1.

A female infant is born through emergency cesarean section to a 34-

year-old mother whose pregnancy was complicated by hypertension
and abnormal fetal heart monitoring. At delivery she is covered in
thick, green meconium and is limp, apneic, and bradycardic. Which
of the following is the best first step in her resuscitation?

A. Administer IV bicarbonate.
B. Intubate with an endotracheal tube and suction meconium from
the trachea
C. Initiate bag-and-mask ventilation.
D. Initiate chest compressions immediately.

2. A term male infant is delivered vaginally to a 22-year-old mother.

Immediately after birth he is noted to have a scaphoid
abdomen,cyanosis, and respiratory distress. Heart sounds are heard on
the right side of the chest, and the breath sounds seem to be diminished
on the left side. Which of the following is the most appropriate next step
in his resuscitation?

A. Administer IV bicarbonate.
B. Intubate with an endotracheal tube.
C. Initiate bag-and-mask intubation.
D. Initiate chest compressions immediately.

3. A 37-week gestation boy is born after an uncomplicated pregnancy to

a 33-year-old mother. At birth he was lethargic and had an HR of 40.
Oxygen was administered via bag and mask, and he was intubated; his
HR remained at 40 beats/min. Which of the following is the most
appropriate next step?

A. Administer IV bicarbonate.
B. Begin chest compressions
 C. Administer IV epinephrine.
D. Administer IV calcium chloride.

4. A term female infant is born vaginally after an uncomplicated

pregnancy. She appears normal but has respiratory distress when she
stops crying. When crying she is pink; when not she makes vigorous
respiratory efforts but becomes dusky. Which of the following is the
likely explanation for her symptoms?
A. Choanal atresia
B. Diaphragmatic hernia
C. Meconium aspiration
D. Neonatal narcosis
5. A 36-week gestation infant is delivered via cesarean section because of
macrosomia and fetal distress. The mother has pregestational diabetes
(insulin dependent, with vascular disease); her hemoglobin A1c is 15%
(normal 7%). This infant is at risk for hypocalcemia,cardiomyopathy,
polycythemia, andwhich of the following? hypocalcemia,cardiomyopathy,
polycythemia, andwhich of the following?

A. Congenital dislocated hip

B. Dacryostenosis
C. Respiratory distress syndrome
D. Hyperglycemia

6. A term infant weighing 4530 g is born without complication to a

mother with gestational diabetes. At 12 hours of life, he appears mildly
jaundiced. Vital signs are stable, he is eating well, and his blood type is
the same as his mother’s blood type. Which of the following serum
laboratory tests are most likely to help you evaluate this infant’s
jaundice?
A. Total protein, serum albumin, and liver transaminases
B. Total and direct bilirubin, liver transaminases, and a hepatitis panel
C. Total bilirubin and a hematocrit
D. Total bilirubin and a glucose

7. Which of the following is NOT a symptom of hypoglycemia?

A. Tachypnea
B. Hypothermia
C. Poor feeding
D. Vomiting

8. A term boy born to a mother with insulin-dependent pregestational

diabetes has a bedside capillary glucose of 32 mg/dL at 1 hour of life.
He is awake and has normal vital signs. Which of the following is the
most appropriate next step in management?
A. Instruct the mother to breast-feed him and recheck the glucose in
30 minutes.
B. Place an IV and administer glucose.
C. Recheck the glucose in 1 hour.
D. Measure his serum insulin level.

9. Target SPo2 at 3 mins of life is

A. 60-70%
B. 80-90%
C.90-100%
D.70-80%

10. The best way to increase oxygen is by

A. Increasing PIP
B. Increasing PEEP
C. Increasing inspiratory time
D. Increasing PEEP plateau

11. Which of the following is an antidote for the extravasation of

dopamine and other vasoconstrictor
A. Hyaluronidase
B. Phentolamine
C. Multiple needle puncture
D. Hydrogel dressing

12. What is the best way to determine the difference between SIADH
and third space loss?
A. By checking urine output
B. By checking urinary sodium
C. By checking urinary osmolality
D. By checking urine-specific gravity

13. The most common congenital coagulation disorder is

A.Factor VIII deficiency
B.Von willebrand disease
C.DIC
D. Factor XI deficiency
14. After initial control with Phenobarbitone alone if no recurrence of
seizures in next 72 hours then the right approach is
A. Stop Phenobarbitone after tapering the dose
B. Stop Phenobarbitone and start Phenytoin
C. Start tapering of Phenobarbitone and start Phenytoin
D. Stop Phenobarbitone without tapering of dose

