PAEDIATRICS PRACTICE 9

                             SINGLE BEST OPTION SERIES
         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.        Clinical staging of hypoxic-ischaemic encephalopathy is done using:
   a.       Sarnat grading scale
   b.      Apgar score
   c.       Bishop score
   d.      Melbourne classification
   e.      Prechtl and Bailey scale
   2.       Which of the following is incorrect about hypoxic-ischaemic encephalopathy?
   a.       Uptake of excitatory neurotransmitter(glutamate) is impaired in the brain
   b.      There is excitatory amino acid receptor(including the N-methyl-D-Aspartate receptor) over activation
   c.        There is Na+/K+ ATPase over activity.
   d.      There is intracellular calcium activation
   e.      Allopurinol and opioids have been found to be neuroprotective inpatients with this disorder.
   3.       Which of the following is not a feature of grade 1 (mild) hypoxic-ischaemic encephalopathy:
   a.       Hyper alert
   b.      Seizures
   c.       Dilated, reactive pupils
   d.      Normal or increased tone
   e.      Regular respiration.
   4.       The most common cause of seizure in the neonatal period is:
   a.       Neonatal tetanus
   b.      Neonatal meningitis
   c.       Hypoxic-ischaemic encephalopathy
   d.      Congenital pneumonia
   e.      Rupture of the great cerebral vein
   5.       Features seen in a neonate with hypoxic-ischaemic encephalopathy does not usually include:
   a.       Generalized seizures
   b.      Seizures that is difficult to control with anti-convulsants.
   c.       Failure of Moro and tonic neck reflexes to habituate
   d.      Mydriasis in mild hypoxic-ischaemic brain damage
   e.      Cortical thumb
   6.       Which of the following is a usual treatment option for hypoxic-ischaemic brain damage:
   a.       Ventilatory support.
   b.      Hyperthermia
   c.       Exchange blood transfusion
   d.      Electroconvulsive therapy.
   e.      None of the above
   7.       Which of the following criterion is most consistent with the diagnosis of mild hypoxic-ischaemic encephalopathy:
   a.       Absence of seizures
   b.      Low APGAR score
   c.       Hypotonia
   d.      Proximal muscle weakness
   e.      Obtunded state of consciousness
   8.       The most useful and practical test for determining the prognosis of hypoxic-ischaemic encephalopathy is:
   a.       Cranial CT-SCAN
   b.      MRI
   c.       EEG
   d.      Somatosensory evoked potentials
   e.      Cranial ultrasound.
   9.       The criteria to use hypothermia in the management of hypoxic ischaemic encephalopathy does not include:
   a.       Newborn of greater than 35 weeks gestation or more
   b.      The cooling must be started within 6 hours of birth
   c.       Umbilical cord or arterial P^H of less than 7 or base deficit of greater than or equal to 12 within 60 minutes of birth
   d.      Apgar score of 3 or less.
   e.      The newborn should have acrocyanosis
   10.   The following are causes of hypoxic ischaemic encephalopathy except:
   a.       Asphyxiation
   b.      Umbilical cord prolapsed
   c.       Uterine rupture
   d.      Fetomaternal haemorrhage
   e.      None of the above.
   
   
   
   
   
   
   
   
   
   
   ANSWERS:
   1. a
   2. c
   3. b
   4. c
   5. a
   6. a
   7. a
   8. b
   9. e
   10. e
   
   
   
   

                                           REMEMBER
   ” Some people sin by not working diligently for six days whereas, others – because of greed, unbelief or powerlessness- sin by working also on a day of rest and worship. Either way of breaking this   command results in poverty.”   By  Vishal Mangalwadi.