Neonatology (Resuscitation, Respiratory Disorders, Neonatal Jaundice, LBW) MCQs

Pediatrics · 100 free questions with answers & explanations.

1. A term neonate delivered by emergency cesarean section for fetal distress is apneic, limp, and has a heart rate of 50 bpm at birth. What is the FIRST step in neonatal resuscitation after cord clamping and warming?
2. A 28-hour-old term neonate presents with jaundice. Total serum bilirubin is 14 mg/dL. Baby is feeding well, examination is normal, and Coombs test is negative. What is the MOST likely diagnosis?
3. A preterm neonate at 32 weeks gestation develops respiratory distress within 2 hours of birth with grunting, subcostal retractions, and central cyanosis. Chest X-ray shows a ground-glass appearance with air bronchograms. What is the MOST appropriate initial management?
4. A neonate is born at 36 weeks with a birth weight of 1.8 kg. The birth weight is below the 3rd percentile for gestational age. Which complication is this neonate at HIGHEST risk for in the immediate postnatal period?
5. A 3-day-old neonate develops bilious vomiting, abdominal distension, and bloody stools. Abdominal X-ray shows pneumatosis intestinalis. What is the MOST likely diagnosis?
6. A 28-week preterm neonate on mechanical ventilation develops sudden deterioration with decreased breath sounds on the left, shifted cardiac impulse to the right, and desaturation. Chest X-ray shows hyperlucency on the left with mediastinal shift. The MOST appropriate immediate intervention is:
7. A term neonate born to a Rh-negative mother with anti-D titer of 1:128 presents at birth with severe hydrops fetalis, hemoglobin 6 g/dL, and total bilirubin 9 mg/dL at 2 hours of life. The SINGLE most important initial intervention is:
8. A 32-week preterm neonate on nasal CPAP with FiO2 0.35 shows persistent respiratory distress and CXR reveals bilateral ground-glass opacification with air bronchograms. Surfactant is administered intratracheally. Which specific phospholipid component of surfactant is MOST critical for reducing alveolar surface tension?
9. A term neonate presents on day 4 with jaundice. Total bilirubin is 18 mg/dL (unconjugated). Mother's blood group is O positive, baby's blood group is A positive. Direct Coombs test is weakly positive. Which mechanism BEST explains the hemolysis in this case?
10. A 1.2 kg neonate born at 30 weeks gestation develops abdominal distension, bloody stools, and X-ray shows pneumatosis intestinalis with portal venous gas on day 8. Which of the following is the MOST likely pathophysiological trigger in this preterm infant?
11. A preterm neonate at 28 weeks gestation is born with severe respiratory distress. Chest X-ray shows a 'ground glass' appearance with air bronchograms and reduced lung volumes. Surfactant therapy is initiated. Which surfactant preparation is derived from bovine lung lavage and contains SP-B and SP-C proteins?
12. A term neonate on day 4 of life has serum total bilirubin of 18 mg/dL with predominantly unconjugated fraction. Mother is blood group O Rh-positive, baby is A Rh-positive. Direct Coombs test is positive. Which of the following features most distinguishes ABO incompatibility from Rh isoimmunization?
13. A 32-week preterm neonate is on mechanical ventilation for respiratory distress syndrome. On day 3, the nurse notices worsening oxygenation and a continuous machinery murmur at the upper left sternal border. Echocardiography confirms a hemodynamically significant patent ductus arteriosus. Which of the following is the most accurate statement regarding indomethacin use in this context?
14. A neonate born at 26 weeks gestation develops periventricular-intraventricular hemorrhage on cranial ultrasound. Grade III IVH is identified. Which of the following is the most accurate classification of Grade III IVH according to Papile?
15. A 3-day-old neonate presents with episodes of jitteriness and seizures. Blood glucose is 30 mg/dL. The neonate is the large-for-gestational-age (LGA) infant of a gestational diabetic mother. Despite correction with IV glucose, hypoglycemia recurs. Serum insulin is elevated at the time of hypoglycemia. Which of the following is the most likely diagnosis?
16. A preterm neonate born at 28 weeks develops hypotension on day 1. Echocardiography reveals a large patent ductus arteriosus (PDA) with left-to-right shunt. Indomethacin is planned. Which of the following is an absolute contraindication to indomethacin in this neonate?