15. Meningitis is confirmed if CSF contains

A WBC of 10/mm3 in less than seven days old
B. WBC of 10/mm3 in more than seven days old
C. WBC of 15/mm3 in less than seven days old
D. WBC of 20/mm3 in less than seven days old
16. You monitor a baby with shock with the following parameters
EXCEPT
A. Urine output
B. Sensorium
C. Capillary refill time
D. Pupillary reaction
17. In case of presumed neonatal sepsis without abdominal distension do
the following
A. Keep NPO for at least 3 days
B. Introduce feeding as soon as possible
C. Keep NPO till full course of antibiotics is given
D. Keep NPO till culture report is available
18. Moderate Hypothermia in a neonate is defined as an axillary
temperature
A. < 34 degree C
B. < 32 degree C
C. 36-36.4 degree C
D. 32-35.9 degree C
19. A 2 kg neonate, on day 6 of life is taking 100ml/kg/day of feeds out
of daily requirement of 150 ml/kg / day of daily fluids required. Next
step is to
A. Stop iv fluids
B. Taper and stop iv fluids
C. Taper iv fluids
D. None of the above

20. The two important parameters which help in ascertainment of the

type of initial feeding include:
A. Weight and gestation
B. Gestation and hemodynamic stability
C. Clinical stability and weight
D. Absence of tachypnea and birth asphyxia
21. Prenantal diagnosis is possible for all except
A. DMD
B. Ectodermal dysplasia
C. Sickle cell trait
D. Beta thalassemia
22. A 21-day-old male infant presents with history of recurrent oral
thrush and eczematous skin rash. The WBC counts are persistently low
with normal morphology. Nitroblue tetrazolium test is negative. The
most likely diagnosis is
A. Severe combine immunodeficiency
B. Chronic Granulomatous Disease
C. Leukocyte Adhesion Defect
D. Bruton's disease
23. Placental pathology would be most important in diagnosis and
management in which of the following
A. GBS infection
B. Listeria infection
C. Syphilis
D. Preeclampsia
24. Biphasic stridor occurs in all EXCEPT
A. Vocal cord paralysis
B. Subglottic stenosis
C. Laryngomalacia
D. Tracheomalacia
25. Cerebral blood flow decreases with all EXCEPT
A. Decrease pCO2
B. Increase pO2
C. Increase serum glucose
D. Increase fetal Hb
26. Syndrome of inappropriate antidiuretic hormone (SIADH) is
characterized by all EXCEPT
A. Low urine output
B. Low Na excretion
C. High Urine Osm
D. Weight gain

27. A 20-hr old 1.2 kg preterm baby nursed in incubator is stable on

24% O2 NCPAP and TPN @ 4.5 ml/hr ( D 8%, P 2 g, no Fat, no lytes)
is noted to have a blood gas of 7.26/51 CO2/ 45 O2/19 HCO3/-4. Serum
Na is 130, Cl 90, HCO3 19. The acidosis is most likely due to
A. Use of amino acid
B. Resolving RDS
C. Decrease fluid intake
D. Lactic acidosis
28. Human mature human milk as compared to mature cow milk is
deficient in
A. Vitamin B
B. Vitamin A
C. Vitamin E
D. Vitamin C
29. You are asked to attend M&M monthly meeting for the month of
March. The data presented to you is as under
No. of live birth during March = 416 No. of still birth, after 28 wk = 2
No. of still birth, before 28 wk =0 Neonatal death before 7 days = 1
Neonatal death within 28 days = 4 Term infant = 342 34-36 wks = 42
28-34 wks = 24 24-27 wks= 8 The neonatal mortality rate would be
A. 4 per 1,000 live birth
B. 6 per 1,000 live birth
C. 8 per 1,000 live birth
D. 12 per 1,000 live birth
30. A 37 wk 4.5 Kg IDM, born after difficult labor, is noted to have
respiratory distress. The CBC showed WBC of 24 with bands of 4%, Hb
is 19 g/dl. Chest x-ray showed no fractures and clear lung fields. The
most likely cause for the respiratory distress is
A. Pneumonia
B. Respiratory distress syndrome
C. Hyperviscosity syndrome
D. Diaphragmatic paralysis
31. Premature infants are prone to apnea. The main reason is
A. Preterm infants have more quiet sleep than REM sleep
B. Hering-Breuer deflation reflex is more prominent during REM sleep
C. Preterm infants have blunted response to CO2
D. Supplemental oxygen may be helpful is decreasing apneic episodes
32. Positive Wright stain for neutrophils with negative Gram stain is
suggestive of
A. Benign pustular melonosis
B. Erythema toxicum
C. Milia
D. Staphylococcal scalded skin syndrome

