Pediatrics Recalls By Subject – Newborn

A 36-hour-old newborn girl, delivered at home, is brought to the hospital due to multiple seizures. Serum glucose is normal, PT, PTT are prolonged, and a CT scan reveals a focal brain bleed.

Which of the following is the most likely cause of this newborn’s bleeding?

A 4-month-old girl, until now has been exclusively breastfed, is brought for examination due to bloody stools. On examination – gaining weight well, vital, soft abdomen, no signs of anal fissure. Stool PCR negative for enteropathogens. The mother indicates that for the past few weeks, she has been fed infant formula.

What is the most recommended treatment in this case?

Which of the following is typical of a newborn to a mother with gestational diabetes?

A 10-day-old male was referred for investigation due to refusal to eat, multiple emesis events, and lack of weight gain. On examination – micropenis, no testicles palpated in the scrotum. Which of the following laboratory findings is typical of the presumed diagnosis of the baby?

A premature neonate was born at week 29, now week 32. Fed with infant formula in amounts suitable for his weight. On examination he is panting and grunting, pale, and his abdomen is swollen and tender, bloody stools.

What is the next step in the management of this case?

A 2-month-old infant is evaluated for apathy and poor feeding. On examination – tachycardia and mild extremity tremor. Labs – glucose 35 mg/dl, urinary ketones negative.

Which of the following is the most likely diagnosis?

A 6-weeks-old male infant with a history of normal pregnancy and delivery, presents with vomiting after each meal, restlessness and failure to gain weight over the last few days. A photo of physical examination findings is below

Which of the following is the most appropriate treatment?

A 9-months old infant was born at a weight of 3000 gr, and now weighs 6000 gr. He has been admitted due to his second episode of pneumonia. Examination is positive for cervical lymphadenopathy and hepatosplenomegaly. Blood work is presented in the table 

Which of the following test will most likely promote the diagnosis?

A 3-week-old breast fed newborn, born at term following a normal pregnancy and delivery presents with a few days of increasing vomiting, failure to gain weight and restlessness.

Below is an abdominal ultrasound

.

Which of the following are the most likely laboratory results?

A 5-year-old presents with fever, nuchal pain, apathy, and repeated vomiting beginning on the day of admission. Examination reveals temperature of 39oC, heart rate of 50 bpm, blood pressure of 150/90 mmHg, room air saturation 97%, and compromised consciousness.

Which of the following is the most appropriate management in this case?

A 2-week-old newborn presents with respiratory distress and cyanosis appearing after birth. The mother describes respiratory distress and cyanosis at rest, which improve when the baby is crying. In addition, she describes slow nursing due to respiratory distress.

Which of the following tests will promote the diagnosis?

Newborn screening of a week-old newborn revealed total T4<2 mcg/dl (normal value >10 mcg/dl). The parents are healthy and not related. Examination reveals an umbilical hernia, a large fontanelle, and no goiter.

Which of the following is the most likely cause of this condition?

A term newborn exhibits profound cyanosis shortly after birth. Echocardiograph reveals the aorta attached to the right ventricle, and the pulmonary artery to the left ventricle.

Which of the following is the most appropriate initial treatment?

During an examination of a 1-month-old baby, you notice asymmetrical hip folds, and positive Ortolani and Barlow maneuvers.

Which of the following is the test of choice to determine the most likely diagnosis?

A 3-day-old newborn presents with apathy, vomiting, and reduced feeding.

Examination is positive for signs of dehydration, micropenis, and testicular hyperpigmentation.

Laboratory results reveal hyponatremia and hyperkalemia.

Which of the following is typical of the newborn’s most likely diagnosis?

An infant’s neurological exam is positive for the finding in the photo

Which of the following is true?

On routine examination of a 1-month old infant, you notice asymmetrical lower limb folds. Barlow and Ortolani tests are positive.

Which of the following is a risk factor of this condition?

Routine newborn examination reveals the finding in the photo below. Karyotype is found to be XX.

Which of the following is the most likely etiology of this condition? 

A 3-months-old infant presents with stridor, episodes of spitting up and vomiting, with arching of the back and neck. The mother reports the stridor is improved while arching. Thickening of the feeds was unhelpful.

Which of the following tests is most appropriate for the most likely diagnosis?

All of the following reflexes are seen in a normal newborn, except:

A 13-day-old newborn presents with a rectal temperature of 38.3ºC. She is feeding well, with no vomiting, and has normal bowel movements. Physical examination is normal.

Which of the following is the most recommended workup?