17. A 3-day-old term neonate develops jaundice. Serum total bilirubin is 18 mg/dL (direct 0.4 mg/dL). Mother is O positive, baby is A positive. Direct Coombs test is weakly positive. The most appropriate immediate management is:
18. A 32-week neonate is intubated at birth for respiratory distress syndrome. Despite surfactant administration, the ventilator requirement increases over the next 48 hours. X-ray shows pulmonary interstitial emphysema (PIE). The ventilator strategy most likely to limit further barotrauma is:
19. A term neonate delivered by emergency caesarean section for cord prolapse is limp at birth with a heart rate of 50 bpm. No spontaneous respirations are noted. After 30 seconds of positive pressure ventilation (PPV) with room air, heart rate remains 50 bpm. The next step according to NRP 2020 guidelines is:
20. A neonate born at 26 weeks gestation weighs 780 g and is now 36 weeks postmenstrual age. He has been on a nasal cannula at 0.5 L/min. He is observed to have 3 apnoeas per day, each requiring gentle stimulation. The most appropriate management is:
21. A term neonate develops hypoglycaemia on day 1 (blood glucose 28 mg/dL) despite being breastfed. On examination, the baby is large for gestational age, has a distended abdomen, and macroglossia. The most likely cause of hypoglycaemia in this neonate is:
22. In a neonate with suspected persistent pulmonary hypertension (PPHN), pre- and post-ductal oxygen saturation monitoring is being performed. Pre-ductal SpO2 is 95% and post-ductal SpO2 is 82%. The most appropriate first-line intervention is:
23. A 28-week preterm neonate is born via emergency caesarean section. At 1 minute, the infant has a heart rate of 55 bpm, minimal respiratory effort, and is limp. After initial steps of resuscitation for 30 seconds there is no improvement. What is the NEXT most appropriate step?
24. A term neonate develops cyanosis shortly after birth. Echocardiography reveals a large PDA. The radiograph shows reduced pulmonary vascularity. The oxygen saturation is 72% in the right hand and 70% in the right foot. Which additional congenital heart defect is MOST likely coexisting?
25. A 3-day-old neonate born at 37 weeks presents with serum bilirubin of 18 mg/dL, predominantly indirect. The direct antiglobulin test (DAT/Coombs) is negative. The baby's blood group is A+ve and the mother's is O+ve. What is the MOST likely cause of jaundice?
26. A 1.1 kg, 29-week preterm neonate on day 5 of life develops abdominal distension, bilious aspirates, bloody stools, and a fixed dilated bowel loop on X-ray. What is the MOST appropriate initial intervention?
27. Which of the following is the MOST accurate criterion for defining respiratory distress syndrome (RDS/HMD) in a preterm neonate on chest X-ray?
28. A 29-week preterm neonate is delivered and requires surfactant therapy. The antenatal steroid course was completed 48 hours before delivery. At 2 hours of life, the infant has worsening respiratory distress with FiO2 requirement of 0.40, bilateral ground-glass appearance on X-ray, and air bronchograms. Which surfactant preparation is derived exclusively from a synthetic source and contains SP-B and SP-C peptide analogues?
29. A term neonate born by emergency cesarean section for fetal distress is noted to have Apgar scores of 3 and 6 at 1 and 5 minutes respectively. After initial resuscitation the neonate develops seizures at 12 hours of age, hypotonia, and has an abnormal amplitude-integrated EEG. Sarnat staging places this infant in Stage II HIE. Which statement about therapeutic hypothermia in this infant is MOST accurate?
30. A 34-week AGA neonate develops hyperbilirubinemia at 36 hours. Total serum bilirubin (TSB) is 14 mg/dL. Direct Coombs test is negative, blood group is B positive (mother is O positive). The neonate is breastfed. Which factor MOST increases the risk of bilirubin-induced neurologic dysfunction (BIND) at this bilirubin level?
31. A 1200 g neonate born at 30 weeks gestation develops abdominal distension, bilious vomiting, and bloody stools at 10 days of life. X-ray shows pneumatosis intestinalis and portal venous gas. Bell staging of this condition would be Stage IIB. Which of the following is the MOST appropriate next step?
32. A 2-day-old term neonate presents with tachypnea, grunting, and cyanosis. Chest X-ray shows a 'white-out' left lung with mediastinal shift to the right and a scaphoid abdomen. The MOST likely diagnosis and the embryological defect responsible are:
33. A premature neonate of 28 weeks develops apnea of prematurity requiring pharmacological management. Methylxanthine therapy is initiated. Which of the following statements about caffeine citrate compared to theophylline in apnea of prematurity is CORRECT?