E. Bullous impetigo

33. Maternal serum alpha-fetoprotein (MSAFP)

A. Get access to mother via feto-maternal hemorrhage
B. Is most sensitive when measured during 16-18 wks of gestation
C. Correlates directly with fetal AFP at any gestational age
 D. Correlates inversely with amniotic AFP at any gestation gestational
age
34. A preterm baby is NPO and receiving IVF via PIV. The labs are : Na
135, Cl 99, HCO3 21, glucose 90, BUN 14, creatinine 0.3 and serum
osmolality is 280. The IV came out and it took 2 hrs to get the IV and
restart the fluids. The Na now is 140, glucose is 50 and BUN is 24. His
new serum osmolality would be
A. Increased
B. Decreased
C. Remain unchanged
D. Cannot asses with the data
35. A 6 day-old preterm infant is noted to have bilateral eye discharge.
The conjunctiva looks hyperemic with some yellow discharge. The gram
stain of the discharge is negative. The most appropriate management is
A. Oral erythromycin
B. Saline wash q 4-6 hr
C. IV ceftriaxone
D. Massage on inner canthus

36.Which one of the following is not used in rapid assessment of

gestational age after birth
a. Ear lobe
b. Breast nodule
c. Scalp hair
 d. Skin

37.Which of the following is true about hip dislocation test

a. Ortolani test uses adduction and mild pressure directing posteriorly

b. Ortolani test uses abduction and mild pressure directing anteriorly
c. Ortolani test is used to dislocate the reduced head of femur
d. B///////////////////////////////////////////////////////////////////////////////////////////////////////
arlow test is used to reduce the dislocated head of femur

38.If meconium stained like fluid is reported in <34wks of gestation, all of the
following is true except

a. The fetus is growth restricted term infant

b. The fluid may acutually be purulent considering pseudomonas and
listeria
c. The fluid may actually be bile stained
d. The fluid may suggest no pathology

39. The preferred route for rapid drug administration in delivery room during
resuscitation is

a. Umbilical vein
b. Endotracheal tube
c. Peripheral vein
d. Intraosseous

40. Normal rectal temperature of a neonate is

a. 36.0-36.5
b. 36.5-37.5
c. 37.0-37.5
 d. 35.5-36.5

41. AAP and AHA states that

a. If there is no HR after 20 mins of adequate resuscitation efforts

discontinuation of resuscitation efforts may be appropriate
b. If there is no HR after 10 mins of adequate resuscitation efforts
discontinuation of resuscitation efforts may be appropriate
c. If there is no HR after 30 mins of adequate resuscitation efforts
discontinuation of resuscitation efforts may be appropriate
d. If there is no HR after 15 mins of adequate resuscitation efforts
discontinuation of resuscitation efforts may be appropriate

42.Currently, maximum subsequent dosing of surfactant is

a. Once
b. Twice
c. Thrice
d. Four times

43.Preterm infant kidney is less able to concentrate urine due to all except

a. An anatomically shorter loop of Henle

b. Distal tubular system that is less responsive to ADH
c. Relatively high interstitial urea concentration
d. Collecting system that is less responsive to ADH

44.HMF fortification for all preterm VLBW infants needs to be continued till

a. The infant reaches 40wks or attains 2kg (whichever is later)

b. The infant reaches 37wks or attains 2kg (whichever is later)
c. The infant reaches 42wks or attains 2 kg (whichever is later)
d. The infant reaches 38wks or attains 2 kg (whichever is later)
e.
45. AAP recommends that routine cranial USG be performed on all infants
<30wks gestation

a. At 7-14 days of age and then between 36-40wks postmenstrual age

b. At 7-14 days of age and then between 34-36wks postmenstrual age
c. At 7-14 days of age and then between 40-44wks postmenstrual age
46.At 7-14 days of age and then between 32-34wks postmenstrual age

47.Recurrence of NEC is about

a. 1%
b. 3%
c. 5%
d. 2%

48.What histopathological finding helps in differentiation of NEC from SIP

A. Intact submucosa
B.
C. Intact mucosa
D. Necrosis
E. Overgrowth of submucosa

49.All of the following cases can have absence of gas in the abdomen except

A. Esophageal atresia

B. Patients on muscle paralyzing agents

C. Patients with severe cerebral anoxia resulting in cerebral depression

D. Esophageal atresia with TOF

50.Which of the following is not a pain assessment scale

A.PIPP

B.NIPS
 C.N-PASS

D.NPAI

1. Thermoregulation in newborn
2. Indications of surgery in NEC
3. Approach towards bleeding neonate
4. Discuss the pathogenesis and management of HIE
5. Management septic shock in a neonate
6. Therapeutic approach for management of apnea of prematurity
7. Evaluation and treatment of HIV exposed young infant
8. Management of perinatal varicella-zoster infection
9. Approach to a baby with hyperinsulinemic hypoglycaemia

10. Development and maturation of nervous system, cerebral blood

flow, blood brain barrier.