PAEDIATRICS ESSAY GUIDE (Past Questions)
[Batch K academic board]
SHIVERING AND NON-SHIVERING THERMOGENESIS/INCUBATOR CARE/KMC
Write short notes on Kangaroo mother care
List 5 complications that may arise from the use of incubator in neonatal care [Write
short notes]
NEONATAL JAUNDICE/JAUNDICE IN CHILDREN
List 5 investigations in the diagnosis of unconjugated hyperbilirubinaemia. **
List 5 causes of conjugated hyperbilirubinaemia in infancy. **
List 4 complications of phototherapy
- Dehydration
- Diarrhea
- Dermatitis
- retinal damage
List 4 signs of hyperbilirubin toxicity (Define or explain)
- Lethargy
- Opisthotonus posturing ***
- seizures
- bulging anterior fontanelle ***
- Loss of moro reflex ***
- hypertonia ***
- cerebral palsy
- poor suckling
- high pitched cry
List 4 causes of persistent jaundice in infancy (Define or explain)
- URTI
- Sepsis
- Breast milk jaundice
- Hepatitis
- G6PD deficiency
- Hypothyroidism
- Extra-hepatic biliary atresia
, Baby B, 48 hours old, was admitted with a day history of refusal of feeds. The baby
was delievered to a 15 year old primiparous woman in a taxi on her way to the
hospital. Pregnancy was un-supervised and complicated by chorioamnionitis. Mothers
LMP was 25th May 2015. The infant weighs 900gms and had jaundice reaching the
palms and the soles.
a) What is your diagnosis?
b) Outline the treatment of this child.
c) List 2 most important public health issues that need to be addressed in this
presentation.
A 5 day old baby was brought to the outborn SCBU with history of yellowish
discolouration of the eyes, noticed 2 days prior to presentation, there was no history
of fever. He was delivered at 37 completed weeks gestation to a 27 year old para
3+0 mother. Baby and father both have blood group B+. There is history of jaundice
in older brothers during their neonatal period.
a) State 3 questions you would want to ask to make a diagnosis
- What is the mother’s blood group
- FH of G6PD deficiency
- Is the child having adequate breast milk intake?
b) List 3 examination findings
- Yellowish discoloration of skin and sclera
- ill looking
- palor
c) List the 2 most likely differential diagnosis
- Neonatal jaundice secondary to Rh incompatibility
- Neonatal jaundice secondary to G6PD deficiency
- Neonatal jaundice secondary to ABO incompatibility
d) List 3 investigations
- ABO and Rh blood group of mother and baby
- serum bilirubin levels
- G6PD assay
- Coomb’s test to rule out immune mediated hemolysis
e) State 1 treatment modality
- Phototherapy
f) State 2 complications of any of the treatment modalities stated above
- dermatitis
- dehydration
- diarrhea
- retinal damage
Write short notes on Birth injuries
, Cephalohematoma
HAEMORRHAGIC DISEASE OF THE NEWBORN
RESPIRATORY PROBLEMS IN NEWBORN
Respiratory distress syndrome in the newborn
Causes of poor abdominal wall movement in respiration in the newborn.
A 30 minute old baby girl delivered at 32 weeks gestation was admitted into the
outborn section of the SCBU. The delivery was at home, via SVD to a 30 year old para
2+1 (1 alive) mother. Baby did not cry immediately after delivery until after 10
minutes. The pregnancy history revealed that the mother booked at 30 weeks
gestation and she had features suggestive of urinary tract infection (UTI) 1 week prior
to delivery. Weight of the baby on admission was 1.2kg and admitting PCV was 34%.
a) What is your diagnosis?
b) Mention 5 findings you hope to elicit in the general physical examination of the baby.
c) List 5 problems/complications you anticipate in the baby
d) Outline your treatment plan for the baby
e) Outline the content of your counseling to the mother on prevention of recurrence.
NEONATAL RESUSCITATION
Like 5 equipments necessary in neonatal resuscitation [Write short notes]
NEONATAL SEPSIS/NEONATAL TETANUS
A 9 day old term baby was presented to you following home delivery to a 16 year
old mother, with the complaints of refusal of feed and low grade fever. The
pregnancy was not booked. Major findings on physical examination were foul
smelling umbilical cord, opisthotonus posturing, respiratory distress and
temperature of 380C.
a) What is the most likely diagnosis?
- NEONATAL TETANUS
b) What are the 2 likely differential diagnosis?
- KERNICTERUS
- NEONATAL MENINGITIS
c) Enumerate 5 aims of management of a) above.
Aim:
- neutralize toxins,
- prevent further toxin production,
- prevent spasms,
- maintain hydration and electrolyte balance,
- maintain nutrition, respiration and prevent pneumonia