34. A neonate born at 36 weeks has bilateral congenital cataracts detected on routine red reflex examination. Which TORCH infection is most associated with bilateral cataracts alongside microphthalmia and cardiac defects (PDA, pulmonary artery stenosis), and what is the critical period during which maternal infection leads to this triad?
35. A preterm neonate born at 28 weeks gestation is intubated and given surfactant. Despite improvement in oxygenation, PaO2 remains 45 mmHg on FiO2 0.6. Echocardiography reveals a large patent ductus arteriosus with left-to-right shunt. Which mechanism explains why surfactant therapy can paradoxically unmask or worsen a PDA in preterm infants?
36. A term neonate develops generalised myoclonic seizures at 4 hours of life. Blood glucose is 5.2 mmol/L, serum calcium is normal, and there is no history of asphyxia. The mother received isoniazid throughout pregnancy without pyridoxine supplementation. The MOST appropriate immediate treatment is:
37. A 2-day-old neonate born at 35 weeks has a total serum bilirubin of 14 mg/dL. The Coombs test is negative and the blood group is O+. The mother is B+. A peripheral smear shows microspherocytes. Which enzyme assay would MOST likely identify the aetiology of haemolysis in this infant?
38. In a neonate receiving phototherapy for indirect hyperbilirubinaemia, the nurse notices the baby's skin appears bronze-brown. Total bilirubin is 9 mg/dL and direct bilirubin is 7 mg/dL. What complication has developed and what is the pathophysiology?
39. A 30-week neonate on mechanical ventilation develops sudden respiratory deterioration with hypotension and distended abdomen. Transillumination of the chest is positive on the right side. The MOST immediate intervention is:
40. A 3-day-old neonate born at 32 weeks gestation has feeds withheld due to abdominal distension, bloody stools, and pneumatosis intestinalis on abdominal X-ray. Platelets are 40,000/µL and CRP is 45 mg/L. Which staging best fits this presentation and guides the management approach?
41. A neonate born to a mother with systemic lupus erythematosus presents at 3 weeks with complete heart block (ventricular rate 45/min) on ECG. The baby appears comfortable. Which maternal antibody is responsible and what is the mechanism?
42. A 34-week gestation infant is delivered via emergency C-section for placental abruption. Apgar scores are 1 at 1 minute and 4 at 5 minutes. Therapeutic hypothermia (cooling) is initiated. Which of the following is a CONTRAINDICATION to therapeutic hypothermia?
43. A 28-week preterm neonate weighing 980 g is born. After cord clamping and warming, the baby has no spontaneous respiration, HR 55/min, and central cyanosis. Initial ventilation with T-piece resuscitator is performed. After 30 seconds of PPV, HR is 68/min. What is the MOST appropriate next step?
44. A neonate born at 34 weeks gestation develops hypotonia, seizures, and encephalopathy within 12 hours. EEG shows burst-suppression pattern. The baby had a 10-minute APGAR of 4. Which intervention, if started within 6 hours of birth, has been shown to reduce death and disability in this condition?
45. A 3-day-old term neonate presents with jaundice. Total serum bilirubin is 22 mg/dL. Direct Coombs test is positive, and the mother is blood group O, Rh positive. The baby is blood group A, Rh positive. Which mechanism best explains this jaundice?
46. In a very low birth weight (VLBW) neonate on parenteral nutrition, the serum alkaline phosphatase is 1800 U/L, phosphorus is 1.2 mg/dL, and the chest X-ray shows generalized bone demineralization with cupping of distal radius. Which supplementation is MOST critical to prevent progression?
47. A 29-week neonate develops sudden deterioration with bradycardia, hypotension, and a tense, distended abdomen at day 10 of life. Abdominal X-ray shows pneumatosis intestinalis with portal venous gas. What is the MOST appropriate immediate management?
48. A term neonate at 6 hours of life develops respiratory distress, tachypnea, and grunting. Chest X-ray shows a 'ground glass' appearance with air bronchograms bilaterally. The mother had an elective cesarean section at 38 weeks. What is the MOST likely diagnosis?
49. A preterm neonate of 28 weeks gestation develops refractory hypoxemia on day 3. Chest X-ray shows bilateral diffuse ground-glass opacities with air bronchograms. Surfactant therapy is administered endotracheally. Which phospholipid component, maximally reduced in surfactant-deficient lungs, is the primary determinant of surface tension reduction at end-expiration?
