Which of the following measurements should be regarded as normal when assessing a 1-

day-old boy who had been born at term?

Weight of 4.5kg True False

A heart rate of 70 True False

A respiratory rate of 50 breaths/min True False

Potassium of 5.5mmmol/L True False

Glucose 2.6 mmol/L True False

Which of the following are recognised complications for babies of diabetic mothers?

Hypoglycaemia True False

Learning delay True False

Increased neonatal mortality True False

IUGR True False

Increased risk of RDS True False

Which of the following is/are true regarding neonatal jaundice?
It may be a sign of hypothyroidism True False

When occurring less than 12 hours of age, it is usually physiological True False

It is most commonly caused by haemolytic anaemia True False

It may be iatrogenic True False

It should always be treated with phototherapy True False

Well established causes of neonatal hypotonia include which of the following?

Maternal myasthenia gravis True False

Werdnig Hoffman disease True False

Neonatal infection True False

Hypothyroidism True False

Maternal treatment with diazepam True False

A newborn baby boy has facial deformities and a small-misproportioned head. He is irritable,
hypotonic and has severe tremors.

What diagnosis, related to antenatal care, would best account for these symptoms?

Fetal alcohol syndrome

 AIDS

Downs syndrome

Microcephalus

Hydrocephalus

Which of the following can cross the placenta to the foetus?

Maternal IgM True False

Salmonella True False

Carbimazole True False

Cocaine True False

Warfarin True False

Causes of bulging fontanelle include which of the following?

Dehydration True False

Intracranial haemorrhage True False

Meningitis True False

Hyperthyroidism True False

Congestive heart failure True False

Which of the following measurements should be regarded as normal when assessing a 1-

day-old boy who had been born at term?

Correct
Weight of 4.5kg True False

Correct
A heart rate of 70 True False

Incorrect
A respiratory rate of 50 breaths/min True False

Incorrect
Potassium of 5.5mmmol/L True False

Incorrect
Glucose 2.6 mmol/L True False

4.5kg is over the 95th centile. The respiratory rate of a young infant is 30-50 breaths per
minute. Potassium of 5.5 is normal in a neonate. Hypoglycaemia is diagnosed when blood
glucose <2.6 mmol/L.

Which of the following are recognised complications for babies of diabetic mothers?

Incorrect
Hypoglycaemia True False

Incorrect
Learning delay True False

Incorrect
Increased neonatal mortality True False

Correct
IUGR True False

Incorrect
Increased risk of RDS True False

Macrosomia is a complication of IDM. Shoulder dystocia may delay delivery leading to low
Apgars, acidosis, meconium aspiration and hypoxic-ischemic encephalopathy. Obstetric
interventions may lead to fractured clavicles and brachical plexus injury.

Which of the following is/are true regarding neonatal jaundice?

Incorrect
It may be a sign of hypothyroidism True False

Correct
When occurring less than 12 hours of age, it is usually physiological True False

Correct
It is most commonly caused by haemolytic anaemia True False
 Incorrect
It may be iatrogenic True False

Correct
It should always be treated with phototherapy True False

Neonatal jaundice may be a sign of underlying pathology particularly when presenting in

the first day of life. However, when presenting after a day of life, it is usually physiological
and will not require treatment.

Concerning severe birth asphyxia

Incorrect
HIE cannot be reliably diagnosed in premature babies True False

Incorrect
Neonatal seizures carry a poor prognosis True False

Incorrect
Mortality in the first week is very high True False

Correct
Apgar score is a good predictor of long-term outcome True False

Incorrect
Gestational age influences the Apgar score True False
Apgar score is a poor predictor of long-term outcome and varies with gestational age. There
is a close relationship between depression of Apgar score and mortality.

Well established causes of neonatal hypotonia include which of the following?

Incorrect
Maternal myasthenia gravis True False

Incorrect
Werdnig Hoffman disease True False

Incorrect
Neonatal infection True False

Incorrect
Hypothyroidism True False

Incorrect
Maternal treatment with diazepam True False

Incorrect
A newborn baby boy has facial deformities and a small-misproportioned head. He is irritable,
hypotonic and has severe tremors.

What diagnosis, related to antenatal care, would best account for these symptoms?

Fetal alcohol syndrome

Correct answer

AIDS Your answer

 Downs syndrome

Microcephalus

Hydrocephalus

FAS was first reported as a syndrome in 1973 and is now thought to be one of the major
causes of mental retardation, having an incidence of 0.23 per 1000 live births. It has been
estimated that between 10 and 20% of mild mental retardation cases are caused by
maternal alcohol use. Severity and timing of alcohol consumption, bingeing, polydrug use
(including smoking) during pregnancy, genetic variation and low socioeconomic status are
all aetiological factors. Alcohol inhibits N-methyl-d-aspartate (NMDA) receptors, which
mediate the postsynaptic excitatory effects of glutamate, and this is thought to have an
effect on cell proliferation.

Affected newborns are often irritable, hypotonic, experience severe tremors and show
other signs of alcohol withdrawal. The cardinal signs are facial features, growth deficit and
central nervous system impairment. Facial features include epicanthic folds, microcephaly,
short palpebral fissure, underdeveloped philtrum and a thin upper lip. There are often
associated behavioural difficulties including hyperactivity and sleep disturbance. Optic
nerve hypoplasia with poor visual acuity, hearing loss and receptive and expressive
language deficits can also be seen. Cardiac and renal abnormalities include atrial and
ventricular septal defects, renal hypoplasia and bladder diverticula.

Which of the following can cross the placenta to the foetus?

Correct
Maternal IgM True False

Correct
Salmonella True False

Incorrect
Carbimazole True False
 Incorrect
Cocaine True False

Incorrect
Warfarin True False

IgG but not IgM can cross the placenta. Cocaine, carbimazole and warfarin readily cross the
placenta and affect the fetus. Bacteria such as salmonella may cause neonatal infection but
do not actually cross the placenta.

Causes of bulging fontanelle include which of the following?

Correct
Dehydration True False

Incorrect
Intracranial haemorrhage True False

Incorrect
Meningitis True False

Incorrect
Hyperthyroidism True False

Incorrect
Congestive heart failure True False

Dehydration causes a sunken fontanelle.