Give me the mcqs on Pediatrics of normal newborn topic based on fmge type of questions
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I now have enough material from authoritative textbooks to craft a solid set of FMGE-style MCQs on the Normal Newborn topic. Let me compile them.
FMGE-Style MCQs: Normal Newborn (Pediatrics)
1. Apgar Score
Q1. The Apgar score is assessed at which time points after birth?
- A) 1 minute and 3 minutes
- B) 1 minute and 5 minutes
- C) 2 minutes and 5 minutes
- D) 5 minutes and 10 minutes
Answer: B - 1 minute and 5 minutes after birth. If the 5-minute score is <7, scoring continues every 5 minutes until a score of ≥7 is reached. (Park's Preventive & Social Medicine; Harriet Lane Handbook)
Q2. Which of the following is NOT one of the five components of the Apgar score?
- A) Heart rate
- B) Muscle tone
- C) Blood pressure
- D) Reflex response
Answer: C - Blood pressure is not part of the Apgar score. The five components are: Heart rate, Respiratory effort, Muscle tone, Reflex response (irritability), and Color. (Park's PSM)
Q3. A newborn at 1 minute has heart rate 90/min, weak cry, some flexion of extremities, grimace on suctioning, and body pink with blue extremities. What is the Apgar score?
- A) 5
- B) 6
- C) 7
- D) 8
Answer: B - 6
- Heart rate 90 (slow, below 100) = 1
- Respiratory effort (weak cry / slow irregular) = 1
- Muscle tone (some flexion) = 1
- Reflex (grimace) = 1
- Color (body pink, extremities blue) = 1 Total = 5 -- wait, let me recount: 1+1+1+1+1 = 5
Correction: Answer A - 5
Q4. An Apgar score of 0-3 at 1 minute indicates:
- A) Normal newborn
- B) Mildly depressed newborn
- C) Moderately depressed newborn
- D) Severely depressed newborn
Answer: D - Score 0-3 = severely depressed; 4-6 = moderately depressed; 7-10 = normal/reassuring. (Park's PSM, Harriet Lane)
Q5. What Apgar score threshold requires prompt resuscitative action?
- A) Score <7
- B) Score <5
- C) Score <3
- D) Score <6
Answer: B - A score below 5 requires prompt action. (Park's PSM)
2. Neonatal Vital Signs & Weight
Q6. What is the normal respiratory rate in a neonate?
- A) 15-20 breaths/min
- B) 20-30 breaths/min
- C) 30-60 breaths/min
- D) 60-80 breaths/min
Answer: C - Normal neonatal respiratory rate is 30-60 breaths/min. (Tintinalli's Emergency Medicine)
Q7. A term newborn's birth weight is 3.2 kg. On day 4, the weight is 2.9 kg. What is the correct interpretation?
- A) Pathological weight loss - requires investigation
- B) Normal physiological weight loss
- C) Indicates malabsorption
- D) Suggests dehydration and requires IV fluids
Answer: B - Newborns may lose up to 10-12% of birth weight in the first 3-7 days. Here 9.4% loss is within normal limits if behavior, stooling, and voiding are normal. (Tintinalli's)
Q8. By what age should a normal newborn regain its birth weight?
- A) 5-7 days
- B) 7-10 days
- C) 10-14 days
- D) 3 weeks
Answer: C - Infants should no longer be losing weight by 5-7 days and should regain birth weight by 10-14 days. (Tintinalli's)
Q9. What is the average daily weight gain in the first 3 months of life?
- A) 10-15 g/day
- B) 15-20 g/day
- C) 20-30 g/day
- D) 30-40 g/day
Answer: C - 20-30 grams/day in the first 3 months; 15-20 g/day for the next several months. (Tintinalli's)
3. Neonatal Stool & Feeding
Q10. A newborn fails to pass meconium in the first 48 hours. Which conditions must be ruled out?
- A) Intussusception and volvulus
- B) Hirschsprung's disease and cystic fibrosis
- C) Necrotizing enterocolitis and pyloric stenosis
- D) Duodenal atresia and annular pancreas
Answer: B - Failure to pass meconium within the first 24-48 hours may suggest Hirschsprung's disease or cystic fibrosis. (Tintinalli's)
Q11. The first stool (meconium) of a newborn is best described as:
- A) Yellow, seedy, and soft
- B) Greenish-brown and transitional
- C) Thick, sticky, and black
- D) Watery and green
Answer: C - Meconium is thick, sticky, and black. Transitional stools (greenish-brown) appear after milk feeding begins, replaced by yellow seedy milk stools by day 3-4. (Tintinalli's)
Q12. A breastfed newborn feeds every 1-3 hours. The mother is worried about overfeeding. What is the correct counseling?