50. A 3-day-old term neonate presents with jaundice. Total serum bilirubin is 18 mg/dL, direct bilirubin 0.3 mg/dL. The neonate's blood group is A positive and the mother's is O positive. DAT (Coombs) is weakly positive. The most specific test to confirm ABO hemolytic disease of the newborn in this setting is:
51. During neonatal resuscitation in the delivery room, a term infant born through meconium-stained amniotic fluid is not vigorous (limp, HR <100, apneic). According to current NRP guidelines (2021), the recommended immediate next step is:
52. A 1500 g preterm neonate develops abdominal distension, bilious aspirates, and bloody stools on day 10. Abdominal X-ray shows pneumatosis intestinalis. The most specific radiological sign confirming advanced necrotising enterocolitis with intestinal perforation is:
53. A neonate at 36 weeks gestation develops hypotension on day 1 refractory to fluid boluses (40 mL/kg normal saline given). Blood gas: pH 7.28, PCO2 38, HCO3 17 mEq/L, BE -9. Echocardiography shows normal cardiac anatomy and elevated pulmonary artery pressure equal to systemic pressure with right-to-left shunting at PDA and foramen ovale. The first-line pharmacological agent recommended for persistent pulmonary hypertension of the newborn (PPHN) in this setting is:
54. A 28-week preterm infant is being monitored for intraventricular hemorrhage (IVH). Cranial ultrasound on day 5 shows blood in the germinal matrix extending into the ventricle, which is dilated. This corresponds to which grade of IVH according to the Papile classification?
55. A term neonate develops early-onset neonatal seizures within 12 hours of birth. The mother received adequate prenatal care and had prolonged rupture of membranes. CSF: glucose 20 mg/dL (blood glucose 80 mg/dL), protein 180 mg/dL, neutrophils 500/mm³. After blood cultures, the most appropriate empirical antibiotic regimen is:
56. A neonate born at 32 weeks gestation develops worsening respiratory distress within 2 hours of birth. CXR shows a ground-glass appearance with air bronchograms. Which of the following is the MOST accurate statement regarding the pathophysiology of this condition?
57. A 28-week neonate on mechanical ventilation develops sudden oxygen desaturation, hypotension, and bulging fontanelle on day 3 of life. Cranial ultrasound shows Grade IV intraventricular hemorrhage. What is the SINGLE MOST IMPORTANT predisposing factor for Grade III-IV IVH in preterm neonates?
58. A term neonate born by emergency cesarean section for fetal distress presents with tachypnea, mild cyanosis, and a CXR showing fluid in the horizontal fissure and perihilar streaking. Oxygen saturation improves rapidly with 40% oxygen. Which is TRUE about this condition?
59. A 3-day-old term neonate has serum bilirubin of 22 mg/dL (predominantly unconjugated). Blood group of mother is O-positive and baby is A-positive. Direct Coombs test is positive. Which characteristic DISTINGUISHES ABO hemolytic disease from Rh hemolytic disease in the neonate?
60. A preterm neonate at 30 weeks gestation is treated with prophylactic indomethacin for PDA. After 2 doses, you note oliguria and rising creatinine. Which of the following is the MOST appropriate next step?
61. A term neonate develops hypoxemic respiratory failure unresponsive to 100% oxygen, with pre-ductal SpO2 of 95% and post-ductal SpO2 of 78%. Echocardiography shows right-to-left shunting across the ductus arteriosus and foramen ovale. Which intervention is MOST LIKELY to provide the most immediate hemodynamic benefit?
62. In neonatal resuscitation using the NRP algorithm, which of the following findings would prompt a provider to deliver positive pressure ventilation after initial steps of warmth, stimulation, and clearing of airway?
63. A 2.1 kg neonate born at 34 weeks is found to have blood glucose of 34 mg/dL on routine screening at 1 hour of life. She appears asymptomatic with good tone and feeding well. What is the MOST APPROPRIATE initial management?
64. A preterm neonate at 28 weeks gestation is mechanically ventilated for RDS. Chest X-ray shows diffuse granular haziness with air bronchograms and low lung volumes. Arterial blood gas shows PaO2 45 mmHg, PaCO2 58 mmHg, pH 7.19 on FiO2 0.6. What is the most specific pathophysiological defect?
65. A term neonate develops jaundice on day 1 of life. Total bilirubin is 14 mg/dL at 18 hours of age. Blood group: mother O negative, baby A positive. DCT (direct Coombs test) is positive. What is the most likely cause?
66. In the Neonatal Resuscitation Program (NRP) algorithm, after 30 seconds of effective positive pressure ventilation with 21% oxygen in a term neonate with no spontaneous respirations and heart rate 55 bpm, what is the next step?
