Mock Exam 6

Neonatology
ANSWER
Part One MRCPCH
Educational Materials from MRCPCH2009 for Part 1
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A. HIV virus
B. Hepatitis B virus
C. CMV Virus
D. Erythrovirus
E. Papilloma virus
F. Rubella virus
G. Pox virus
H. Varicella virus
I. E-coli
J. Listeria monocytogenes
K. Group B streptococcus
L. Klebsiella spp
M. Anthrax
N. Bacteroids
O. Toxoplasma gondii
P. Candida albicans
Q. Spirochetes
R. Aspergillus spp

Choose the most likely organism for each of the following scenarios:

SELECT ONE ANSWER ONLY FOR EACH QUESTION

1. Gram positive rods present in dairy products producing early and late onset
sepsis. Pustular skin rash is common. Meconium like stained liquor

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2. Baby born well or unwell and may develop visual problem even after few
months and treated with Pyrimethamine and sulfadiazine for up to one year.
Mother need to be treated with Spiramycin.
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3. Diagnosed by isolating the organism or detection of early-antigen flurescent

foci (DEAFF Technique) from Urine and other body fluid and producing
intracranial calcification. !
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4. The organism is teratogenic with sever distinct skin lesions if the mother got
infected during the first trimester while there is a risk of the mother’s illness if
she got infected within the week around delivery. "
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A. Urgent chest X-ray

B. Urgent arterial blood gas
C. Septic screen
D. Blood transfusion
E. Transillumination test
F. Needle insertion in 2nd left intercostals space
G. Coagulation study
H. Call the consultant to come from home
I. Check the Blood pressure
J. Check the endotracheal tube position and patency
K. Abdominal X-ray
L. Intracranial ultrasound
M. Brain MRI
N. Urgent ECG
O. Assess the modified Glasgow coma scale

Choose the most appropriate action for each of the following scenarios:

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SELECT ONE ANSWER ONLY FOR EACH QUESTION

1. You are following a preterm baby; 29 weeks on his second day. She is on
moderate setting ventilation being very stable with near normal blood gas.
The reason is respiratory distress syndrome and mother has been given
steroid 2 days before delivery. After you round you went to your room. Two
hours later the nurse has call you to come urgently as the baby is suddenly
desaturated with bradycardia. You came and found the baby in bad
condition. You did your first step assessment and the condition is reversed
immediately after your appropriate action. What is your assessment?
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2. You are following a preterm baby; 29 weeks on his second day. She is on
moderate setting ventilation being very stable with near normal blood gas.
The reason is respiratory distress syndrome and mother has been given
steroid 2 days before delivery. After you round you went to your room. Two
hours later the nurse has call you to come urgently as the baby is suddenly
desaturated with bradycardia. You came and found the baby has limited
chest movement on the right side. You did your essential step of assessment
and it was positive. You call for immediate intervention. What is this step? $
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3. You are following a preterm baby; 29 weeks on his second day. She is on
moderate setting ventilation being very stable with near normal blood gas.
The reason is respiratory distress syndrome and mother has been given
steroid 2 days before delivery. After you round you went to your room. Two
hours later the nurse has call you to come as the baby is gradually
desaturated and ventilation setting is rising. You came and found the baby
off colored and lethargic. You did your essential step of assessment and
asked for blood transfusion. What is this step? %
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A. Aspirin
B. Warfarin
C. Phenytoin
D. Valproate
E. Carbamazepine
F. Levetiracetam
G. Benzodiazepin
H. Thiouracil
I. Sulphmethoxazol
J. Hydralazin
K. Dipyridamole
L. Thalidomide
M. Haloperidol
N. Methadone
O. Cocaine
P. Lithium

Choose the well recognized teratogenic drug associated with each of the following:

SELECT ONE ANSWER ONLY FOR EACH QUESTION

0 Midfacial hypoplasia and neural tube defect '

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4 Limb deficiency; Sirenomelia %
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6 Ebstein anomaly (
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A. 11 β hydroxylase deficiency.
B. Middle Aortic syndrome.
C. Previous umbilical artery catheterization.
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E. Maternal Cocaine abuse.
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A. Macrosomia secondary to passing of high calories through placenta
B. Persistent septal hypertrophic cardiomyopathy
C. Higher incidence and severity of Jaundice due to hemolytic process.
D. Hypermagnesemia secondary to hypocalcemia
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A. Preterm less than 30 weeks
B. Baby weight less than 1 kg
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D. Grade IV intraventricular Hemorrhage
E. Platelet count less than 10
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A. Inappropriate Ventilation setting
B. Patent ductus arteriosus
C. Hypertension
D. Hypotension
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A. Start suction and free oxygen flow and wait for spontaneous breathing
B. Start bag and musk ventilation
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D. Intubate the baby and give the chance for spontaneous breathing
E. Try to pass NGT to check for bilateral choanal atresia.
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B. Twin to twin transfusion
C. Wolf-Parkinson-White syndrome
D. Congenital Lupus
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C. Prothrombin and Thrombin time are prolonged
D. UK recommendation in all breast fed babies is oral or IM vitamin K
E. If the baby is symptomatic treatment with oral vitamin K is required.
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A. Persistent hyperinsulinemia hyperglycemia of infancy.
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E. Glycogen storage disease type I
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A. Pneumatosis intestinalis means stage 3 NEC by Bell’s staging criteria.
B. Known risk factor in VLBW is early breast feds even in small amount.
C. Serial abdominal X-ray is usually required regardless radiation risk.
D. Polycythemia is one of the underlying risk factor
E. Surgical intervention is limited to perforation or bowel resection.
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