A 5-week-old baby, born following a normal pregnancy and delivery, had not had significant postnatal hyperbilirubinemia, and has not been treated with antibiotics or hospitalized. The baby presents with a fever of 38.5°C, and is generally well, with a normal physical examination.

Which of the following will support low risk of a serious bacterial infection?

A 4-week-old infant is evaluated for projectile vomiting without bile content for the past 24 hours. The infant is in no distress, wants to eat, but vomits right after. He has passed a normal bowel movement about 4 hours prior to admission.
Abdominal ultrasound demonstrates the finding in the photo below.

Which of the following is the definitive treatment for the most likely diagnosis?

3-days-old newborn has not passed stools and is evaluated due to distended abdomen and vomiting. Below is his abdominal X-ray.

Which of the following is the most likely diagnosis?

A 2-month-old infant is examined due to an abnormal red reflex test at birth. The parents report he is developing well. His examination is attached in the photo

Which of the following may explain his finding?

 A 1-week-old newborn’s examination reveals the skin finding in the photo.

Follow-up shows growth of the lesion. The rest of the examination is unremarkable, and there are no additional lesions.
Which of the following is the most recommended treatment?

Which of the following is an indication for soy-based formula?

Which of the following most accurately fits the description of transient tachypnea of newborn?

A two-week-old male is brought to the clinic due to a lesion on his shoulder (shown in the image).

The lesion was observed already after birth. Other than this finding, his examination is normal. What is the recommended treatment for this case?

A newborn screening test for a 5-day-old child reported low T4 levels in the presence of high TSH. Which of the following tests is the test of common choice to confirm the etiology of the child’s illness?

A two-month-old female baby arrives for evaluation due to complaints that have persisted since she was a week old, including, among other things, noisy breathing and stridor mainly when lying on her back, feeding difficulties and slow weight gain. On her examination – the baby is alert and vital, saturation 98% in RA, equal and good air intake, inspiratory stridor is heard, on auscultation to the heart – regular sounds without murmurs, the rest of the examination without findings.

What is the most recommended treatment in this case?

A 15-day-old baby with a fever of 38.2°C. Normal obstetric course, heart rate and blood pressure are normal, no fever-related findings on physical examination. Laboratory test: leukocytes 6000 with normal differential, normal hemoglobin and platelets, normal complete chemistry panel.

Which of the following tests must be performed as part of proper case management?

A term, few hours old newborn, with a history of a normal pregnancy and delivery, presents with respiratory distress. Examination reveals dyspnea and grunting, use of accessory muscles, and abdominal breathing.

Auscultation to the lungs reveals bowel sounds. X-ray is below.

Which of the following is the most likely diagnosis?

A two-month-old male arrives for examination due to findings on his scalp (image attached). Attempting to peel off the scabs leads to pulling out the roots of the hair along with the scab. On physical examination, except for slight skin dryness and the findings on the scalp, the baby is alert, and relaxed, with no other findings.

What is the recommended treatment at this stage?

A few-hours-old newborn develops the finding in the photo below

Which of the following is a common complication of this condition?

A preterm infant is delivered via an emergency cesarean section at 25-weeks’ gestation due to placental abruption.

He requires intubation and is treated with surfactant. At 3 days of age a routine brain ultrasound is performed.

Which of the following condition is this test screening for?

A 24-hour-old newborn, with Polyhydramnios during pregnancy, is evaluated for large volume watery stool that is hard to distinguish from urine.

Which of the following is the most likely etiology?

A few-hour-old newborn presents with cyanosis and respiratory distress since birth, which improves while crying. An attempt to pass a nasogastric tube failed.
Which of the following is the most likely diagnosis?

A term 3600 g newborn is diagnosed with indirect hyperbilirubinemia at the age of 24 hours. Labs – total
bilirubin 25 mg/dl, direct bilirubin 1.3 mg/dl, no evidence of hemolysis. He is treated with phenobarbital
due to insufficient response to phototherapy and bilirubin levels decrease substantially.
Which of the following is the most likely diagnosis?

A 1-month-old infant presents with worsening stridor during crying since she was two weeks old. She is gaining weight well, and does not spit up.

Which of the following tests will establish the most likely diagnosis?

A one-month-old male infant is brought to the emergency room due to a focal seizure. The pregnancy was normal, home birth. The baby is breastfed and gaining weight well. In the anamnesis: after circumcision, he was hospitalized for one day for observation due to bleeding. There is no evidence of diseases in the family.

What is the most likely cause of the baby’s illness?