67. A 1200-gram preterm infant at 30 weeks gestation is found to have a haemodynamically significant patent ductus arteriosus (PDA) on echocardiography with left-to-right shunting and pulmonary congestion on day 3. Which pharmacological agent is the current first-line treatment?
68. A 26-week preterm neonate is intubated for RDS and receiving surfactant replacement therapy. On day 4, the nurse notes sudden deterioration: SpO2 falls to 75%, heart rate drops to 90/min, bilateral breath sounds are asymmetric (reduced on right), and the trachea is deviated to the left. The IMMEDIATE intervention is:
69. A term neonate born to a hepatitis B surface antigen (HBsAg)-positive mother is ready for discharge. The mother is also HBeAg-positive. What is the correct prophylaxis protocol per guidelines?
70. A 34-week neonate is on phototherapy for neonatal jaundice. The TSB at 36 hours of age is 14 mg/dL. Total serum bilirubin rises to 18 mg/dL at 60 hours despite intensive phototherapy. The threshold at which exchange transfusion is indicated in this gestation and age (per AAP guidelines nomogram) is approximately:
71. A neonate born at 28 weeks gestation develops progressive respiratory distress within 4 hours of birth, grunting, intercostal retractions, and a chest X-ray showing bilateral diffuse ground-glass opacification with air bronchograms. Surfactant therapy is given. Which surfactant preparation is derived from bovine lung lavage and contains SP-B and SP-C proteins?
72. A term neonate with meconium-stained amniotic fluid is born vigorous (crying, good tone, HR >100). Regarding management of the airway, what is the current NRP (2015 onwards) recommendation?
73. A 4-day-old term breastfed neonate has serum bilirubin of 18 mg/dL. He is feeding well, urine is yellow, stool is yellow. Coombs test is negative. What is the most likely cause and initial management?
74. A 30-week preterm neonate (1.2 kg) develops worsening respiratory distress, grunting, and requires increasing oxygen support in the first 6 hours of life. CXR shows diffuse ground-glass opacity with air bronchograms and reduced lung volumes. Surfactant is administered. Which surfactant preparation and route of administration constitutes the LESS INVASIVE SURFACTANT ADMINISTRATION (LISA) technique?
75. A term neonate develops severe unconjugated hyperbilirubinemia (total bilirubin 28 mg/dL) at 36 hours of life. Blood group is O Rh-positive mother, A Rh-positive infant. DAT (Coombs test) is positive. The infant is developing hypotonia. What is the MOST appropriate urgent intervention?
76. A neonate born after emergency cesarean section for fetal distress has Apgar score 3 at 1 minute and 5 at 5 minutes. Cord pH is 7.00. At 6 hours of age, the baby has seizures, hypotonia, and absent Moro reflex. According to the modified Sarnat criteria for Hypoxic-Ischemic Encephalopathy (HIE), which GRADE is this and is this infant eligible for therapeutic hypothermia?
77. A neonate has necrotizing enterocolitis (NEC). Plain abdominal X-ray shows pneumatosis intestinalis and portal venous gas. He has abdominal wall erythema and clinical deterioration despite antibiotics. According to Bell's staging criteria, what stage is this and what is the management?
78. A preterm neonate born at 28 weeks gestation is intubated and ventilated for respiratory distress syndrome (RDS). Despite surfactant and ventilation, the PaCO2 is 68 mmHg and PaO2 is 48 mmHg (FiO2 0.6). Which ventilation strategy is most associated with improved outcomes in preterm RDS?
79. A term neonate develops jaundice at 36 hours. Transcutaneous bilirubin is 16 mg/dL. Blood type is A Rh-positive; mother is O Rh-positive. The neonate has a positive DAT (Coombs test). Peripheral smear shows microspherocytes. What is the mechanism of hemolysis?
80. A 30-week preterm neonate is found to have a large patent ductus arteriosus causing significant left-to-right shunting with hyperdynamic precordium, bounding pulses, and wide pulse pressure. Indomethacin treatment is being considered. Which is a contraindication to indomethacin use for ductal closure?
