Test Bank For Remington and Klein's Infectious Diseases
of the Fetus and Newborn Infant, 9th Edition
Edited by Yvonne Maldonado, Victor Nizet, Elizabeth D. Barnett, Kathryn M. Edwards,
and Richard Malley.
@2026
,Chapter 1. Current Concepts of Infections of the Fetus and Newborn Infant
Remington and Klein's Infectious Diseases of the Fetus and Newborn Infant, 9th
Edition edited by Yvonne Maldonado, Victor Nizet, Elizabeth D. Barnett, Kathryn M.
Edwards, and Richard Malley.
1. Which feature of the neonatal immune system most significantly predisposes newborns
to severe bacterial infection?
A. Excessive complement activation
B. Reduced neutrophil storage pool and impaired chemotaxis
C. Hyperactive T-cell responses
D. Increased opsonization capacity
Correct Answer:
B. Reduced neutrophil storage pool and impaired chemotaxis
Explanation:
Neonates, particularly premature infants, have quantitatively and functionally impaired
neutrophils. They possess a smaller marrow neutrophil reserve and reduced chemotaxis,
adherence, and phagocytosis, limiting effective bacterial clearance.
Clinical Reasoning:
This explains why neonates can deteriorate rapidly during sepsis and why even minor
bacterial invasion may lead to systemic infection.
Why the Other Options Are Wrong:
• A: Complement activity is reduced, not excessive.
• C: Neonatal T-cell function is immature rather than hyperactive.
• D: Opsonization is impaired because of reduced complement and antibody
function.
Neonatal Relevance:
Premature infants are especially vulnerable to overwhelming sepsis due to innate immune
immaturity.
,Safety Pearl:
A normal initial CBC does not exclude neonatal sepsis because immune responses may be
blunted.
2. Early-onset neonatal sepsis is most commonly acquired through:
A. Contaminated infant formula
B. Hematogenous spread from maternal genital tract organisms before or during delivery
C. Vector-borne transmission after birth
D. Exposure to hospital equipment after 7 days of life
Correct Answer:
B. Hematogenous spread from maternal genital tract organisms before or during delivery
Explanation:
Early-onset infection typically results from vertical maternal-fetal transmission occurring
transplacentally or during passage through the birth canal.
Clinical Reasoning:
Recognition of maternal intrapartum risk factors guides empiric therapy and prevention
strategies.
Incorrect Options:
• A: Formula contamination is associated with some late-onset infections.
• C: Vector-borne spread is uncommon in neonatal sepsis.
• D: Nosocomial infections are more characteristic of late-onset disease.
Neonatal Relevance:
Group B Streptococcus and Escherichia coli are classic vertically transmitted pathogens.
Safety Pearl:
Maternal fever and prolonged rupture of membranes warrant close neonatal evaluation.
, 3. Which maternal condition most strongly increases risk for neonatal Group B
Streptococcal disease?
A. Maternal hypothyroidism
B. Prolonged rupture of membranes
C. Maternal anemia
D. Polyhydramnios
Correct Answer:
B. Prolonged rupture of membranes
Explanation:
Prolonged rupture of membranes facilitates ascending bacterial colonization from the
maternal genital tract into the amniotic cavity.
Clinical Reasoning:
The duration of membrane rupture is a critical factor in neonatal sepsis risk assessment.
Incorrect Options:
• A, C, D: These are not primary risk factors for neonatal GBS disease.
Neonatal Relevance:
Ascending infection can cause fetal exposure before delivery.
Safety Pearl:
Duration of membrane rupture >18 hours increases concern for early-onset sepsis.
4. Which immunoglobulin is primarily transferred transplacentally to the fetus?
A. IgA
B. IgM
C. IgG
D. IgE
Correct Answer:
C. IgG
Explanation:
Maternal IgG crosses the placenta via Fc receptors, especially during the third trimester.
of the Fetus and Newborn Infant, 9th Edition
Edited by Yvonne Maldonado, Victor Nizet, Elizabeth D. Barnett, Kathryn M. Edwards,
and Richard Malley.
@2026
,Chapter 1. Current Concepts of Infections of the Fetus and Newborn Infant
Remington and Klein's Infectious Diseases of the Fetus and Newborn Infant, 9th
Edition edited by Yvonne Maldonado, Victor Nizet, Elizabeth D. Barnett, Kathryn M.
Edwards, and Richard Malley.
1. Which feature of the neonatal immune system most significantly predisposes newborns
to severe bacterial infection?
A. Excessive complement activation
B. Reduced neutrophil storage pool and impaired chemotaxis
C. Hyperactive T-cell responses
D. Increased opsonization capacity
Correct Answer:
B. Reduced neutrophil storage pool and impaired chemotaxis
Explanation:
Neonates, particularly premature infants, have quantitatively and functionally impaired
neutrophils. They possess a smaller marrow neutrophil reserve and reduced chemotaxis,
adherence, and phagocytosis, limiting effective bacterial clearance.
Clinical Reasoning:
This explains why neonates can deteriorate rapidly during sepsis and why even minor
bacterial invasion may lead to systemic infection.
Why the Other Options Are Wrong:
• A: Complement activity is reduced, not excessive.
• C: Neonatal T-cell function is immature rather than hyperactive.
• D: Opsonization is impaired because of reduced complement and antibody
function.
Neonatal Relevance:
Premature infants are especially vulnerable to overwhelming sepsis due to innate immune
immaturity.
,Safety Pearl:
A normal initial CBC does not exclude neonatal sepsis because immune responses may be
blunted.
2. Early-onset neonatal sepsis is most commonly acquired through:
A. Contaminated infant formula
B. Hematogenous spread from maternal genital tract organisms before or during delivery
C. Vector-borne transmission after birth
D. Exposure to hospital equipment after 7 days of life
Correct Answer:
B. Hematogenous spread from maternal genital tract organisms before or during delivery
Explanation:
Early-onset infection typically results from vertical maternal-fetal transmission occurring
transplacentally or during passage through the birth canal.
Clinical Reasoning:
Recognition of maternal intrapartum risk factors guides empiric therapy and prevention
strategies.
Incorrect Options:
• A: Formula contamination is associated with some late-onset infections.
• C: Vector-borne spread is uncommon in neonatal sepsis.
• D: Nosocomial infections are more characteristic of late-onset disease.
Neonatal Relevance:
Group B Streptococcus and Escherichia coli are classic vertically transmitted pathogens.
Safety Pearl:
Maternal fever and prolonged rupture of membranes warrant close neonatal evaluation.
, 3. Which maternal condition most strongly increases risk for neonatal Group B
Streptococcal disease?
A. Maternal hypothyroidism
B. Prolonged rupture of membranes
C. Maternal anemia
D. Polyhydramnios
Correct Answer:
B. Prolonged rupture of membranes
Explanation:
Prolonged rupture of membranes facilitates ascending bacterial colonization from the
maternal genital tract into the amniotic cavity.
Clinical Reasoning:
The duration of membrane rupture is a critical factor in neonatal sepsis risk assessment.
Incorrect Options:
• A, C, D: These are not primary risk factors for neonatal GBS disease.
Neonatal Relevance:
Ascending infection can cause fetal exposure before delivery.
Safety Pearl:
Duration of membrane rupture >18 hours increases concern for early-onset sepsis.
4. Which immunoglobulin is primarily transferred transplacentally to the fetus?
A. IgA
B. IgM
C. IgG
D. IgE
Correct Answer:
C. IgG
Explanation:
Maternal IgG crosses the placenta via Fc receptors, especially during the third trimester.
