Mock Exam 6

Neonatology
Part One MRCPCH
Educational Materials from MRCPCH2009 for Part 1
Number of questions: 20
Score: 100 marks
Time: 30 Minutes

MRCPCH2009 SITE

ELBABA M.A.

Mock Exam Series # 6

Neonatology Test 1

MRCPCH2009 Site
ELBABA M.A.

____________________________________________________________________________

EXTENDED MATCHING QUESTIONS

Q. 1 (20 Marks)
This is a list of organisms may affect the mother during pregnancy:
A. HIV virus
B. Hepatitis B virus
C. CMV Virus
D. Erythrovirus
E. Papilloma virus
F. Rubella virus
G. Pox virus
H. Varicella virus
I. E-coli
J. Listeria monocytogenes
K. Group B streptococcus
L. Klebsiella spp
M. Anthrax
N. Bacteroids
O. Toxoplasma gondii
P. Candida albicans
Q. Spirochetes
R. Aspergillus spp
Choose the most likely organism for each of the following scenarios:
SELECT ONE ANSWER ONLY FOR EACH QUESTION
Note: Each answer may be used more than once
1. Gram positive rods present in dairy products producing early and late onset
sepsis. Pastular skin rash is common. Meconium like stained liquor
2. Baby born well or unwell and may develop visual problem even after few
months and treated with Pyrimethamine and sulfadiazine for up to one year.
Mother need to be treated with Spiramycin.
3. Diagnosed by isolating the organism or detection of early-antigen flurescent
foci (DEAFF Technique) from Urine and other body fluid and producing
intracranial calcification.
4. The organism is teratogenic with sever distinct skin lesions if the mother got
infected during the first trimester while there is a risk of the mothers illness if
she got infected within the week around delivery.

__________________________________________________________________________
http://sites.google.com/site/mrcpch2009/

mrcpch2009@gmail.com

Mock Exam Series # 6

Neonatology Test 1

MRCPCH2009 Site
ELBABA M.A.

____________________________________________________________________________

Q. 2 (15 Marks)
This is a list of actions you may ask or do it:
A. Urgent chest X-ray
B. Urgent arterial blood gas
C. Septic screen
D. Blood transfusion
E. Transillumination test
F. Needle insertion in 2nd left intercostals space
G. Coagulation study
H. Call the consultant to come from home
I. Check the Blood pressure
J. Check the endotracheal tube position and patency
K. Abdominal X-ray
L. Intracranial ultrasound
M. Brain MRI
N. Urgent ECG
O. Assess the modified Glasgow coma scale
Choose the most appropriate action for each of the following scenarios:
SELECT ONE ANSWER ONLY FOR EACH QUESTION
Note: Each answer may be used more than once
1. You are following a preterm baby; 29 weeks on his second day. She is on
moderate setting ventilation being very stable with near normal blood gas.
The reason is respiratory distress syndrome and mother has been given
steroid 2 days before delivery. After you round you went to your room. Two
hours later the nurse has call you to come urgently as the baby is suddenly
desaturated with bradycardia. You came and found the baby in bad
condition. You did your first step assessment and the condition is reversed
immediately after your appropriate action. What is your assessment?
2. You are following a preterm baby; 29 weeks on his second day. She is on
moderate setting ventilation being very stable with near normal blood gas.
The reason is respiratory distress syndrome and mother has been given
steroid 2 days before delivery. After you round you went to your room. Two
hours later the nurse has call you to come urgently as the baby is suddenly
desaturated with bradycardia. You came and found the baby has limited
chest movement on the right side. You did your essential step of assessment
and it was positive. You call for immediate intervention. What is this step?

__________________________________________________________________________
http://sites.google.com/site/mrcpch2009/

mrcpch2009@gmail.com

Mock Exam Series # 6

Neonatology Test 1

MRCPCH2009 Site
ELBABA M.A.

____________________________________________________________________________

3. You are following a preterm baby; 29 weeks on his second day. She is on
moderate setting ventilation being very stable with near normal blood gas.
The reason is respiratory distress syndrome and mother has been given
steroid 2 days before delivery. After you round you went to your room. Two
hours later the nurse has call you to come as the baby is gradually
desaturated and ventilation setting is rising. You came and found the baby
off colored and lethargic. You did your essential step of assessment and
asked for blood transfusion. What is this step?

