Neonatology Prometric Style Questions – 50 Cases with Answers

What this deck covers

Neonatology Prometric Style Questions 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. Meconium and a floppy baby
2. Adding up at one minute
3. Rate still fifty after thirty seconds
4. How long before the cord is cut
5. Ground glass at twenty-eight weeks
6. Pink froth in the tube
7. Fluid in the fissure after a section
8. A scaphoid abdomen at birth
9. Before he is moved
10. The tube that would not pass
11. Yellow before a day old
12. Still yellow at three weeks
13. Arching with a shrill cry
14. Grunting two hours after birth
15. Yellow and unwell at a week
16. Feeding after the injections
17. Cold after a home delivery
18. Flat at birth after an abruption
19. Where the preterm brain gives way
20. Blood in the ventricles at day four
21. Distended at twelve days
22. A silent risk to the eyes
23. Pauses at five days
24. Who needs the heel pricks
25. A lump that stops at the suture
26. Boggy swelling that crosses everything
27. A limp arm after a hard shoulder
28. A clunking hip in a breech girl
29. Jittery at a day and a half
30. Bowel outside with no covering
31. Protecting what is outside
32. Two bubbles and no gas beyond
33. Green vomit on day three
34. No meconium and an explosive gush
35. How the blue light helps
36. Two probes before discharge
37. One eye that does not glow
38. Failing the screen twice
39. Pus from both eyes on day two
40. A red ring around the cord
41. One that cannot be felt
42. A dimple with a hairy patch
43. Bounding pulses at six days
44. Still in oxygen at term
45. Sudden collapse on the ventilator
46. Soap bubbles and a tiny colon
47. No opening where it should be
48. Falling centiles on mother’s milk
49. Low and jittery at four hours
50. Keeping the smallest ones warm

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Intubate and suction the trachea under direct vision, Clamp immediately to allow assessment, Respiratory distress syndrome, Congenital diaphragmatic hernia, Intensive phototherapy alone, Avoid breastfeeding entirely because of the risk, Basal ganglia and thalamic injury, Congenital cataract, Caput succedaneum, Ultrasound of the hips and orthopaedic referral, Wrap the bowel in clingfilm and give fluids, Meconium ileus, Refer urgently to ophthalmology, Topical antiseptic and review in two days.

Clinical pearls from this deck

• In the newborn, almost every problem is solved by inflating the lungs. Anything that delays that, however traditional, is doing harm.
• Nobody has ever been resuscitated by an Apgar score. Assess the heart rate, the breathing and the tone, and act on those.
• Before you start compressions, prove the chest is moving. Compressions without inflation pump deoxygenated blood around a dying baby.
• The minute costs nothing and buys iron for six months. Reserve immediate clamping for the baby who genuinely cannot wait.
• Congenital pneumonia can look exactly like this on the film. Take cultures and cover with antibiotics in every preterm baby you treat for surfactant deficiency.
• Listen for a continuous murmur after surfactant. The duct that was silent while the lungs were stiff becomes loud once they are compliant.

This deck is open to everyone with no sign-in. Work through it once for recognition, then again a week later to test yourself.

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