Neonatology – Set 1

What this deck covers

Neonatology – Set 1 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. Limp newborn at one minute
2. Waiting for the one-minute number?
3. Pustules from birth, brown spots
4. Wet newborn, main route of loss
5. Term newborn, starting gas mix
6. Blue and gasping at one minute
7. No chest rise after mask breaths
8. White cysts on a newborn palate
9. Cool baby after a home birth
10. Slow heart, acid cord gas
11. Drowsy after a cord prolapse
12. Lighter on day 3 than at birth
13. Mouth and nose at the perineum
14. Diamorphine an hour before birth
15. What the Apgar counts
16. Cord still on at 5 weeks
17. Preterm girl, heart rate 40
18. Too cold for the ward device
19. Parents ask about the cord gas
20. Right-wrist probe reads 70%
21. Blotchy rash on day 2
22. Newborn seizure on her first day
23. Umbilical line in, slow heart
24. Slow pulse after a roadside birth
25. Blue marks on the lower back
26. Proving where the tube lies
27. Floppy baby after green liquor
28. Second Apgar still below 7
29. Hot baby with a red navel
30. Where a cold newborn’s heat is made
31. Day 2 with little urine
32. Lungs inflating, pulse still 40
33. Grandmother’s surgical spirit
34. Still slow after adrenaline
35. Were both cord vessels sampled?
36. Late cord separation, dry abscess
37. Cold house, sleepy five-day-old
38. Freckle-like marks ringed with scale
39. Crying at birth through green liquor
40. Slow sinus rhythm at 30 hours
41. No heartbeat twenty minutes on
42. Firm white lumps on the gum ridge
43. Two weeks on dialysis
44. Pale after a retroplacental clot
45. Keeping a newborn warm at delivery
46. Navel still moist at 4 weeks
47. Parents ask about the future
48. Chest moving, no own breathing yet
49. Chest will not rise, mouth green
50. Watching an infected navel

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Chest compressions at a ratio of 3:1, Convection to the draught, Adrenaline 100 micrograms/kg via a tube, Sodium bicarbonate 4.2% intravenously, It is advised only if the fetal trace is abnormal, X-linked chronic granulomatous disease, Base deficit of 5 or more on its own, Cooling to 32 °C for 48 hours, starting by 6 hours, Refer for laser treatment now, None after the 5-minute score, Renal vein thrombosis, Switch to the tracheal route only, Skin-to-skin contact on his mother alone, Rewarm her to 36.5 °C straight away.

Clinical pearls from this deck

• Not breathing after drying: airway, five inflation breaths, then look at the heart rate.
• Resuscitate the baby, not the Apgar score.
• Pustules at birth that leave brown spots: pustular melanosis, reassure.
• First minutes of life: dry the baby, remove the wet towel, cover the head.
• Term baby at birth: breathe for him in air, then follow the saturations.
• Blue all over scores 0; each sign that is only half-present scores 1.

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.