Neonatal nutrition

1.	A newborn baby has energy stores mostly in the liver and subcutaneous tissues. T

2.	Energy stores in the fetus builds up mainly in the last 5 – 6 weeks. T

3.	Newborns require less protein intake than adults. F

4.	Renal function with regards to concentration and excretion of solutes is limited in newborn. T

5.	Breast milk contains a high amount of iron. F

6.	Breast feeding may be associated with prolonged neonatal jaundice. T

7.	Babies who are breast fed have a tendency to hemorrhagic disease of newborn. T

8.	The normal breast milk is inadequate to meet nutritional needs of pre-term infants of 34 – 36 weeks gestation. T

9.	Neonates need about 100 – 120 kcal/kg body weight a day to grow adequately. T

10.	Breast fed babies have lesser chance of allergies later on in life. T

Prematurity

1.	Pre-terms are those born before 38 weeks gestation. F

2.	Pre-terms account for 6 – 7% of births in Singapore. T

3.	A problem that may be present in most infants is intraventricular haemorrhage. F

4.	Pre-terms have a predisposition to impaired body temperature control because of a limited ability to increase heat production. T

5.	Pre-terms are likely to have a decreased bilirubin binding capacity because they are more likely to be hypothermic / acidotic. T

6.	Pre-terms require more water because of increased GFR. F

7.	Besides an immature respiratory center and narrow airway, weak respiratory muscles contribute to recurrent apnoea in pre-terms. T

8.	Acute problems common in severe pre-term requiring surgery are ligation of PDA and tracheostomy. F

9.	A counsellor’s primary use to mothers of preterms is to facilitate payment to the hospital. F

10.	The survival rate for a 30-week pre-term is 80 – 90%. T

Hemorrhagic disease in newborn

1.	Anemia in the neonatal period is due to hemolysis or failure of erythropoiesis. F

2.	Hb level in the 1st week of life is 10 – 14 g/dL. F

3.	Reticulocyte count in a term newborn is 2 – 5%. T

4.	Hb concentration in capillary is more than that in a vein. F

5.	Beta-thalassaemia in newborn is diagnosed by identifying target cells in the peripheral blood firm. F

6.	In G6PD deficiency, hemolysis is self-limited. T

7.	Physiological anemia of newborn can be prevented by early iron supplementation. F

8.	Apnoea in pre-term infant may be a manifestation of anemia. T

9.	Haemorrhagic disease of newborn presents between day 2 and day 7. T

Neonatal jaundice

1.	The average lifespan of RBC in the newborn is 120 days. F

2.	The average Hb level in a newborn is 11g/dL F

3.	The absence of bacteria in newborn gut decreases the enterohepatic circulation F

4.	Breast milk increases enterohepatic circulation. T

5.	A risk factor for kernicterus includes hypoalbuminaemia T

6.	Packed RBC matched against mother’s blood should be used for exchange transfusion. F

7.	Onset of physiological jaundice usually occurs after day 4. F

8.	Jaundice over limbs is severe. T

Extremes of birth weight

1.	Intrauterine infections are likely to result in asymmetrical IUGR. T
(Comments: question is not precise: answer depends on when the infection occurred  ( first trimester : then symmetrical IUGR or death ) and the type of infection ( chronic - producing symm IUGR or acute and in the 3rd tyrimester - asymm IUGR) )

2.	Complications in an IUGR infant includes hypocalcaemia. T

3.	Another complication in an IUGR is hypothermia. T

4.	Anemia is common in infant of a diabetic mother. F

5.	Infants of diabetic mother are prone to chronic intrauterine infections. F

Congenital Malformations

1.	Down’s syndrome is caused by Trisomy 18. F

2.	All congenital malformations have a genetic basis. F

3.	Anal abnormalities are part of VATER. T

4.	Congenital talipes equino varices is a deformity caused by a restriction in intrauterine environment.

5.	Folic acid decreases incidence of neural tube defects. T

6.	G6PD is a sex-linked recessive condition. T

7.	Risk of mothers under age of 25 having a Down’s baby is 1 in 3,000. F

8.	Antenatal karyotyping can detect most congenital malformations. F

9.	The best time to do a fetal anomaly scan is 32 – 34 weeks. F

10.	Congenital rubella can cause abnormalities of the eye. T

Birth injuries

1.	A cephalohaematoma is a collection of blood in the subperiosteal space of skull bone. T

2.	Shoulder dystocia is an important risk factor for birth injury. T

3.	Erb-Duchenne paralysis involves the C7, C8 and T1 roots of brachial plexus. F

4.	Fractures of clavicle are usually complicated by nerve injuries and poor bone union. F

5.	Recovery from caput succadenum may take several weeks. F

6.	Cephalohaematomas usually cross suture lines of the head. F

7.	In fractures of the long bones, bony union takes a shorter time in babies than in adults. T

8.	Decreased movement of affected limb is one of the signs of a fracture of a long bone. T

9.	A subaponeurotic hemorrhage is always small and well defined. F

10.	Phrenic nerve paralysis causes elevation of the affected diaphragm. T

Infection of newborns

1.	Penicillin is the drug of choice in the treatment of congenital syphilis. T

2.	The cerebral calcifications in congenital CMV infection are typically diffuse in distribution. F

3.	Congenital rubella syndrome is characterized by the constellation of cataracts, sensorineural hearing loss and congenital heart disease. T

4.	Antepartum transmission is the most common cause of neonatal HIV infection. F

5.	Components of the neonate immune system that produces an inflammatory response to limit bacterial invasion includes phagocytes. T

6.	Group B streptococcus is a common cause of early onset infection. T

7.	Listeria is a common cause of late onset infection. F

8.	The following is a useful group of tests for diagnosing neonatal infection: white cell count, platelet count, C-reactive protein, culture of nasal swab. F

9.	1st line antibiotics commonly used for suspected perinatally acquired infection are cefotaxime and gentamicin. F