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

NEONATOLOGY MCQS

PEDIATRICS MCQS

MCQS#01

A full-term infant born is noted to have ambiguous genitalia and elevated blood pressures. The rest of the physical examination is unremarkable. Laboratory evaluation reveals normal serum electrolytes with elevated serum androgens and deoxycorticosterone.

Of the following, which enzymatic defect is responsible for this infant’s congenital adrenal hyperplasia?

A. Aromatase

B. 5 alpha-reductase

C. 11 beta-hydroxylase

D. 17 alpha-hydroxylase

E. 21-hydroxylase

MCQS#02

Of the following, the most likely congenital cardiac defect in an infant of a diabetic mother is:

A. Ebstein’s anomaly

B. Tetrology of Fallot

C. Transposition of the great vessels

D. Tricuspid atresia

E. Truncus arteriosus

MCQS#03

A full-term male infant has prolonged indirect hyperbilirubinemia, a large posterior fontanel, hypotonia, and feeding difficulties. The neonatology fellow suspects that the infant has congenital hypothyroidism. Laboratory evaluation reveals a low thyroxine concentration and elevated thyroid-stimulating hormone.

The most likely cause for this infant’s hypothyroidism is:

A.  Deiodase deficiency

B.  Organification defect

C.  Panhypopituitarism

D.  Thyroid dysgenesis

E.  Thyroid-stimulating hormone resistance

MCQS#04

A 1-week old full-term infant has an intraparenchymal cerebral hemorrhage. His urine output is 10 mL/kg/hour. Laboratory evaluation reveals Na+=158 mEq/L, K+=4.1 mEq/L, Cl-=118 mEq/L, HCO3-=30 mEq/L, and serum and urine osmolality of 310 mOsm and 125 mOsm, respectively.

Upon administration of exogenous vasopressin (anti-diuretic hormone), the MOST likely impact on this infant’s osmolality is:

A.  Decrease in serum and urine osmolality

B.  Decrease in serum osmolality and increase in urine osmolality

C.  Increase in serum and urine osmolality

D.  Increase in serum osmolality and decrease in urine osmolality

E.  No change in serum or urine osmolality

MCQS#05

A female infant of a diabetic mother is admitted to the Neonatal Intensive Care Unit with irritability, tremulousness, and concern for seizure activity. Physical examination reveals a jittery full-term infant with laryngospasm and episodes of rhythmic left lower extremity jerking. Her chest radiograph reveals a normal cardiothymic silhouette. Her electrocardiogram reveals a prolonged QT interval. Her blood glucose is 80 mg/dL.

Serum electrolyte evaluation of this infant would most likely reveal:

A.  Hypercalcemia

B.  Hyperkalemia

C.  Hypermagnesemia

D.  Hypocalcemia

E.  Hypomagnesemia

Check Answers: TOMORROW