Q. 3 (15 Marks)
This is a list of some medications:
A. Aspirin
B. Warfarin
C. Phenytoin
D. Valproate
E. Carbamazepine
F. Levetiracetam
G. Benzodiazepin
H. Thiouracil
I. Sulphmethoxazol
J. Hydralazin
K. Dipyridamole
L. Thalidomide
M. Haloperidol
N. Methadone
O. Cocaine
P. Lithium
Choose the well recognized teratogenic drug associated with each of the following:
SELECT ONE ANSWER ONLY FOR EACH QUESTION
Note: Each answer may be used more than once
1. Midfacial hypoplasia and neural tube defect
2. Limb deficiency; Sirenomelia
3. Ebstein anomaly

__________________________________________________________________________
http://sites.google.com/site/mrcpch2009/

mrcpch2009@gmail.com

Mock Exam Series # 6

Neonatology Test 1

MRCPCH2009 Site
ELBABA M.A.

____________________________________________________________________________

BEST OF FIVE QUESTIONS

(5 Marks each)
1. The following may be the reason of neonatal hypertension EXCEPT:
A. 11 hydroxylase deficiency.
B. Middle Aortic syndrome.
C. Previous umbilical artery catheterization.
D. Congenital nephritic syndrome.
E. Maternal Cocaine abuse.
2. Maternal Diabetes mellitus affects babies as following : SELECT ONE
A. Macrosomia secondary to passing of high calories through placenta
B. Persistent septal hypertrophic cardiomyopathy
C. Higher incidence and severity of Jaundice due to hemolytic process.
D. Hypermagnesemia secondary to hypocalcemia
E. Higher incidence of Microcolon and caudal regression syndrome
3. All of the following are contraindication to ECMO therapy EXCEPT:
A. Preterm less than 30 weeks
B. Baby weight less than 1 kg
C. Oxygenation index more than 70%
D. Grade IV intraventricular Hemorrhage
E. Platelet count less than 10
4. All of the following
is considered as a risk factor for periintraventricular hemorrhage in preterm EXCEPT:
A. Inappropriate Ventilation setting
B. Patent ductus arteriosus
C. Hypertension
D. Hypotension
E. Maternal use of steroid
5. You have been faced with a flat baby immediately after birth. The baby
is not breathing and heart rate is maintained. You observed a scaphoid
abdomen. Mother was not given Narcotic. What is your first action? :
A. Start suction and free oxygen flow and wait for spontaneous breathing
B. Start bag and musk ventilation
C. Intubate the baby electively and start bag ventilation
D. Intubate the baby and give the chance for spontaneous breathing
E. Try to pass NGT to check for bilateral choanal atresia.
__________________________________________________________________________
http://sites.google.com/site/mrcpch2009/

mrcpch2009@gmail.com

Mock Exam Series # 6

Neonatology Test 1

MRCPCH2009 Site
ELBABA M.A.

____________________________________________________________________________

MULTIPLE TRUE/FALSE QUESTIONS

(5 Marks each)
1. You have been called to see a fresh baby with generalized edema and
ascitis. There are no signs of heart failure and investigations revealed
No RH incompatibility. The following may be incriminated as a cause:
A. Finnish nephrotic syndrome
B. Twin to twin transfusion
C. Wolf-Parkinson-White syndrome
D. Congenital Lupus
E. Erythrovirus infection
2. In baby with Hematocrit 0.75. The following complications may occur:
A. Paucity of movement on one side of the body
B. Lip smacking and cycling movement
C. Abdominal distension and bloody diarrhea
D. Hematuria and flank mass
E. Superior vena cava syndrome
3. Which is true concerning hemorrhagic disease of the newborn :
A. It may occur after the third week of life
B. It is due to deficiency of factor II, VII, IX and X
C. Prothrombin and Thrombin time are prolonged
D. UK recommendation in all breast fed babies is oral or IM vitamin K
E. If the baby is symptomatic treatment with oral vitamin K is required.
4. Non ketotic hypoglycemia in newborn is present in :
A. Persistent hyperinsulinemia hyperglycemia of infancy.
B. Beckwith-Wiedmann syndrome.
C. Infant of diabetic mother
D. Medium chain acyl coenzyme A deficiency
E. Glycogen storage disease type I
5. Considering Necrotizing enterocolitis which is or are true? :
A. Pneumatosis intestinalis means stage 3 NEC by Bells staging criteria.
B. Known risk factor in VLBW is early breast feds even in small amount.
C. Serial abdominal X-ray is usually required regardless radiation risk.
D. Polycythemia is one of the underlying risk factor
E. Surgical intervention is limited to perforation or bowel resection.

ELBABA 2011

End of material

__________________________________________________________________________
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mrcpch2009@gmail.com