81. A preterm neonate of 28 weeks gestation develops progressive respiratory distress within 2 hours of birth. Chest X-ray shows bilateral ground-glass opacity with air bronchograms and low lung volumes. The PRIMARY pathophysiological defect is:
82. A term neonate has a serum bilirubin of 18 mg/dL at 36 hours of age. Direct Coombs test is positive. The mother is blood group O Rh-positive, and the infant is blood group A Rh-positive. The MOST likely cause of hemolytic jaundice is:
83. A 3-day-old term neonate has serum total bilirubin of 22 mg/dL. Phototherapy was started at 24 hours and has been ongoing for 2 days. The next step in management at this bilirubin level in a term, otherwise healthy newborn at 72 hours is:
84. A 26-week preterm infant (birth weight 800 g) develops bloody stools, abdominal distension, and pneumatosis intestinalis on abdominal X-ray at day 12 of life. The HALLMARK radiological finding that indicates intestinal wall necrosis in this condition is:
85. A term neonate has HR 80/min and is apneic at 1 minute of life despite adequate drying, stimulation, and positioning. Positive pressure ventilation (PPV) with 21% O₂ is started. After 30 seconds of PPV, HR is 55/min. What is the NEXT step per NRP 2022 guidelines?
86. A 29-week preterm neonate develops progressive respiratory distress within 2 hours of birth: expiratory grunting, subcostal retractions, nasal flaring, and cyanosis. CXR shows bilateral ground-glass opacification with air bronchograms. What is the primary biochemical deficiency, and which surfactant proteins are deficient in this condition?
87. A term neonate develops jaundice at 30 hours of life. Total serum bilirubin (TSB) is 14 mg/dL. Blood group of mother is O positive; baby is A positive. Direct Coombs test (DCT) is positive. Which of the following statements about this condition is CORRECT?
88. A term neonate born through thick meconium-stained amniotic fluid is vigorous at birth (good tone, strong cry, HR >100). Per current NRP 2022 guidelines, which is the CORRECT initial management?
89. A preterm infant of 28 weeks gestation is delivered. Initial steps of NRP are performed. The baby has labored breathing and HR is 100 bpm. The correct initial FiO2 for positive pressure ventilation in this preterm (<35 weeks) infant per NRP 2023 guidelines is:
90. A 32-week preterm infant develops respiratory distress within 2 hours of birth. CXR shows bilateral ground-glass opacities with air bronchograms and reduced lung volumes. Surfactant therapy is given. The surfactant preparation currently preferred due to clinical superiority in clinical trials is:
91. A term neonate born via emergency cesarean section for fetal distress has Apgar scores of 3 at 1 min and 5 at 5 min. After initial resuscitation, the infant has encephalopathy signs. The most neuroprotective intervention to be initiated within 6 hours is:
92. A 4-day-old term infant has unconjugated hyperbilirubinemia (TSB 19 mg/dL). Phototherapy is initiated. Which of the following factors would indicate a need for EXCHANGE transfusion rather than intensified phototherapy alone?
93. A male neonate born at 32 weeks gestation is noted to have bluish discoloration of the hands and feet 10 minutes after birth. He is vigorous, crying lustily, and has a heart rate of 140/min. Central cyanosis is absent. What is the most appropriate next step?
94. A term neonate develops jaundice on day 2 of life. Total serum bilirubin is 14 mg/dL (predominantly unconjugated). The infant is breastfed, active, and feeding well. Blood group of mother is O positive; baby is A positive; direct Coombs test is positive. Which of the following is the most likely diagnosis?
95. A 28-week preterm neonate develops increasing respiratory distress, grunting, and intercostal retractions within 4 hours of birth. Chest X-ray shows a ground-glass appearance with air bronchograms. Arterial blood gas reveals PaO2 of 45 mmHg on FiO2 of 0.4. What is the primary pathophysiological defect in this condition?
96. A neonate born to a diabetic mother has a blood glucose of 28 mg/dL at 2 hours of age. He is jittery with a high-pitched cry. Which of the following best explains the mechanism of neonatal hypoglycemia in this infant?
97. A 3-day-old term neonate presents with bilious vomiting, abdominal distension, and failure to pass meconium. X-ray shows dilated loops of bowel with a 'ground glass' appearance in the lower abdomen and absence of air-fluid levels. Sweat chloride test is later found to be elevated. What is the most likely diagnosis?
98. A term neonate at 1 minute of life has heart rate of 50 bpm despite adequate positive pressure ventilation for 30 seconds. The next step is:
99. A preterm neonate at 28 weeks gestation develops progressive respiratory distress from birth with grunting, subcostal retractions and central cyanosis. CXR shows bilateral diffuse ground-glass opacity with air bronchograms. The deficit responsible is:
100. A 4-day-old term neonate has total serum bilirubin of 22 mg/dL (indirect 21 mg/dL). He is exclusively breastfed and has lost 8% of birth weight. Blood group mother O+, baby A+, DAT positive. The mechanism of hyperbilirubinemia is: