageHypoglycemiaPneumothoraxSevere respiratory distress syndrome

Question 25

A healthy newborn baby boy may(one incorrect)have erythema of the umbilical skin extending on to the abdomenproduce breast milkhave a single palmar creasehave an umbilical herniavomit blood if breast feeding

Question 26

A 14-day-old preterm infant, whose birthweight was 980 g at an estimated gestational age of 27 weeks, is receiving full enteral feedings of fortified human milk. The infant is breathing spontaneously in room air and has no evidence of cardiac, renal, or intracranial abnormalities. Of the following, the most desirable goal of enteral nutrition in this infant is to achieveFetal rate of body weight gainFetal rate of crown-heel length gainFetal rate of head circumference gainIntrauterine body compositionNormal blood urea concentration

Question 27

The interruption in the transfer of nutrients from the mother to the fetus that occurs following birth canbe minimized by early administration of parenteral nutrition in VLBW neonates within the first 24 hours after birth. Of the following, the most common metabolic consequence of early parenteral nutrition with amino acids isHyperammonemiaHyperglycemiaHyperkalemiaIncrease in blood urea nitrogen valuesMetabolic acidosis

Question 28

A 3600-g, breast-fed female, 42 weeks GA, is noted to have persistent hyperbilirubinemia at 2 weeks of age. On examination, the infant has not gained weight since birth and has decreased tone, an umbilical hernia, and an anterior fontanel measuring 4 x 6 cm. The most likely diagnosis isCrigler-Najjar syndromeGilbert diseaseBiliary atresiaHypothyroidismgalactosemia

Question 29

Fractured clavicle (multiple choices)occurs more frequently in infants of diabetic mothersrequires treatment with a slingis associated with Erbs palsycauses an asymmetric Moro reflexis not painful

Question 30

Minimal enteral feeding, also called gut priming or trophic feeding, is designed to improve gastrointestinal function and is used frequently in the nutritional management of VLBW neonates. The most accurate statement regarding minimal enteral feeding is that itIncreases plasma concentrations of gastrointestinal hormonesIs best avoided in infants weighing 500 to 600 gIs contraindicated in the presence of assisted ventilationIs contraindicated in the presence of indwelling umbilical cathetersPrevents necrotizing enterocolitis

Question 31

The only inborn error of metabolism associated with neonatal hyperammonemia that is X-linked in inheritance isHyperinsulinism/hyperammonemia syndromeIsovaleric acidemiaMedium-chain acyl-CoA dehydrogenase deficiencyOrnithine transcarbamylase deficiencyPyruvate carboxylase deficiency

Question 32

A 750-g black female experienced respiratory distress after a preterm delivery at 27 wks gestation. Pregnancy was uncomplicated, but labor was abrupt and therefore the mother did not receive steroid or penicillin therapy. The baby required intubation and MV with 100% O2. The possible causes of respiratory distress include (multiple choices)PneumothoraxRespiratory distress syndromePatent ductus arteriosusGroup B streptococcal sepsisTransient tachypnea

Question 33

The patient in Question 32 was also treated with endotracheal instillation of exogenous surfactant. This is likely to be beneficial by (multiple choices)Preventing bronchopulmonary dysplasiaReducing the incidence of pneumothoraxReducing mortalityMore rapid improvement of RDSPreventing oligouria

Question 34

Approximately 10% of infants born with congenital diaphragmatic hernia (CDH) have significant heart defects. The most common congenital heart defect associated with CDH isAortic arch obstructionTetralogy of FallotTotal anomalous pulmonary venous returnTransposition of the great arteriesVentricular septal defect

Question 35

Contemporary management of gastroschisis is associated with a 10% to 25% incidence of postoperative intestinal and related complications. The most common postoperative complication of surgical repair of gastroschisis isAbdominal compartment syndromeEnterocutaneous fistulaNecrotizing enterocolitisRenal ischemiaShort bowel syndrome

Question 36

Amniotic fluid volume varies substantially at each week of human gestation, as reflected in the wide range of normal values. The largest variation in amniotic fluid volume occurs at the gestational age of26 to 27 weeks29 to 30 weeks32 to 33 weeks35 to 36 weeks38 to 39 weeks

Question 37

You wish to determine the incidence and natural course of necrotizing enterocolitis in preterm neonates. Of the following, the best study design to address this question is aCase-control studyDescriptive observational studyProspective cohort studyRandomized clinical trialSystematic meta-analysis

Question 38

The most common fetal cause of polyhydramnios isDecreased absorption of amniotic fluid due to gastrointestinal atresiaDecreased fetal swallowing from neuromuscular disorderExcessive transudation of fluid from an abdominal wall defectIncreased fetal lung fluid secretion associated with gestational diabetesIncreased fetal urine output from hydrops associated with anemia

Question 39

A 4-week-old, A-positive, African-American former 40-weeks-gestational age infant was born to an O-positive mother and experienced hyperbilirubinemia requiring 2 days of phototherapy in the NB nursery after birth. The infant appears apathetic and demonstrates pallor, a grade 2/6 ESM, and a HR 175 bpm. The most likely diagnosis isAnemia of chronic diseaseG-6-PD deficiencyHereditary spherocytosisSicle cell anemia with hemolytic crisisABO incompatibility with continued hemolysis

Question 40

The following predispose a baby to be small for gestational age (multiple choices)Placental insufficiencyTwin pregnancyCongenital infectionMaternal diabetesAlcohol consumption

Question 41

The small for gestational age newborn baby is at increased risk of (multiple choices)HypoglycemiaPolycythemiaHypothermiaHypothyroidismCardiac abnormalities

Question 42

A term infant is born with Apgar score 5 and 7 at 1 and 5 min respectively. The infant has a HR 170 bpm and demonstrates pallor with hepatosplenomegaly. A Kleihauer-Betke test was positive. The most likely diagnosis isErythroblastosis fetalisHereditary spherocytosisChronic feto-maternal transfusionABO incompatibilityBlackfan-Diamond syndrome

Question 43

The twin-twin transfusion is unique to twins that areDizygotic, dichorionicDizygotic, monoamnionicDizygotic, monochorionicMonozygotic, dichorionicMonozygotic, monochorionic

Question 44

The amino acids derived from swallowedamniotic fluid are important for fetal gastrointestinal development. The amino acid considered conditionally essential for normal growth and maturation of the fetal gastrointestinal tract isAlanineCitrullineGlutamineLeucineValine

Question 45

Respiratory distress syndrome is exacerbated by the following ExceptHypothermiaAcidosisHypoxiaMeconium aspirationWithholding enteral feeds

Question 46

The most important determinant of endotracheal tube resistance isAirflow velocityBiofilm coatingGas densityTube curvatureTube diameter

Question 47

Bilirubin conjugated in the liver and secreted into bile can be deconjugated in the gut, then reabsorbed into the bloodstream, resulting in enterohepatic bilirubin circulation. The enzyme most responsible for contributing to enterohepatic bilirubin circulation isBeta-glucuronidaseBilirubin hydrogenaseBilirubin oxidaseBiliverdin reductaseUridine diphosphoglucuronate glucuronosyltransferase

Question 48

The most widely used and accurate method for estimating amniotic fluid volume is byDetermination of dye dilution by timed amniocentesisPalpation of the fetus by the Leopold maneuverPalpation of the uterus for fundal heightUltrasonographic measurement of the amniotic fluid indexUltrasonographic measurement of the largest vertical pocket

Question 49

A NB female has a ventricular septal defect, cleft lip and palate, imperforate anus. All of the following tests would be appropriate ExceptKaryotype analysisTORCH titerRenal USCranial USSkeletal survey

Question 50

A 2700-g, 36-wks-GA white male is born after 22 hrs of premature rupture of the amniotic membranes. The Apgar scores are 3 and 5. He immediately experienced respiratory distress and cyanosis requiring ET intubation and MV with 100% O2. Vital signs are T: 35.7C, HR 195 bpm, mean BP 22 mm Hg. WBC 1500/ L, platelets 59,000/ L. The next most appropriate treatment for this baby is to administerSurfactant by aerosolIV ampicillin and gentamicin/cefotaximeIV steroidsIV acyclovirHFOV

