Newborn Emergencies

  1. A 10-day old male presents with bilious emesis. What is the most likely

    1. Appendicitis

    2. Pyloric stenosis

    3. Malrotation with midgut volvulus

    4. Feeding intolerance

  2. A 2-week-old-male presents with lethargy and vomiting. His electrolytes
    reveal sodium of 121 meq/L, potassium of 7.0-meq/l and blood glucose of 40
    mg/dl. What is the most likely diagnosis?

    1. Dehydration

    2. Congenital adrenal hyperplasia

    3. Inborn error of metabolism

    4. Pyloric stenosis

  3. The drug of choice for treating a newborn with presumed ductal-dependant
    cyanotic congenital heart disease is:

    1. Morphine

    2. Dobutamine

    3. Prostaglandin E1

    4. Indomethacin

  4. How should a neonate with lethargy and a blood sugar of 20mg/dl be

    1. Oral feeds with apple juice

    2. 25% dextrose solution

    3. 10% dextrose solution

    4. 50% dextrose solution

  5. A 2-day-old female presents with abdominal distension and vomiting. She
    has not yet passed a meconium stool. What is the most likely diagnosis?

    1. Hirschsprung Disease

    2. Malrotation with midgut volvulus

    3. Necrotizing enterocolitis

    4. Constipation

  6. A 3-week-old female presents with persistent seizures despite aggressive
    management with benzodiazepines and phenobarbital. The mother reports giving
    her daughter some water to “stop her from getting dehydrated.” What is the
    most likely cause of her status epilepticus?

    1. Hypoglycemia

    2. Diabetes insipidus

    3. Hyponatremia

    4. Hypokalemia

  7. A 1-week-old male presents with some mild erythema around his umbilicus
    extending onto the abdominal wall. Which of the following is the correct
    management for this patient?

    1. Reassurance and continue with alcohol wipes of umbilicus

    2. Topical antibiotic ointment and recheck the patient the next day

    3. Discharge on cephalexin and recheck the next day

    4. Perform a full septic workup and admit the patient

  8. A 5-day old, well-appearing male is brought to the ED by his mother today
    because she noted that he has a cluster of vesicles on his scalp. Which of the
    following should be the management approach?

    1. Skin biopsy

    2. IV acyclovir and a full septic workup

    3. Oral acyclovir

    4. Discharge, with next day follow up

  9. Which of the following heart rates is most suggestive of supraventricular
    tachycardia in a newborn?

    1. 180 BPM

    2. 230 BPM

    3. 150 BPM

    4. 210 BPM

  10. Vaginal bleeding in a 3-day-old female is:

    1. Is always indicative of child abuse

    2. May be due to withdrawal of maternal hormones

    3. Is suspicious for gonorrhea

    4. Is most commonly due to a vaginal foreign body-such as baby wipes

  11. A 3-week old male presenting to the emergency department with vomiting and
    altered mental status and acidosis. What additional laboratory test should be
    included in your evaluation?

    1. Ammonia level

    2. Cortisol level

    3. Serum acetone

    4. Thyroid function test

  12. Which of the following are causes of shock in the newborn?

    1. Infection

    2. Inborn errors of metabolism

    3. Child abuse

    4. Thyrotoxicosis

    5. All of the above



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