Neonatology – Prometric Style Questions, Set 2

What this deck covers

Neonatology – Prometric Style Questions, Set 2 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 board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Losing weight on day four
2. While her milk comes in
3. Bruised on day six
4. Yellow on the drip
5. Ready to try the breast
6. Spots that move overnight
7. A stain above the eye
8. Blisters wherever he is touched
9. Growing since he was born
10. Missing skin on the scalp
11. Before the heel prick
12. Afraid to hold him
13. Too bright and too loud
14. Before the tube goes in
15. Time with their baby
16. How cold and for how long
17. Cysts on the scan at four weeks
18. Floppy but wide awake
19. Are those fits or not
20. Focal fits in a well baby
21. Jittery at thirty-six hours
22. Epilepsy drugs and a planned pregnancy
23. The features and what follows
24. Unsettled on day one
25. Fast heart at eight days
26. Rising salt on day three
27. No wet nappy yet
28. Alkalotic on the lung unit
29. A lump and blood in the urine
30. Watching the preterm skeleton
31. Counselling at the edge of viability
32. Into the bag, straight from birth
33. White at birth after an abruption
34. Ten minutes with no output
35. How much oxygen at the start
36. Judging milestones in a preterm baby
37. What happens after discharge
38. Vaccines while still an inpatient
39. Getting through the first winter
40. What will he be like
41. While the retrieval team travels
42. Move her or move him
43. Crashing on the motorway
44. Leaving the mother behind
45. Low sugar before the journey
46. A lump where the cord was
47. Breast swelling in a newborn girl
48. One foot corrects and one does not
49. Born with teeth
50. Where the baby sleeps at home

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Reassure, as some weight loss is normal, Stopping all lipid administration permanently, Laser treatment in the first weeks, Underlying defect and associated anomalies, Sedate him to reduce his response to handling, Cooling to 30 degrees for 24 hours, Serial cranial ultrasound scans, Stop the drug as soon as pregnancy is confirmed, Neonatal thyrotoxicosis, Pyloric stenosis, That resuscitation is mandatory at this gestation, Continue for a further 30 minutes, Discharge to the general practitioner alone, That he will certainly develop normally.

Clinical pearls from this deck

• Watch a whole feed before advising anything. Painful for her almost always means badly attached, and that is fixable in ten minutes.
• Donor milk is a bridge, not a destination. Everything on the unit should be pointed at getting her own supply going.
• When parents decline it, name the late bleed into the brain at six weeks. That is the risk they are actually deciding about.
• The gut needs something in it. Small feeds do more for this liver than any drug you can add to the bag.
• Follow the baby, not the clock. Forcing a bottle on a preterm infant who is not ready creates an aversion that lasts months.
• Ask whether the spots are in the same places as yesterday. A rash that moves overnight in a well baby is this and nothing else.

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.