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Full term baby is noted to have cyanosis and apnea. An O2 monitor is placed on the baby.

When feeding, his O2 sat is in the 60s, but when crying, his O2 sat is in the 90s/ What will
you immediately do for this patient?
A. ECG
B. Ventilation Perfusion Scan
C. Nasal Catheterization
D. Hb Electrophoresis
E. Bronchoscopy

A large term for gestational age baby was born to a mother with gestational diabetes about 50
hours ago. The infant is now diaphoretic and irritable, and has tremor and twitching of the
extremities. What is the likely metabolic disorder?
A. Hypoglycemia
B. Hypocalcemia
C. Hypophosphatemia
D. Hyperglycemia
E. Hypokalemia

The nurse from NICU asks you to evaluate a baby. The infant, born at 32 weeks gestation is
now only 1 week old, and has been doing well on nasogastric feeding. This afternoon
however, the nurse noticed that the baby has vomited the last two feedings and seems less
active. There is a tense abdomen that appears distended, and the patient has grossly bloody
stool. How will you manage this patient?
A. Emergency surgical laparoscopy.
B. Continue feeding as gastroenteritis is usually self-limited.
C. Stool culture to identify the pathogen.
D. Stop feeds, begin intravenous fluids and initiate systemic antibiotics.
E. Immediate radiological study.

You are now responsible for creating a new standardized vaccination program in Trinidad
and Tobago for newborns. Which of the following vaccines will you include in your order?
A. MMR
B. Hepatitis B
C. Combination diphtheria, tetanus and acellular pertussis
D. Inactivated Polio Virus
E. Hemophilus Influenza B

A 1 week old infant presents to you with blue discolorations over the lower back and
abdomen. The mother claims the lesions have been there since birth. On examination of the
infant, the infant is growing at a normal rate and is in the normal percentiles for height and
weight. What is your next step?
A. Report the family to child protective services for child abuse.
B. Intramuscular Vitamin K administration.
C. Counseling the mother on the normalcy of this condition.
D. Measurement of PT and aPTT.
E. Soft tissue films of the lower back to identify calcifications.

The mother of a 3 week old infant comes to your clinic and asks if her infant can switch to
goat's milk instead of breast milk, as the mother complains of "colic" on breastfeeding. What
do you advise the mother?
A. Goat's milk has a poorer caloric quality than breast milk.
B. Ensure mother continues breastfeeding and inform her that she is using an improper
technique to breastfeed the child.
C. Goat's milk has a lower folic acid level than breast milk.
D. Goat's milk has insufficient whey for the infant.
E. Prescribe antibiotics for the mother and instruct her to continue breast feeding.