2. Apgar score.

***) An infant at birth exhibits pink body with blue extremities, pulse rate of 120/min, lusty cry, limp muscle tone and irregular slow respiration. The Apgar score is:

1. 2

2. 4

3. 6

4. 8

5. 10

Answer: C* 6

***) A newborn baby delivered with peripheral cyanosis, crying well, weak muscle tone, RR = 22/min irregular and HR = 80/min, his Apgar score:

1. 4

2. 5

3. 6

4. 7

5. 8

Answer: C* 6

***) An infant born with good respiration, vigorous cry, heart rate of 105, moving all extremities, body pink and extremities blue. The Apgar score is

1. 10

2. 9

3. 8

4. 7

5. 6

Answer: B* 9

***) All are component of APGAR score, except:

1. Heart rate

2. Blood pressure

3. Respiratory effort

4. Reflexes

5. Skin color

Answer: B* Blood pressure

3. Sepsis in the Neonate.

***) Beta Hemolytic streptococci group A is responsible for all the following except:

1. Acute glomerulonephritis

2. Rheumatic fever

3. Neonatal sepsis

4. Scarlet fever

5. Impetigo

Answer: C* Neonatal sepsis

***) All of the following are predisposing factors of neonatal sepsis, except:

1. Hypothermia

2. Instrumental delivery

3. Twins

4. Amnionitis

5. Umbilical infection

Answer: C* Twins

***) Predisposing factors for neonatal septicemia include each of the following, except:

1. Febrile maternal illness

2. Twins

3. Frank amnionitis

4. Umbilical infection

5. Endotracheal intubation

Answer: B* Twins

4. Cyanosis.

***) All of the following can cause cyanosis, except:

1. Renal failure

2. Congestive heart failure

3. Polycythemia

4. Cold

5. Cor pulmonale

Answer: A* Renal failure

***) A newborn, 12 hours old, cyanosed when he is quiet, becomes pink on crying, the most probable diagnosis is:

1. Respiratory distress syndrome

2. Congenital pneumonia

3. Diaphragmatic hernia

4. Intracranial hemorrhage

5. Bilateral choanal atresia

Answer: E* Bilateral choanal atresia

5. Respiratory Distress.

***) The most likely finding in a neonate with asphyxia is:

1. Alkalemia

2. Hypoxia

3. Hypocapnia

4. Tachycardia

5. Increased anal sphincter tone

Answer: C* Hypoxia

***) The features of respiratory distress in newborn are the following, except:

1. Tachypnea

2. Flaring of nostrils

3. Cyanosis

4. Grunting on expiration

5. Projectile vomiting

Answer: E* Projectile vomiting

***) Compliance of the lung is increased in which of the following:

1. Diffuse pulmonary fibrosis

2. Pleural thickening

3. Healed tuberculosis with scarring

4. Emphysema

5. Hyaline membrane disease

Answer: E* Hyaline membrane disease

***) Regarding hyaline membrane disease all of the following are true, except:

1. Tachypnea is always present

2. Affects mainly premature babies

3. Expiratory grunting is present

4. The clinical picture will develop within 4-6 hours

5. Oxygen by mask is the best management

Answer: E* Oxygen by mask is the best management

6. Diaphragmatic Hernia.

***) The high postoperative mortality for newborn with congenital diaphragmatic hernia is due to:

1. Increased intra-abdominal pressure

2. Persistent patent ductus arteriosus

3. Failure of the collapsed lung to expand

4. Mediastinal shift with impaired venous return

5. Abnormal pulmonary microvasculature

Answer: E* Abnormal pulmonary microvasculature

***) An infant is delivered at full term by a spontaneous vaginal delivery to a 29 year old primigravida. At delivery, the infant is noted to have subcostal retractions and cyanosis despite good respiratory effort. The abdomen is scaphoid. On bag and mask ventilation, auscultation of the lungs reveals decreased breath sounds on the left, with heart sounds louder on the right:

1. Dextrocardia with situs inversus

2. Diaphragmatic hernia

3. Pneumonia

4. Pulmonary hypoplasia

5. Spontaneous pneumothorax

Answer: B* Diaphragmatic hernia