13.

The following sentences about complications and supportive therapy in neonatal

sepsis are true:
A. Metabolic alkalosis may accompany sepsis and is treated with bicarbonate
B. Digoxin is used like a pressor agent
C. Decreased prothrombin time and partial thromboplastin time arc observed in
disseminated intravascular coagulation and measures include fresh frozen plasma, vitamin K,
platelet infusion
D. Assure adequate oxygenation with blood gas monitoring E. Seizure control with Phenobarbital
14. In the management of shock and hypotension it is necessary to administrate:
A. Dopamine
B. Intravenous colloid and crystalloid
C. Inotropic agents
D. Albumin
E. Dextran (10mifkg intravenously over 30 min)
15. Risk factors for hypocalcaemia are:
A. Acidosis
B. Diuretics treatment
C. Meconium aspiration
D. TORCH infections
E. Blood transfusions
16. If hypoglycemia is not present the treatment of seizures is made with:
A. Phenytoin 20 g/kg
B. Diazepam 5 mg/kg
C. Pirimidone 60 gilcg
D. Phenobarbital 20 mg/kg
E. No answer is correct
17. Management of pulmonary hypertension in the newborn includes:
A. Hypoventilation
B. Infusion of nahco3 or THAM
C. Phannacologic pulmonary vasoconstrictor
D. Therapy with Tolazoline
E. Extracorporeal membrane oxigenators in severe cases
18. Recognize the signs of respiratory distress:
A. Bradypnea
B. Nasal flaring
C. Expiratory grunting
D. Coughing paroxysm
E. Fever
19. Which of the following markings and/or symptoms are present in congestive heart
failure in the newborn:
A. Excessive weight gain (edema)
B. Bradycardia
C. Increased respiratory rate (>60/min)
D. Increased liver size
E. Increased heart size (cardiac/thoracic ratio >60%)
20. Prevention of hyperbilirubinemia is made by:
A. Phototherapy
B. Generous hydration
C. Diuretic administration
D. Antibiotic administration
E. Phenobarbital administration
21. Most common conditions associated with primary microcephaly include:
A. Trisomy 18
B. Beckwith's syndrome
C. Rubinstein-Taybi syndrome
D. Achondroplasia
E. Trisomy 13

22. The causes of hemolytic anemia are:

A. ABO incompatibility, hereditary spherocytosis
B. Elliptocytosis. Stomatocytis
C. Syndrome Blackfan Diarpond
D. Infection or maternal drugs
E. A-thalassemia
23. In supine position the normal posture of newborn's limbs are:
A. Flexion of superior limbs
B. Extension of superior limbs
C. Flexion of inferior limbs
D. Extension of inferior limbs
E. No answer is correct
24. The clinical features of periventricular/intraventricular hemorrhage may include:
A. Generalized tonic seizures
B. Bulging anterior fontanel
C. Tachycardia
D. Coma
E. Tachypnea
25. Grasp reflex:
A. Is present from birth to 3-4 months
B. This reflex is elicited by placing a finger or an object in the open palm of each hand and
the normal infant will grasp the finger or the object and will attempt removal if the grip is
reinforced
C. Begins to disappear at 3-4 months and is replaced by voluntary gasp provoked by seeing
an object
D. Thc absence of the grasp reflex at birth may be the consequence of peripheric motor
nerves lesions (brachial palsy if the absence is unilateral) or central motor nerves lesions
E. The persistence of' the grasp reflex after four months means the presence of tonic
cerebral mechanism. Which can be observed in hydrocephaly, corpus striatum lesions
26. The necrotizing enterocolitis risk factors are:
A. Prematurity
B. Feeding
C. Gastric ulcer
D. Chronic pancreatitis
E. Hypoxia
27. Motor development of the infant and child:
A. At age of I month he is able to hold his head erect for a few hours
B. At age of 4 months he plays with toys when these are in his hand but can't pick it up if the
toy falls
C. At age of 6 months he turns from prone to supine
D. At age of 9 months he indicates an object with his forefinger, thumb-forefinger
grasp
E. At age of I year and o months he walks up and down stairs with supports on
banister
28. The assessment and care in the delivery room consists in:
A.
Suction and aspiration of upper airway
B. Clamp and cut the umbilical cord at 25-30 em from the bottom of the implant in the
abdomen, after it sops
pulsing (especially at those with isoimmurtiration and at
those who need resuscitation)
C.
Place the infant on a cold and sterile field
D.
Prophylaxis against gonocotxal ophthalmia
E. Clean the skin with a sterile cotton smooth in Vaseline and remove the blood spots and the
amniotic fluid
29. Language development of the infant and child:
A. At age of 1 month he utters larynx's sounds
B. At age of 3 months he syllabify ba. Di. 'Ea'
.
C. At age of 8 months he pronounces clearly isolated or repetitive syllables: ma-ma'. -ba-ba',..
D. At age of 1 year he pronounces correctly 2-3 words
E. At age of I year and 6 months he comprehends more words (10 usually)