You are examining a newborn with the findings described in the image. Background: born to a mother who suffered from diabetes during pregnancy, with a birth weight of 5,200 kg, vaginal birth.

What is the most appropriate treatment for his condition?

A 2-day-old newborn, born at home presents with seizures. Head CT demonstrated a recent brain bleed.
Coagulation function tests are disrupted (INR 2.3).

Which of the following routine newborn care would have prevented this condition?

A 5-day-old newborn is admitted due to hyperbilirubinemia. His bilirubin is 18 mg/dl,

with 0.5 mg/dl direct bilirubin. Coombs test is negative.

Which of the following diagnoses is compatible with this newborn?

In which of the following is breast feeding of a term newborn contraindicated?

Which of the following is a normal developmental test for a 3-months-old infant

A 5-months-old infant presents with respiratory distress especially during feeds, stridor, and dysphagia with arching of the back during swallowing. Echocardiography reveals right aortic arch.

Which of the following is the most appropriate treatment?

A newborn is born at term, via vaginal delivery, with birth weight of 4200 gr and Apgar 9/10.

The finding in the picture is found on routine examination.

Which of the following is the most common complication of this finding?

A 24-hours-old newborn, born at 38 weeks with birth weight of 2400 gr develops respiratory distress accompanied by grunting, tachypnea, and cyanosis. Examination reveals a scaphoid abdomen, right sided heart sounds, and

decreased breath sounds. A nasogastric tube is inserted and is seen in the attached picture.

Which of the following is the most likely diagnosis?

Which of the following is recommended by the American academy of pediatrics (AAP) to reduce sudden infant death syndrome (SIDS)?

A newborn was born on time by elective cesarean section. Normal weight for gestational age. At 13 hours old he appears yellow, in total, bilirubin blood tests: 10mg% of which 1mg% is direct, the rest of the physical examination is normal. What is the most likely cause of these findings?

When examining a newborn in the delivery room, pallor reacts to irritation of the nostrils with a cough. The limbs are slightly flexed without active movement, the newborn cries and breathes well, and the pulse – is 120. What is his Apgar score?

When examining a few-day-old newborn relaxed, the following finding (see image) is observed.

What is the standard treatment in this case?

A premature neonate, born at 29 weeks of gestation, is now 14 days old. Has been drowsy for several hours and has a distended, tender abdomen. An abdominal X-ray was performed – see the attached image.

Which of the following is a protective factor for the baby’s likely diagnosis?

Which of the following recommendations is included in the American Pediatric Association’s recommendations for preventing infant death?

A full-term newborn with a birth weight of 1900 grams and a head circumference below the 3rd percentile is under investigation. A brain ultrasound reveals periventricular calcifications. His diagnosis was performed via a PCR of a pathogen in the urine.

What is the most common complication for his likely diagnosis?

A premature baby was born to a diabetic mother via a Caesarian section in week 27. Following delivery, the baby developed significant respiratory distress and was treated with surfactant.

Which of the following findings can most likely explain his medical condition?

A newborn, full-term, started suffering from respiratory distress a few hours after his birth. Examination – hyperventilating and sighs, uses axiliary muscles, impression of abdominal respiration. Lung auscultation – bowel sounds are heard. Chest X-ray – the finding in the attached image is demonstrated.

What is the newborn’s likely diagnosis?

A full-term female newborn, stopped breathing after her birth, loses tonus and has cyanosis. Examination – no respiration and no response to stimuli, pulse 70 beats per minute. What is the next step in case management?

Which of the following conditions is a risk factor for Sudden infant death syndrome?

A 3-day-old male, has not had bowel movement yet. Was examined due to a swollen abdomen and vomiting.

The abdominal X-ray demonstrates the following finding:

What is the probable diagnosis for the baby?

As part of jaundice follow-up in a 9-week-old baby, a hemoglobin value of 10.5 g/dL is obtained. The mother is a vegetarian, the baby is breastfed and gaining weight, the physical examination is normal.

What is the most reasonable reason for this hemoglobin value?

A 10-day-old newborn female was born in a normal delivery, with a birth weight of 4.500 kg with the finding described in the image.

What would be the most appropriate treatment at this stage?

Male, 2 months old, normal development/ Birth weight of 3000 grams, now weighing 4200 grams. Examined due to repeated episodes of non-stop crying, lasting about 3 hours, at a frequency of about 3 days a week. Posseting observed once every few days in a small amount.

What is the reasonable treatment approach for this case?

An ECG was performed on a newborn with the attached results.

What anamnestic detail can explain the findings seen on the ECG?