Question 51

The patient described in Question 50 is most likely suffering fromRespiratory distress syndromeDiaphragmatic herniaCongenital pneumonia with sepsisPneumothoraxTORCH infection

Question 52

Transient tachypnea of the newborn(multiple choices)occurs in 15% of full-term babiescan be diagnosed if onset occurs up to 48 hours post deliveryis caused by delayed absorption of fetal lung fluidis more common in babies delivered by cesarean sectioncannot be clearly differentiated from early pneumonia

Question 53

A baby presents in heart failure at 5 days of age. The baby is not centrally cyanosed. The differential diagnosis includes(multiple choices)Atrial septal defectFallots tetralogyHypoplastic left heartCoarctation of the aortaTricuspid atresia

Question 54

A well baby has difficulty sucking. Causes for this could be (multiple choices)MicrognathiaDystrophia myotonicaCleft palatePrader-Willi syndromeBulbar palsy

Question 55

The causes for failure to pass meconium in the first 24 hours of life include(multiple choices)Cystic fibrosisHyperthyroidismHirschsprungs diseaseHiatus herniaGalactosemia

Question 56

Polycythemia in the neonatal period is associated with the following ExceptTrisomy 21The donor twin in a twin-twin transfusionMaternal diabetesIntrauterine growth restrictionRespiratory distress

Question 57

A preterm baby of 30 weeks gestation is intubated and ventilated. On the 2nd day of life he suddenly deteriorates. The differential diagnosis includes (multiple choices)An intraventricular hemorrhageA blocked endotracheal tubeA pulmonary hemorrhagePneumoniaSelf-extubation

Question 58

The blueberry muffin appearance in infants with TORCH infections most likely representsDermal erythropoiesisPalpable purpuraMetastatic hepatic tissueViral lesionsNone of the above

Question 59

Necrotizing enterocolitis presents with(multiple choices) A distended abdomenBlood-stained fecesSepticemiaBilious vomitingPerforation of small bowel

Question 60

When a newborn fails to achieve or sustain the normal decrease in pulmonary vascular resistance at birth, the result is hypoxemic respiratory failure or persistent pulmonary hypertension of the newborn (PPHN). Of the following, the mediator most responsible for normal pulmonary vascular transition at birth isAsymmetric dimethylarginine.Endothelin-1LeukotrieneNitric oxideThromboxane

Question 61

The triggering mechanism that has become the standard of care in neonatal synchronized ventilation involvesAirflow triggerEsophageal probePressure triggerSurface capsuleThoracic impedance

Question 62

The clinical and ultrasonographic feature most consistent with the compensated phase of fetal hypoxemia isAbnormal biophysical profileAbsent fetal weight gainDiminished cardiac ventricular complianceIncreased diastolic flow in middle cerebral arteryLost fetal heart rate variability

Question 63

Harlequin color changes is a sign ofCongenital ichthyosisTORCH infectionErythrodermaNormal physiologySpinal cord trauma

Question 64

The risk of developing necrotizing enterocolitis is increased in(multiple choices)Breast-fed babiesAsphyxiated babiesPremature babiesInfants who have the umbilical artery catheterizedInfants who have had no milk feeds

Question 65

A 2-day-old is noted to have conjunctival and retinal hemorrhage. The most likely etiology isChild abuseMaternal alloimmune thrombocytopeniaMaternal idiopathic thrombocytopenic purpuraForce of birthing processForceps delivery

Question 66

Inhaled nitric oxide (iNO) has many of the characteristics of an ideal selective pulmonary vasodilator and, therefore, is used widely in the treatment of PPHN. Of the following, the lung disease most resistant to iNO isBacterial pneumoniaCongenital diaphragmatic herniaIdiopathic PPHNMeconium aspiration syndromeRespiratory distress syndrome

Question 67

The most common cause of nutritional intrauterine growth restriction is maternalChronic diseaseDrug addictionHypertensionInfectionMalnutrition