30. General principles of diversified feeding are:

A.
New food should be introduced even if the baby is not healthy
B.
The choice of the first food diversification is depending on development particularities of
babies
C.
Solid and semisolid food is given with the teaspoon
D.
The baby must eat all portion of the food
E.
Is recommended that only one food is introduced a week
31. Foods used in diversification are:
A.
At 3-4 months: - vegetables soup with 3 5% flour without gluten
B.
At 5 months: egg, ham without fats
C.
At 6 months: fruit juice
D.
At 6 months: - yolk of egg boiled. Yoghurt. Lean white fish meat, chicken liver
E.
At 6 weeks: cream, cheese dumpling, mixed meat balls (in soup). Bread
32. Cardiogenic shock may occur in:
A.
Arrhythmias
B.
Birth asphyxia
C.
Liver injury
D.
Hypercalcemia and hyperglycemia associated with hyponatremia
E.
Hypoplastic left heart
33. The following findings should alert you to the possibility of GI pathology:
A. Any amount of bile-stained residual
B. A residual of undigested formula or breast milk less than 1-2 cc/kg
C. Vomiting
D. Distended abdomen, especially if bowel loops are visible
E. Symptoms suggesting infection or sepsis, such as increasing frequency of
apnea/bradycardia episodes
34. Theophylline toxicity includes all of the following signs EXCEPT:
A. Tachycardia
B. Bradycardia
C. Jitteriness
D. Feeding intolerance
E. Seizures
35. Which are the causes of heart murmurs in infants presenting Ito 6 weeks of age:
A. Semilunar valve stenosis
B. Tricuspid regurgitation
C. Ventricular septal defects
D. Mitral regurgitation
E. Patent ductus arteriosus
36. In the antibiotic therapy in neonatal sepsis:
A.
Isn't begun before definition of an etiologic agent.
B. In early onset neonatal sepsis the therapy usually begin with a third generation
cephalosporin.
C. When group 13 streptococci is documented as the causative agent Vancomycin
is the drug of choice.
D. Monitoring for antibiotic toxicity is important especially for aminoglycosides and
vancomycin.
E. Continuing therapy is based on culture and sensitivity results.
37. The following sentences regarding respiratory distress (RDS) are true:
A.
Is the most common chronic lung disease in children.
B.
The incidence of RDS increases with decreasing gestational age.
C.
Is produced by an inadequate releasing of pulmonary surfactant.
D.
Is a inflammation of the small airways
E.
Are at increased risk infants born of diabetic mothers.

38. The active contraction of the neck's flexor muscles of the newborn estimates:
A.
Hypotonia (head is hyperextended during this maneuver)
B.
Hypertonia of napes's muscles (head is balanced)
C.
Hypotonia (head is balanced)
D.
Hypertonia of napes muscles (head is hyperextended during this maneuver)
E.
No answer is correct.
39. Defining characters of the term newborn are:
A.
Gestational age: 38-40 w
B.
Birth weight = 2900-3200 grams
C.
Length= 49-52 cm
D.
Head Scum. = 34-36 cm
E.
No answer is correct
40. The definition of acute renal failure requires:
A.
Absence of urinary output
B.
Oliguria
C.
Polyuria
D.
Increase in serum creatinine
E.
Decrease in serum creatinine
41. The newborn with an APGAR score of 5 and lower requires the following special
procedures:
A.
They don't need any special procedures
B.
Continuous catheter and mechanical suction of the upper airway
C.
Oxygen
D.
Cardiac resuscitation if the pulse is < 60/min or absent
E.
Intubation and mechanical ventilation if there is no spontaneous respiration
42. The assessment and care in the newborn ward consist in:
A.
Gender identification
B.
Complete physical examination
C.
Appropriate diagnosis and estimation of a possible pathology
D.
Prophylaxis of hemorrhagic disease using vitamin K! Prophylaxis of
rachitism by administration of vitamin D3 or D2 immunization with BCG
before leaving the hospital.
E.
No answer is correct.
43. All of the following are symptoms of hypoglycemia
A.
Jitteriness and irritability
B.
Apnea and cyanosis
C.
Fever
D.
Hypotonia and poor feeding
E.
Convulsion
44. Hypoglycemia is defined by a bloodsugar less than:
A.
40 mg/di
B.
50mg/d1
C.
60 mg/d1
D.
70 mg/d1
E.
80 mg/di
45. The most common cause of obstructive cholestasis is:
A.
Biliary atresia
B.
Hepatitis
C.
Alphal-antitrypsin deficiency
D.
Cholelithiasis
E.
Congenital bile duct abnormalities

