NEONATOLOGY MCQS

NEONATOLOGY MCQS

MCQS#01

A neonatologist meets with a pregnant woman at 36 weeks’ gestation with Graves disease. Her condition has been well-controlled and there have been no signs of fetal distress.

Which of the following statements about the effects of maternal Graves disease on the fetus or infant is FALSE?

A.  A small number of infants may develop primary hypothyroidism

B.  Exophthalmos can occur in affected infants

C.  Fetal hydrops can occur in affected fetuses

D.  Fetal hyperthyroidism typically develops during the 2nd half of gestation

E.  Half of the neonates born to mothers with Graves disease develop                      hyperthyroidism

MCQS#02

You are asked to evaluate an otherwise healthy, well appearing 4-day old term newborn because of an abnormal thyroid-stimulating hormone (TSH) concentration measured on the infant’s newborn state screen. The screen had been erroneously sent shortly after birth. The infant is breastfeeding well, with normal voiding and stooling patterns.

You speak with the family and tell them that you plan to repeat the newborn screen but are not worried because:

A.  The infant is well appearing, without clinical signs of hypothyroidism

B.  The infant’s reverse triiodothyronine (rT3) is also elevated

C.  There is a TSH surge after birth, with markedly elevated TSH concentrations        compared to older infants

D.  The TSH concentration is suppressed at birth and takes several days to              reach a normal level

E. The TSH measurement is not as reliable as measuring thyroxine (T4)

MCQS#03

A neonatologist is evaluating an infant of a diabetic mother who was born at term weighing 4.6 kg. The infant appears plethoric and is admitted to the NICU for management of hypoglycemia. The family asks the neonatologist to discuss neonatal complications of maternal diabetes.

Which of the following findings in the newborn is NOT associated with maternal diabetes?

A.Hypoglycemia

B. Hypercalcemia

C. Increased intracardiac septal thickening

D.Mild surfactant deficiency

E. Polycythemia

MCQS#04
A neonatologist is asked to consult with a pregnant woman with hyperthyroidism. The woman inquires if her own thyroid hormone crosses the placenta to the fetus.

All of the following can cross the placenta, EXCEPT for:

A. Maternal thyroid-releasing hormone (TRH)

B. Maternal thyroid-stimulating hormone (TSH)

C. Maternal thyroxine (T4)

D. Radioactive iodide

E. TSH receptor antibodies (TRAb)

MCQS#05
A neonatologist is called to the Delivery Room of a term infant with respiratory distress. The infant’s initial physical examination reveals mild respiratory distress and an unexpected finding of ambiguous external genitalia. Review of the maternal records reveals that an amniocentesis had been done showing a 46 XX karyotype.

Which of the following etiologies is LEAST likely to be attributed to an over virilized female?

A. 5-alpha reductase deficiency

B. 11-beta hydroxylase deficiency

C. 21-hydroxylase deficiency

D. Aromatase deficiency

E. Maternal androgen and progesterone therapy

ANSWERS TOMORROW