Deck 45: The Newborn

Question 1

Which tests will identify both neonatal primary and secondary hypothyroidism?

A)TSH
B)free T4
C)total T3
D)total T4

Answer 1

free T4

Question 2

Given that there is no common standard for maximum blood-collection volume for newborns, which of the following is an appropriate guideline for newborns under 7 kg of body weight?

A)Single collections should be under 0.1 mL/kg body weight.
B)Single collections should be under 1.0 mL/kg body weight.
C)Single collections should be under 5.0 mL/kg body weight.
D)Single collections should be under 10.0 mL/kg body weight.

Answer 2

Single collections should be under 1.0 mL/kg body weight.

Question 3

At 36 weeks gestation, fetal hemoglobin accounts for about ______ of total hemoglobin in the fetus; approaching term, the percentage of HbF is approximately ______ of total hemoglobin.

A)90%, 70%
B)70%, 90%
C)50%, 60%
D)60%, 50%

Answer 3

90%, 70%

Question 4

Hyperkalemia in the neonate may result from which of the following situations?

A)physiological anemia
B)physiological jaundice
C)impaired renal excretion
D)all of the above

Question 5

Which of the following are the most common respiratory problems in premature neonates?
1)meconium aspiration syndrome
2)persistent pulmonary hypertension
3)respiratory distress syndrome
4)apnea of prematurity

A)1, 2
B)2, 3
C)3, 4
D)1, 4

Question 6

Which laboratory test has been recognized as an early sensitive marker of sepsis in neonates?

A)high-sensitivity C-reactive protein
B)pro-calcitonin
C)serum amyloid A protein
D)hypoglycemia

Question 7

Which of the following Apgar scores for a neonate would be indicative of the need for immediate resuscitation?

A)7
B)5
C)4
D)2

Question 8

A newborn is 3 days old, weighs 6 pounds, and has failed to pass meconium.Which of the following tests should be performed and under what conditions?

A)Immediately perform a sweat test for cystic fibrosis.
B)Immediately perform a blood culture for infection.
C)Perform a blood culture when the newborn is 10 days old.
D)Perform a sweat test when the newborn is 14 days old and weighs 6.8 pounds.

Question 9

The amplitude of a postnatal ADH surge reflects birth-related factors such as:
1)C-section delivery
2)vaginal delivery
3)hypoxia
4)increased intracranial pressure

A)1, 2, 4
B)1, 3, 4
C)2, 3, 4
D)3, 4

Question 10

Maturation of the renal system normally occurs during which stage(s) of fetal development?

A)first trimester
B)second trimester
C)third trimester
D)both b and c

Question 11

A postnatal rise in TRH induces a(n) ______ in blood TSH levels and a(n) ______ in blood T₄ levels as the fetus transitions from the in-utero environment to the postnatal delivery-room environment.

A)increase, decrease
B)increase, increase
C)decrease, increase
D)decrease, decrease

Question 12

Which of the following are potential problems with the use of whole blood for laboratory analyses?
1)the presence of undetected hemolysis in a whole-blood sample
2)the continuation of glycolysis after whole-blood collection
3)the interference of the anticoagulant with the laboratory analysis of analytes in whole blood

A)1, 2, 3
B)1, 2
C)2, 3
D)1, 3

Question 13

Which of the following series of hormones have low or undetectable blood levels in the newborn and have no known role in normal neonatal physiology?

A)prolactin, FSH, and LH
B)insulin and cortisol
C)growth hormone and ACTH
D)TRH, TSH, T₄

Question 14

Late (>72 hours) neonatal hypocalcemia arises from which of the following?
1)neonatal hypoparathyroidism
2)high phosphate intake
3)phototherapy
4)hypoalbuminemia

A)1, 2, 3
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 15

Which of the following begin to accumulate in the developing fetus during the third trimester of pregnancy?
1)calcium
2)phosphate
3)glucose
4)iron

A)1, 2, 3, 4
B)1, 2, 3
C)1, 2, 4
D)2, 3, 4

Question 16

Which of the following tests have reference intervals that are lower in the newborn than in the adult?
1)vitamin
2)protein
3)trace elements
4)inflammation markers

A)1, 2, 3, 4
B)1, 2, 3
C)1, 3, 4
D)2, 3, 4

Question 17

Which of the following biochemical compounds in neonatal CSF parallels that of the serum concentration?
1)glucose
2)bilirubin
3)lactate
4)protein

A)1, 2, 3, 4
B)1, 2, 3
C)1, 2, 4
D)1, 3, 4

Question 18

Following an initial increase in red blood cell counts following birth, a physiological anemia is seen in newborns for the first 6 to 10 weeks of life.Which of the following may be responsible for this physiological anemia?

A)shortened fetal red blood cell life
B)increased destruction of fetal red blood cells
C)reduced production of erythropoietin
D)both a and c