SOAL-SOAL PERINATOLOGI

TAHAP JUNIOR

PART I.

1. The following definitions are correct…(E)1. Birth weight below the 3rd centile for the chronological age is known as low

birth weight2. Post term applies when a baby is born after 43 weeks3. A head circumference < 10th centile is microcephalic4. A premature baby is one born before 37 weeks gestation

2. The following signs may indicate infection in the neonatal period..(A)1. Increased jitteriness 3. Erratic temperature control2. Quiet, subdued infant 4. Alkalosis

3. Causes of jaundice within the first 24 hours include(B)..1. Severe rhesus incompatibility 3. Congenital infection2. Congenital hypothyroidism 4. Large cephal hematoma

4. Phototherapy for the treatment of jaundice …:(E)1. Is required for most cases of physiological jaundice2. May increase the risk of loose stools3. Uses ultra violet light4. May result in excess fluid loss

5. The onset of respiratory efforts may be delayed after birth due to….(B)1. Extreme prematurity 3. Peripartum asphyxia2. Maternal analgesia 4. Anemia

6. Oxygen treatment may be associated with the following complications and practical problems…(E)

1. Retinopathy2. High concentrations of oxygen may damage the lung3. 100 per cent oxygen may damage the brain4. 100 per cent oxygen may result in atelectasis

7. The etiology of neonatal convulsions includes…(A)1. Hypernatremia 3. Drug withdrawal2. Hypoxic ischaemic encephalopathy 4. Hypercalcemia

Benefits of breast feeding for infant include……

8. Meningkatkan imunitas atau daya tahan tubuh9. Mempererat ikatan batin antara ibu dan anak10. Mengandung kolustrum baik untuk perkembangan otak

SOAL-SOAL PERINATOLOGI

TAHAP MADYA

PART I.

1. The following conditions can result in kern icterus..1. Biliary atresia 3. Hypothyroidism2. ABO incompatibility 4. Rhesus incompatibility

2. A full septic screen is indicated in a neonate with..1. Increasing oxygen requirements2. Hypoglycemia of prematurity3. An unexplained pneumothorax4. The commencement of total parenteral nutrition

3. Pneumothorax is a common complication in the following…1. Premature babies with HMD2. Excessive positive pressure ventilation3. Term babies with meconium aspiration4. Infants with congenital infection

4. Respiratory distress of the newborn due to hyaline membrane disease…1. Does not occur in term babies2. Is more likely in asphyxiated infants3. Can be distinguished from TTN by grunting, recession & tachypnoea which

only commences after 4 hours of age4. Babies with RDS are inactive and have reduced bowel actions

5. Meconium aspiration syndrome… 1. Air trapping is a major problem associated with this condition2. Predisposes to secondary bacterial pneumonia3. The infant’s oropharynx should be aspirated as soon as complete delivery4. Is more common in premature infants

6. Cross infection in neonatal units…1. Has no bearing on the number of patients on the unit2. Face mask should be worn by all visitors3. Mother who breastfeeds their baby should wear face mask4. Hand washing is the best preventative measure

7. In neonatal meningitis…1. A bulging fontanelle is a characteristic sign2. A raised white cell count in the cerebrospinal fluid is always indicative of

meningitis3. A ratio of white:red cells of 1:500 is a consistent finding 4. Obstructive hydrocephalus may be an early and late complication

8. NEC usually involves…1. The terminal ileum2. Infants who have been fed3. Dilated loops of bowel with thickened walls, intramural gas and gas within the

portal vein4. Abdominal distention with an ileus

9. The etiology of neonatal convulsions includes…1. HIE 3. Hypernatremia2. Drug withdrawal 4. Hypercalcemia

10.Periventricular hemorrhage in neonates…1. Is a complication particularly in VLBW2. Usually arises within the first 3 days of life3. Is graded according to the amount of bleeding and the extent of ventricular

distention4. A clotting abnormality is almost always a contributing factor

PART II.

1. Initial assessment performed within a few seconds for every newborn are:A. Is the amniotic fluid clear of meconium?B. Is the breathing or cryng?C. Is there good muscle tone?D. Is the color pink?

2. Initial steps of resuscitation are:A. Provide a warm environmentB. Open the airway by positioning the newbornC. Clear the airwayD. …………….

3. How could you determine heart rate during resuscitation?4. Heart rate for the newborn baby should be…………….

Heart rate could be determined quickly and easily by:

5. ………………………6. ……………………….7. Acceptable methods for administrating free flow oxygen are:

A. Mask from the flow inflating bag held closely over the baby’s mouth and nose

B. Oxygen mask held firmly over the baby’s faceC. …………

Indication for positive pressure ventilation are:

8. ………………………9. ………………………10.………………………

Indication to perform endotracheal intubation are:

11.………………………..12.………………………...13.…………………………

No need to perform resuscitation in a certain condition of the baby, such as:

14.……………….15.……………….

PART III.

1. A 4 hour-old, 32 weeks gestational age male baby who was noted to have cyanosis, tachypneu, minimal retraction, grunting, and decrease air entry on arrival in the special care nursery. The infant was born by an elective cesarean delivery. The mother is diabetic. Apgar score 7 and 9 at 1 and 5 minutes, respectively.

a. The main possible diagnosis for the baby?b. What are the risk factors in this case?c. How could you determine the severity of the illness in this baby?d. What kinds of the important initial work up?

1. …………………………….2. …………………………….3. …………………………….4. …………………………….5. …………………………….

e. Preventive actions before delivery?

2. A 3 days old baby , 34 weeks of gestation, BW 2000 gram, RDS, Kramer 5 jaundice, electrolite Na : 142 K : 4, Ca: 10. There are no sucking and swallowing reflexes. There is no complaint about micturation. Planning for Total Parenteral Nutrition:

a. Total fluid requirement ………………………… ……….ml/kg/day

b. Other factors that have to take into account:

1. ……………….....

2. …………………..

c.Total fluid requirement after other factors have been taken into account: ..............ml

d. 5% amino acid : ........................................................................................ ml

e. 20% lipid :......................................................................................... ml

f. 3% NaCl :..........................................................................................ml

g. Potassium :..........................................................................................ml

h. Ca :..........................................................................................ml

i. Total 10% Dextrose :...... .................... ............................................................ml

j. GIR ;.........................................................................................mg/kg/min

k. Fluid infusion rate : ........................................................................................ml/jam

l. Lipid infusion rate :.........................................................................................ml/jam