1. Extremely Preterm Infant
All but which one of the following factors increases the risk of adverse neurodevelopmental outcome in extremely preterm infants?
a) Grade IV intraventricular haemorrhage.
b) Inadequate antenatal steroids.
c) Female sex.
d) Neonatal meningitis.
e) Chronic neonatal lung disease.
Correct Answer: c) Female sex. Males are at higher risk of adverse outcome than females. Grade IV IVH and Neonatal meningitis significantly increases the risk of adverse neurodevelopmental outcome. Adequate steroid administration decreases the risk of IVH and also the risk of chronic neonatal lung disease which are both associated with adverse outcomes. Babies with chronic neonatal lung disease have higher risk of adverse outcome even when other factors (e.g. gestation, sex, etc.) are corrected for.
2. Very Low Birth Weight (VLBW)
Of the following, the MOST important determinant of neuro-developmental outcome of VLBW infants is
a) Antenatal obstetric management
b) Infant gender
c) Length of gestation
d) Maternal education
e) Socioeconomic status
Correct Answer: c) Length of gestation. Overall survival and neuro-development outcome improves incrementally with each advancing week.
3. Low Birth Weight and Neurodevelopmental Outcome
Which one of the following patients is at highest risk of adverse neurodevelopmental outcome?
a) 23-week male infant.
b) 24-week female infant.
c) 26-week female infant with grade 1 intraventricular haemorrhage.
d) 27-week male and female dichorionic diamniotic (DCDA) twins.
e) 28-week infant with intrauterine growth retardation.
Correct Answer: a) 23-week male infant. Gestation is the biggest independent factor in predicting adverse neurodevelopmental outcome.
4. GBS Pneumonia Vs RDS
Of the following, the MOST helpful finding to distinguish GBS pneumonia from RDS is
a) A normal C-reactive protein level
b) An elevated erythrocyte sedimentation rate
c) Diffuse alveolar infiltrates on chest radiography
d) Increased ratio of bands to segmented neutrophils
e) Persistent hypoxemia on blood gas analysis
Correct Answer: d) Increased ratio of bands to segmented neutrophils
5. Low Birth Weight and NEC
A 31-week female infant is born via elective LSCS for IUGR and reversed end diastolic flow; birthweight is 1010 g. Which one of the following management options will be most effective in decreasing the risk of her developing necrotizing enterocolitis (NEC)?
a) Oral antibiotics.
c) Feeding with breast milk only.
e) Oral immunoglobulin.
Correct Answer: d) The relative risk of developing NEC is 0.35 in infants treated with probiotics compared to placebo.
Oral antibiotics do decrease the risk of NEC but are not recommended because of the possibility of antimicrobial resistance. Prebiotics may be beneficial in reducing the risk of NEC but further studies are still required. The use of breast milk is also recommended but does not have as much effect in reducing the risk as probiotics. Oral immunoglobulin appears to have no benefit in decreasing the risk of NEC.
6. Prematurity and IVH
Which one of the following is the most important risk factor in the aetiology of intraventricular haemorrhage (IVH)?
a) Coagulation disorder.
b) Intermittent positive-pressure ventilation.
d) Extreme prematurity.
e) Hypoxic–ischaemic encephalopathy.
Correct Answer: d) Prematurity is the most important risk factor, with IVH being very rare in term infants.
Coagulation disorder, Pneumothorax, HIE and IPPV increases the risk of IVH but are not the most important factor.Prev Next
"Authored By Dr.Niraj Mahajan"
MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.Read more [+]