Question 68

Fetal undernutrition can have long-term effects on the occurrence of chronic adult diseases, a phenomenon described as fetal programming. Of the following, in addition to coronary heart disease and hypertension, the most common chronic adult disease attributed to fetal programming isChronic obstructive pulmonary diseaseDiabetes mellitusMalignancyOsteoporosisRetinal degeneration

Question 69

A baby with Apgar scores of 1 and 2 at 1 and 5 minutes, respectively, appears hyperalert and has hyperactive deep tendon reflexes and mydriasis. The most likely diagnosis isStage I hypoxic-ischemic encephalopathyStage II hypoxic-ischemic encephalopathyStage III hypoxic-ischemic encephalopathyKernicterusIntraventricular hemorrhage

Question 70

The most typical inspiratory-to-expiratory time used with high-frequency oscillatory ventilation is1:21:31:41:51:6

Question 71

Maternal chorioamnionitis is most likely to prevent the occurrence or severity ofBronchopulmonary dysplasiaCerebral palsyCystic periventricular leukomalaciaIntraventricular hemorrhageRespiratory distress syndrome

Question 72

The clinical manifestation most predictive of intestinal necrosis in necrotizing enterocolitis is:Abdominal tendernessBloody stoolsErythema of the abdominal wallGastric residualsHemodynamic instability

Question 73

A 2-week old preterm neonate (30 weeks) is experiencing recurrent episodes of apnea. The infant is well-oxygenated in room air between episodes and has no clinical or radiographic evidence of lung disease. Mechanical ventilation using the strategy of volume guarantee is started. The most appropriate positive end-expiratory pressure in this infant is0 cm H2O3 cm H2O5 cm H2O8 cm H2O10 cm H2O

Question 74

Many identifiable factors contribute to human preterm birth. Of the following, the largest single category of causes associated with human preterm birth isIdiopathic preterm laborMultiple gestation pregnancyPlacental abruptionPrenatal infectionSubstance abuse

Question 75

The most likely syndrome in an infant who has thrombocytopenia and thumb anomalies isDown syndromeFanconi syndromeKasabach-Merritt syndromeThrombocytopenia with absent radius syndromeTurner syndrome

Question 76

Transient neonatal diabetes mellitus is a rare disorder of genomic imprinting. Its clinical presentation includes intrauterine growth restriction, failure to thrive, hyperglycemia, and dehydration. Of the following, the imprinting defect in transient neonatal diabetes mellitus is most likely to involveChromosome 6Chromosome 7Chromosome 11Chromosome 15Chromosome 21

Question 77

The plasma constituents most commonly implicated in the pathogenesis of transfusion-related acute lung injury areABO alloantibodiesAnti-IgA antibodiesAnti-neutrophil and anti-HLA antibodiesAnti-T agglutininsInflammatory interleukins

Question 78

The first time the human fetus demonstrates swallowing ability is by the gestational age of11 weeks13 weeks15 weeks17 weeks19 weeks(Sucking at 18-20 weeks)

Question 79

The function that plays a major role inregulation of the amniotic fluid volume isFetal lung fluid secretion.Fetal swallowingFetal urine formationIntramembranous absorptionTransmembranous flux

Question 80

Direct-reacting hyperbilirubinemia on the 10th day of life suggests all of the following ExceptCystic fibrosisGalactosemiaNeonatal hepatitisByler syndromeGilbert disease

Question 81

The ventilator variable most influential in avoiding atelectasis in mechanically ventilated neonates isInspiratory timePeak inspiratory pressurePositive end-expiratory pressureTidal volumeVentilator rate

Question 82

Nearly all preterm neonates are most likely to have passed meconium by the postnatal age of48 hours96 hours144 hours192 hours240 hours

Question 83

The most accurate statement regarding gastrointestinal development and enteral feeding in preterm infants is thatDiluted milk empties more slowly from the stomach than does undiluted milkFeeding intolerance is largely due to immaturity of mucosal function rather than motor functionGastric emptying is influenced by the temperature of the milkLarge feeding volumes induce maturation of motor patterns of the gut more effectively than small feeding volumesMotor function develops earlier in the stomach/small intestine than in the rectum/anal canal

