Neomcq
Neomcq
Neomcq
MCQ's, and for his efforts & the valuable time he shares
with our residents to teach us from his experience. May
Allah bless him & bless every person who educates his
students sincerely!
First here are the questions, and then you can check the answers
on page 17 of this document. Good Luck!
The MCQ's
1- A 2-week-old infant is jaundiced. Findings include weight
and length at the 75th percentile for age; icterus; with
hepatosplenomegaly; total bilirubin, 6.3 mg/dL; direct bilirubin,
5.5 mg/dL; alanine aminotransferase activity, 130 U/L; aspartate
aminotransferase activity, 143 U/L; and gamma-glutamyl
transpeptidase activity, 950 U/L.
Of the following, the BEST study to evaluate the excretion of
bile from the liver is
A. computed tomography of the liver
B. hepatic ultrasonography
C. hepatobiliary scintigraphy
D. measurement of galactose-1-phosphate uridyltransferase
activity
E. measurement of the serum alpha1-antitrypsin level
2- Most authorities encourage the early introduction of human
milk in the very-low-birthweight (VLBW) infant. However,
mothers must be informed early in the feeding process that
supplementation of their milk with protein and other nutrients
may be necessary.
The MOST likely explanation for why protein supplementation
of human milk often is required in the VLBW infant is that
A. human milk contains less than half the protein of cow milk
formula
B. the hepatic metabolism of protein is ineffective in most
preterm infants
A.
B.
C.
D.
E.
C.
D.
E.
cyanosis
diminished feeding volume
pretibial edema
D.
E.
A. Crigler-Najjar syndrome
B. jaundice due to parenteral nutrition
C. neonatal hepatitis
D. physiologic jaundice
E. pyloric stenosis
E.
E.
A.
B.
C.
D.
E.
chromosomal abnormality
congenital viral infection
gestational diabetes
hereditary constitution
pregnancy-induced hypertension
13- You are writing orders for parenteral nutrition for a 24-hourold infant who weighs 900 g. The infant is on a ventilator,
but clinically stable.
Of the following, the MOST appropriate order is to
A. add cysteine
B. add sodium to provide 3.0 mEq/kg per day
C. provide a protein intake of 3.0 g/kg per day
D. provide nonprotein calories of at least 30 kcal/kg per day
E. use casein hydrolysate as a source of protein
14-A male infant is delivered after a pregnancy complicated by
breech presentation. Physical examination reveals
internally rotated shoulders, decreased muscle mass,
extended elbows, contractures of the hands, flexion
contractures at the knees, and bilateral equinovarus
deformities.
Of the following, the MOST likely outcome for this infant is
A. ambulation after initiation of early physical therapy and
surgery
B. death during the first year of life due to respiratory failure
C. death in the first days of life due to renal disease
D. progressive contractures and scoliosis
E. severe psychomotor retardation and failure to attain motor
milestones
15- The decreased incidence of enteric infections noted in
breastfed infants compared with formula-fed infants is
MOST likely due to the
A. more alkaline stool pH in breastfed infants
B. nutritional benefits of human milk on the infant's immune
system
C.
D.
E.
D.
E.
pleural effusion
reticulogranular pattern
B.
C.
D.
E.
B. barbiturates
C. cocaine
D. marijuana
E. opiates
33- A 4.3 kg infant is delivered to a woman whose diabetes
mellitus is poorly controlled.
Of the following, the MOST likely neonatal manifestation of
maternal diabetes is
A. diabetic ketoacidosis
B.Hirschsprung disease
C.hypercalcemia
D.polycythemia
E.renal vein thrombosis
34 Of the following, the MOST helpful finding to distinguish
GBS pneumonia from RDS is
A. a normal C-reactive protein level
B. an elevated erythrocyte sedimentation rate
C. diffuse alveolar infiltrates on chest radiography
D. increased ratio of bands to segmented neutrophils
E. persistent hypoxemia on blood gas analysis
34- An 18-hour-old infant of a diabetic mother develops
abdominal distension. Physical examination reveals a
protuberant, firm, but nontender abdomen; patent anus; and no
grossly visible anomalies. The infant has passed no meconium
stool since birth. A supine abdominal radiograph reveals
multiple dilated loops of intestine.
Of the following, a contrast enema would MOST likely confirm
a diagnosis of
A. atresia of the colon
B. Hirschsprung disease
C. hypoplastic left colon syndrome
D. meconium ileus
E. midgut volvulus with malrotation
C .intraperitoneal fluid
D. pneumatosis intestinalis
E. thickening of the bowel wall
38- A term infant is placed under a radiant warmer, the skin is
dried, and the oropharynx and nose are suctioned. After tactile
stimulation, there is minimal respiratory effort, dusky color, and
a heart rate of 86 beats/min. Bag/mask ventilation is performed
for 30 seconds with 100% oxygen at a rate of 40 to 60
breaths/min. The heart rate increases to 100 beats/min.
Of the following, the NEXT best step is to:
A. administer sodium bicarbonate
B. continue bag/mask ventilation at a rate of 20 to 40
breaths/min
C .continue ventilation and begin chest compressions
D. observes for spontaneous respiration and discontinues
ventilation
E. perform endotracheal intubation
39- A 900 g male infant is delivered vaginally to a woman who
had no prenatal care.
Of the following, the physical finding that is MOST consistent
with prematurity rather than intrauterine growth restriction is
A. creases over entire sole of foot
B. descended testes with deep rugae of the scrotum
C. formed and firm pinna with instant recoil
D. gelatinous translucent skin
E. raised areola and 3 mm breast buds\
40 -A 1-day-old infant develops bilious vomiting and gastric
distension. She has been afebrile and has been passing
meconium-laden stools.
Of the following, the most appropriate INITIAL step in the
management of this infant is
A. abdominal radiography to look for the double-bubble sign