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neonatology

Practice targeted AMC-style multiple-choice questions on neonatology.

Related Topics

abdominal painabdominal swellingdifferential diagnosisgastroenterologyneonatepediatricspulmonary diseaserespiratory distresssurfactantvomiting

For preterm neonate with RDS, when is surfactant most effective?

A. Prophylactically
B. After sepsis ruled out
C. After 24 hours
D. Early, within hours
E. Only if FiO2 > 0.8
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A neonate, born at 38 weeks gestation, presents with bilious vomiting starting 12 hours after birth. Antenatal ultrasound revealed polyhydramnios. On examination, the baby is active and has a distended upper abdomen but a scaphoid lower abdomen. An abdominal X-ray shows a 'double bubble' sign. Which of the following is the most appropriate next step in the management of this neonate, considering potential associated complications?

A. Immediately perform a contrast enema to rule out meconium ileus as a cause of the obstruction.
B. Initiate intravenous fluids, nasogastric decompression, and prepare for surgical intervention after stabilization.
C. Begin feeds with a hydrolysed formula to assess tolerance and rule out milk protein allergy.
D. Start the neonate on broad-spectrum antibiotics to cover potential bacterial translocation.
E. Perform an upper gastrointestinal endoscopy to visualize the obstruction and obtain biopsies.
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