Q1 The incidence of neonatal sepsis in the developed countries is now 2-3 per thousand live births.

True      False      Don't Know


Q2 The mortality from neonatal sepsis is around 20% and has not fallen in the last decade or so.

True      False      Don't Know


Q3 Late onset sepsis in the premature infants has a higher mortality rate than early onset sepsis.

True      False      Don't Know


Q4 Eschericia coli is a common pathogen in early onset sepsis of the newborn infants.

True      False      Don't Know


Q5 While preterm infants have normal neutrophil chemotaxis, they have lower levels of IgA, IgM and IgE, resulting in their increased susceptibility to infection.

True      False      Don't Know


Q6 In twins delivered by spontaneous vaginal delivery, the second twin has a higher risk of early onset sepsis.

True      False      Don't Know


Q7

Preterm infants receiving parenteral nutrition via central venous lines should be routinely covered with vancomycin so as to avoid MRSA colonization and prevent nursery outbreak of MRSA.

Phototherapy must be started and an exchange transfusion must be organised immediately

True      False      Don't Know


Q8 More than half of very low birthweight infants with blood culture proven septicaemia have increasing apnoea as one of their clinical presentation.

True      False      Don't Know


Q9 As a result of increased peripheral destruction, the peripheral blood film of a septic newborn will have reduced number of immature white cells.

True      False      Don't Know


Q10

Newborn infants with confirmed sepsis have increased circulating tumour necrosis factor but decreased level of interleukin-6.

True      False      Don't Know


Q11

An IUGR infant with mild hydrocephalus was confirmed to have congenital toxoplasmosis. Medical treatment include pyrimethamine and sulfadiazine and these should be given for full six weeks.

True      False      Don't Know


Q12

Platelet count of <150,000/mm3 in the preterm infant is a sensitive indicator for sepsis as there are not many other conditions that would give rise to thrombocytopenia at this period.

True      False      Don't Know

 


 

 

 

 

 

 

 

 

 

 

 

 

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Answers

Q1 The incidence of neonatal sepsis in the developed countries is now 2-3 per thousand live births.

Ans : True. In the developing countries, however, the incidence is still as high as 10-50/1000 live births.


Q2 The mortality from neonatal sepsis is around 20% and has not fallen in the last decade or so.

Ans : True Moreover, most babies who die from sepsis, die within the first 14 days of life. This may be due to the increasing number of very premature infants being delivered and treated.


Q3 Late onset sepsis in the premature infants has a higher mortality rate than early onset sepsis.

Ans : False. Early onset sepsis tends to be more fulminant and carries a much higher mortality rate. Late onset sepsis, while by no means less important, tends to be more indolent.


Q4 Eschericia coli is a common pathogen in early onset sepsis of the newborn infants.

Ans : True Common pathogens for early onset sepsis include Group B Streptococcus and E coli. Pathogens for late onset sepsis include nosocomial organisms such as coagulase negative Staphylococcus.


Q5 While preterm infants have normal neutrophil chemotaxis, they have lower levels of IgA, IgM and IgE, resulting in their increased susceptibility to infection.

Ans : False Preterm infants have lower levels of IgA, IgM and IgE. They also have reduced neutrophil chemotaxis.


Q6 In twins delivered by spontaneous vaginal delivery, the second twin has a higher risk of early onset sepsis

Ans : False Studies have shown that first twin has a higher risk of developing early onset sepsis, especially in regards to Group B Streptococcus septicaemia .


Q7

Preterm infants receiving parenteral nutrition via central venous lines should be routinely covered with vancomycin so as to avoid MRSA colonization and prevent nursery outbreak of MRSA.

Ans : False. While vigilance against MRSA is a continuous concern of any nursery, over-usage of vancomycin is potentially dangerous as it increases the selective pressure for the development of vancomycin-resistant organisms.


Q8 More than half of very low birthweight infants with blood culture proven septicaemia have increasing apnoea as one of their clinical presentation.

Ans : True In a study involving 395 VLBW infants (Fanarof et al. Pediatr Infect Dis J, 1998; 17:7 593-8), commonest clinical presentations include increasing apnoea, feeding intolerance and abdominal distension, increasing respiratory effort, lethargy and hypotonia.


Q9 As a result of increased peripheral destruction, the peripheral blood film of a septic newborn will have reduced number of immature white cells.

Ans : False Septic infants in fact have increased number of immature white cells. Elevated immature to total white cell (I/T) ratio is often used as an indicator of neonatal sepsis.


Q10

Newborn infants with confirmed sepsis have increased circulating tumour necrosis factor but decreased level of interleukin-6.

Ans : False In neonatal sepsis, both tumour necrosis factor and interleukin-6 are elevated. Recent researches are focusing on these cytokines as potentially useful early laboratory indicators of neonatal sepsis.


Q11

An IUGR infant with mild hydrocephalus was confirmed to have congenital toxoplasmosis. Medical treatment include pyrimethamine and sulfadiazine and these should be given for full six weeks.

Ans : False Recent data suggests that pyrimethamine and sulfadiazine should be given for one full year as these infants have improved neurodevelopmental outcome compared to those given shorter duration of treatment.


Q12

Platelet count of <150,000/mm3 in the preterm infant is a sensitive indicator for sepsis as there are not many other conditions that would give rise to thrombocytopenia at this period.

Ans : False Thrombocytopenia can also occur in respiratory distress syndrome, birth asphyxia, necrotizing enterocolitis .

 


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