Neonatology

Topics in this chapter

• Neonatal Respiratory Disorders
• Neonatal Jaundice and Hyperbilirubinemia
• Congenital and Neonatal Infections
• Neonatal Hematology and Bleeding
• Birth Injuries and Neurologic Disorders
• Neonatal Gastrointestinal Emergencies
• Neonatal Genetic and Chromosomal Disorders

Practice questions

1. Question 1Q-621AA2

   A 32-week preterm male neonate delivered via emergent lower segment caesarean section for fetal distress develops severe respiratory distress within 30 minutes of birth. Chest radiography reveals a generalized reticulogranular pattern with air bronchograms. Which of the following is the primary pathophysiological defect responsible for this condition?

   1. A.Deficiency of pulmonary surfactant leading to increased alveolar surface tension
   2. B.Inability to clear fetal lung fluid due to impaired epithelial sodium channels
   3. C.Aspiration of meconium-stained amniotic fluid causing airway obstruction
   4. D.Pulmonary hypoplasia secondary to prolonged oligohydramnios
   See the answer and solution
2. Question 2Q-998018

   A term male neonate presents on the 3rd day of life with generalized tonic-clonic seizures. He was born at home and did not receive Vitamin K prophylaxis at birth. Laboratory investigations reveal a hemoglobin of 10 g/dL, platelet count of 250,000/uL, prothrombin time (PT) of > 100 seconds, and activated partial thromboplastin time (aPTT) significantly prolonged. Cranial ultrasound shows a massive intracranial hemorrhage. What is the most likely diagnosis?

   1. A.Early vitamin K deficiency bleeding
   2. B.Classic vitamin K deficiency bleeding
   3. C.Late vitamin K deficiency bleeding
   4. D.Disseminated intravascular coagulation
   See the answer and solution
3. Question 3Q-896437

   A newborn infant delivered at 39 weeks of gestation develops marked respiratory distress, tachypnea, and cyanosis within a few hours of life. The mother had elective caesarean section without preceding labor. Chest radiograph demonstrates prominent perihilar streaking, fluid in the interlobar fissures, and mild hyperinflation. The symptoms completely resolve by 72 hours of life with supportive care. What is the diagnosis?

   1. A.Respiratory distress syndrome
   2. B.Transient tachypnea of the newborn
   3. C.Meconium aspiration syndrome
   4. D.Congenital diaphragmatic hernia
   See the answer and solution
4. Question 4Q-262A8F

   A 28-week preterm neonate, currently on mechanical ventilation, suddenly develops acute deterioration with asymmetric chest movements, decreased breath sounds on the right hemithorax, bradycardia, and oxygen desaturation. Transillumination of the right chest shows increased brightness. What is the most immediate lifesaving intervention required?

   1. A.Immediate endotracheal extubation
   2. B.Administration of exogenous surfactant
   3. C.Emergency needle thoracostomy or chest tube insertion on the right side
   4. D.High-frequency oscillatory ventilation
   See the answer and solution
5. Question 5Q-564DE6

   A term female neonate born via vacuum-assisted vaginal delivery presents with a scalp swelling that crosses suture lines, is soft, pitting, and painless. The overlying skin shows ecchymoses. The swelling progressively increases in size over the first 24 hours. What is the most likely diagnosis and potential complication?

   1. A.Cephalhematoma; hyperbilirubinemia and calcification
   2. B.Caput succedaneum; requires urgent surgical drainage
   3. C.Subgaleal hemorrhage; hypovolemic shock and severe anemia
   4. D.Epidural hematoma; uncal herniation and seizures
   See the answer and solution