46. Symtoms of shock are:

A.
Tachycardia
B.
Urine output is approximately 1-2 muvkg/h
C.
Cold extremities
D.
Bradycardia
E.
Weak pulse
47. The urgent treatment of repeated seizures caused by hypoglycemia is made with:
A.
Diazepam
B.
Phenytoin
C.
Glucose(dextrose)
D.
Phenobarbital
E.
Pirimidone
48. For the evaluation of neonatal apnea we may use:
A.
EKG. Echo
B.
Radionuclide scan after feeding marker
C.
Brain-system auditory evoked potentials
D.
Polygrafic study
E.
Oximetry
49. Hyperglycemia in a premature infant is defined as a serum blood glucose level more
than:
A.
B.
C.
D.
E.

110 mg/di
120mg/d1
130 mg/di
140mg/d1
150mg/di

50. The following sentences regarding RBC transfusion are true:

A.
B.
C.
D.
E.

sy

Transfusion should be made only in mptomatic infants

Transfusion should be made in absence apneie episode
Transfusion should be made when baseline heart rate decreases more than 20
bpm
Packed RI3C's should be given in a dose of 10 ml/kg, maximum 15 ml/kg
Transfusion should be made when activity, feeding, responsiveness are
decreasing.

51. The symptoms of acute hypocalcaemia are :

A.
Seizures
B.
Arrhytttmias
C.
Tachypnea
D.
Hypotonia
E.
Diarrhea
52. The following laboratory tests are required in a clinically apparent hemostatic problem:
A.
Platelet count
B.
Hemoglobin
C.
Reticulocytes count
D.
Leukocyte count
E.
Partial thromboplastin time
53. In the hypovolemic shock for volume expansion are used :
A.
Alternative transfusion of packed redcell and Plasmanate when hematocrit 4070
B.
Fresh frozen plasma
C.
Packed red blood when hematocrit is less than 40
D.
Dextran
E.
Plasmanate or albumin when hematocrit is over 50 %

54. For the treatment of apnea of prematurity we use:

C.
Tactile stimulation cutaneous
D.
Diazepam
E.
Teophy 'line
F. Catteine-oxalate
G.
Vestibular stimulation, bump-beds or water beds
55. NEC must be differentiated from:
A. Sepsis associated with abdominal ileus
B. Feeding intolerance
C. Pneumonia associated with abdominal ileus
D. Meconium ileus
E. Infectious enterocolitis
56. Bilirubin concentration (total/direct) establishes the diagnosis of conjugated
hyperbilirubinaemia if direct fraction is greater than:
A.
0.5 mg/di
B.
2.5 mg/m1
C.
1.5 mg/ml
D.
1 mg/ml
E.
035 mg/ml
57. The risk factors for UTI are:
A.
Male newborns
B.
Female newborns
C.
Urinary catheters
D.
Urinary tract obstructions
E.
Neurogenic bladder
58. Etiology of neonatal seizures are:
A.
Hyperglycemia
B.
Intercranial infections
C.
Hypopotassemia
D.
Intercranial hemorrhage
E.
Hypocalcemia
59. Prenatal interventions in periventricular and intraventricular hemorrhage may include
the following:
A.
Antenatal corticosteroids
B.
Antenatal administration of vitamin E to women in premature labour
C.
Prevention of prematurity
D.
Postnatal Phenobarbital
E.
Optimal management of labour and delivery
60. For the treatment of septic shock are used:
A.
Hydrocortisone
B.
Narcane
C.
Dopamine
D.
Naloxone
E.
Diazepam

01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13. c,d
14. c,d
15. b,a
16. d
17. b,d,e
18. b,c
19. a,c,d,e
20. a,b,e
21. c,e,a
22. a,b,e
23. a,d
24. a
25. a,b,c,d,e
26. a,b,e
27. b,c,d,e
28. a,b,d,e
29. a,c,d,e
30. b,c,e
31. a,d
32.
33. b,c,d
34. b
35. c,e
36.
37. b,c,e
38. c,d
39. a,b,c,d
40. b,d
41. b,c,d,e
42.
43. b,d
44. a
45. a,c,e
46. b,c,d,e
47. b,c,d
48. a,b,c,d,e
49.
50.

51. a,b
52. a,e
53.
54. c,d
55.
56.
57. b,c,e
58. b,d,e
59. c,e
60. a