Neonatology – Set 6

What this deck covers

Neonatology – Set 6 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Grunting at 4 hours, febrile mother
2. Day 16 with a long line and apnoeas
3. Positive maternal screen, untreated
4. Floppy and grey on day 6
5. Were the labour antibiotics enough?
6. Maternal HIV found during labour
7. Small baby, petechiae, big liver
8. Reading the spinal fluid result
9. What the sepsis risk tool asks for
10. Shrill cry and a bulging fontanelle
11. Pauses in breathing at 8 hours old
12. Feeding plan in a metabolic crisis
13. Day-11 seizures and scalp vesicles
14. When to reach for the broadest drug
15. Nine hours old and breathing fast
16. How the exposed baby is checked
17. Sleepy on day 4 with deep breathing
18. Unsettled extreme preterm on day 24
19. Proving the timing of an infection
20. The sample before the first dose
21. Pus pouring from both eyes on day 3
22. Ten-day-old with a tense fontanelle
23. A mother who never had chickenpox
24. Mottled preterm, gas at 10 hours
25. A normal marker six hours in
26. Cold to the knees, thready pulses
27. Whose antibodies are these?
28. Timing the spinal tap in a sick baby
29. Planning aminoglycoside monitoring
30. Heavier, puffy and passing little
31. Week-old with fever and blisters
32. Diplococci in the eye discharge
33. Ammonia still climbing after 4 hours
34. Protecting a baby on central access
35. A call from the laboratory at 16 hours
36. Two maternal viruses and a feed plan
37. What the years ahead will involve
38. Cultures still positive on day 4
39. Low sugar in a collapsed 5-day-old
40. Positive blood, clear spinal fluid
41. Positive urine PCR, both ears failed
42. Still febrile, sutures separating
43. Why a second drug joins the first
44. Hard to rouse at 60 hours
45. After the intravenous course ends
46. Well at a day and a half
47. Cracked nipples and a maternal virus
48. Well baby, mother’s smear positive
49. Going home after the antibiotic course
50. Temporal lobe change on day 16

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Routine postnatal care with safety-net advice, Stop feeds and await a metabolic specialist view, Congenital toxoplasmosis, Benzylpenicillin with gentamicin, Neonatal herpes simplex encephalitis, An HIV antibody test at 6 weeks of age, Urine PCR at 6 to 8 weeks of age, Group B streptococcus, It points to a fungal cause, Before antibiotics, however unwell she is, PCR on CSF, blood and vesicle swab, Aseptic care bundles for the line, One hearing test at 1 year, then discharge, 7 days.

Clinical pearls from this deck

• Two or more ordinary features, or any red flag: treat within the hour.
• A line, lipid and a small baby: think of the skin organism first.
• Snuffles plus a rash on the palms and soles: test and treat the baby for syphilis.
• A collapsed newborn gets antibiotics first and a metabolic screen at the same time.
• Four hours of a beta-lactam before birth; anything shorter counts as none.
• Untreated maternal HIV found in labour: three drugs for the baby within 4 hours.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all neonatology case decks · pediatric reference values.