- A) Breastfed infants should feed every 3-4 hours like formula-fed infants
- B) This is normal - breastfed infants prefer shorter feeding intervals
- C) Demand feeding more than 8 times/day is abnormal
- D) Formula supplementation should be started
Answer: B - Breastfed infants prefer shorter intervals (every 1-3 hours) compared to formula-fed infants (every 2-4 hours). (Tintinalli's)
4. Primitive Reflexes
Q13. The Moro reflex (embrace response) in a normal newborn disappears by:
- A) 1-2 months
- B) 2-3 months
- C) 3-6 months
- D) 6-9 months
Answer: C - Moro reflex is present at birth and disappears by 3-6 months. (Harriet Lane Handbook)
Q14. The Moro reflex is elicited by:
- A) Stroking the lateral sole of the foot
- B) Sudden neck extension (allowing head to fall back ~3 cm)
- C) Placing the infant prone and stroking the paravertebral area
- D) Rotating the head laterally 45-90 degrees
Answer: B - Moro: Supine position, sudden neck extension, head allowed to fall back ~3 cm, producing extension-abduction followed by adduction/flexion of upper extremities. (Harriet Lane)
Q15. The Asymmetrical Tonic Neck Reflex (ATNR or "fencer" response) disappears by:
- A) 2-3 months
- B) 4-9 months
- C) 6-12 months
- D) 12-18 months
Answer: B - ATNR is present at birth and disappears by 4-9 months. (Harriet Lane Handbook)
Q16. The Galant reflex is elicited by:
- A) Stroking the palm - causes finger flexion
- B) Stroking the paravertebral area in prone suspension - causes truncal incurvature
- C) Rotating the head - causes extension of chin-side limbs
- D) Placing the foot on a flat surface - causes stepping movements
Answer: B - Galant reflex: Prone suspension, stroking paravertebral area from thoracic to sacral region, producing truncal incurvature with concavity toward the stimulated side. Disappears 2-6 months. (Harriet Lane)
5. Neonatal Jaundice
Q17. Physiological jaundice in a term newborn appears:
- A) At birth
- B) Within the first 24 hours
- C) After the first 24 hours (day 2-3)
- D) After day 7
Answer: C - Physiological jaundice appears after the first 24 hours of life. Jaundice in the first 24 hours is always pathological.
Q18. The mechanism of physiological neonatal jaundice includes:
- A) Conjugated bilirubin accumulation due to biliary obstruction
- B) Increased RBC turnover + immature conjugation pathways in the liver
- C) G6PD deficiency-related hemolysis
- D) Blood group incompatibility
Answer: B - Physiological jaundice results from increased RBC turnover combined with immaturity of bilirubin conjugation pathways (especially exacerbated in premature infants). (Medical Physiology)
6. Umbilical Cord & Newborn Care
Q19. In a term newborn who does not require positive-pressure ventilation, delayed cord clamping should be performed for at least:
- A) 30 seconds
- B) 1-3 minutes
- C) 5 minutes
- D) Until placental delivery
Answer: B - Delayed cord clamping for at least 1-3 minutes reduces the need for blood transfusion, increases iron stores, and may decrease risk of hyperbilirubinemia treatment. (Tintinalli's)
Q20. Which of the following is a correct statement regarding newborn breathing?
- A) Newborn breathing is predominantly intercostal
- B) Apnea of <10 seconds is always pathological
- C) Newborn breathing is almost entirely diaphragmatic
- D) Periodic breathing is never normal in a term infant
Answer: C - Newborn breathing is almost entirely diaphragmatic. The soft anterior thorax is drawn inward during inspiration while the abdomen rises. (Tintinalli's)
Quick Reference Summary
| Topic | Key Fact |
|---|---|
| Apgar timing | 1 min and 5 min |
| Apgar: severely depressed | Score 0-3 |
| Normal RR neonate | 30-60/min |
| Max acceptable weight loss | Up to 10-12% |
| Regain birth weight | By 10-14 days |
| Meconium passage | Within 24-48 hours |
| Moro reflex disappears | 3-6 months |
| ATNR disappears | 4-9 months |
| Delayed cord clamping | ≥1-3 minutes |
| Physiological jaundice onset | After 24 hours |
These 20 MCQs cover the highest-yield subtopics for FMGE: Apgar scoring, neonatal vital signs, weight gain, stool patterns, primitive reflexes, physiological jaundice, umbilical cord care, and feeding. Let me know if you want more questions on a specific subtopic (e.g., birth weight classification, neonatal resuscitation, or screening tests).
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