Neonatology Board Review Questions and Answers
Every month we will upload new free neonatology board review questions and answers (Q&A).
1. While checking the post transfusion hematocrit of a 30 week gestation infant who is on nasal CPAP with resolving Respiratory Distress Syndrome, you notice that post transfusion hematocrit has only increased by one, from 28 to 29. You should check which of the following:
A) Hematocrit of packed red blood cells given to the infant
B) Inappropriate calculation of transfusion requirement
C) Ongoing blood loss
D) Infant has circulating anti-A, Anti B and Anti AB, which have bound to A or B antigens on transfused RBCs (red blood cells)
E) All of the above
2. A 32 week gestation infant has extravasation of intravenously administered solution. Upon examination, you are considering medical therapies. Which one of the following statements is correct?
A) Hyaluronidase is effective in extravasations involving calcium, parenteral alimentation fluids, antibiotics, sodium bicarbonate
B) Hyaluronidase is most effective if given within 24 hours of extravasation
C) Hyaluronidase is recommended for treatment of vasopressor extravasation injury.
D) Terbutaline is effective in extravasations due to parenteral nutrition especially lipids
E) Hyaluronidase is contraindicated in preterm infants
3. Which of the following is advisable for treating extravasation due to dopamine infusion?
E) Topical nitroglycerine
Hyaluronidase is effective in extravasations involving calcium, parenteral alimentation fluids, antibiotics, sodium bicarbonate.
Hyaluronidase is most effective if given within 2 hours of extravasation. In cases where IV catheter is still in place, by pulling it back slightly so that it is in the
subcutaneous plane and injecting hyaluronidase will give maximum results.
Topical nitroglycerine relaxes vascular smooth muscle. It is effective in minimizing the damage done by extravasation due to dopamine. However, there will be some skin absorption and you should monitor for hypotension.