Question 84

Hemorrhagic disease of the newborn(multiple choices)is secondary to low prothrombincan present up to 6 months of lifeis treated with protamine sulphateis prevented by administering vitamin E to all newborn babiescan result in intracerebral hemorrhge

Question 85

The most critical determinantof ventilator-induced lung injury in preterm neonates is excessiveAirway pressureGas flowOxygen concentrationTidal volumeTime constant

Question 86

The postmenstrual age at which preterm infants who have stable cardiopulmonary status and no neurologic abnormalities are likely to be introduced to oral feeding is closest to28 weeks30 weeks32 weeks34 weeks36 weeks

Question 87

All of the following are problems of an infant of a recently diagnosed diabetic mother ExceptHypoglycemiaHypocalcemiaIntrauterine growth restrictionHypomagnesemiahyperbilirubinemia

Question 88

The most critical factor in the development of respiratory distress syndrome in the preterm neonate isImmature composition and biophysical function of surfactantLeaking epithelium/endothelium barrier from lung injuryLow lung gas volume with susceptibility to overdistentionLow surfactant lipid pool sizeSaccular versus alveolar stage of lung development

Question 89

A newborn baby has profound thrombocytopenia. The causes include all of the following ExceptCytomegalovirus infectionAutoimmune neonatal thrombocytopeniaMaternal ingestion of warfarinAlloimmune neonatal thrombocytopeniaGram-negative septicemia

Question 90

The high-frequency ventilator variable most likely to influence oxygenation isAmplitudeFrequencyInspiratory-to-expiratory time ratioMean airway pressureTidal volume

Question 91

A severely hydropic infant is about to be delivered. Complications to be prepared for include all of the following ExceptPulmonary hypoplasiaAbdominal ascitesPolycythemiaHeart failureLaryngeal edema

Question 92

You are called to see a tow-day-old jittery baby. The causes to consider are(multiple choices)Maternal diabetesFetal alcohol syndromeMaternal hyperparathyroidismMaternal thyrotoxicosisCongenital adrenal hyperplasia

Question 93

The distribution of surfactant in the lungs is most efficient when surfactant is administeredAfter a period of mechanical ventilationAs an aerosolized preparationAt a slow rate of infusionAt birth in the presence of fetal lung fluidUsing a smaller volume of the drug

Question 94

Infants at risk of hyperinsulinemic hypoglycemia include all of the following ExceptInfants with nesidioblastosisInfants of diabetic mothersInfants with galactosemiaInfants with leucine sensitivity with hyperammonemiaInfants with Beckwith-Wiedemann syndrome

Question 95

Neural tube defectsOccurs with frequency of 2 per 10,000 birthsHave a genetic predispositionResult from abnormal development of the neural tube at 3-4 months gestationCan be detected antenatally by low maternal serum alpha-fetoprotein levelsAre treated with folic acid

Question 96

Metabolic bone disease of prematurity(multiple choices)Is associated with chronic respiratory distressIs prevented by administration of vitamin DIs less severe in infants fed with breast milk compared to formula-fed infantsCan result in spontaneous fracturesIs caused by a substrate deficiency

Question 97

The most common limb defect associated with amniotic bands isAmputation of digitsCongenital arthrogryposisPreaxial polydactylyProximal syndactylySingle bones in extremities

Question 98

The aromatic amino acid most likely to be detected by tandem mass spectrometry isCitrullineLeucineMethioninePhenylalanineValine

Question 99

Hydrops fetalis is associated with(multiple choices)Beta-thalassemiaDiaphragmatic herniaParoxysmal supraventricular tachycardiaOA materno-fetal blood group incompatibilityTurner syndrome

Question 100

The blood constituents most implicated in the pathogenesis of transfusion-associated graft versus host disease areAnti-neutrophil antibodiesAnti-T agglutininsDonor-derived lymphocytesErythrocytic RhD antigensInflammatory interleukins

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