Neonatal infections — MCQs

A 2-week-old female newborn is brought to the physician for the evaluation of red eyes with discharge for 2 days. She was born at 39 weeks' gestation to a 22-year-old woman. Pregnancy and delivery were uncomplicated. The mother received irregular prenatal care during the second half of the pregnancy. The newborn weighed 3700 g (8 lb 2.5 oz) at birth, and no congenital anomalies were noted. She currently weighs 4000 g (8 lb 13 oz). Examination of the newborn shows pink skin. The lungs are clear to auscultation. There is mucopurulent discharge in both eyes and mild eyelid swelling. Polymerase chain reaction assay of conjunctival scraping confirms the diagnosis. Which of the following is the most appropriate next step in management?

A 6-day-old male newborn is brought to the physician by his mother for the evaluation of yellowing of his skin and eyes for one day. The mother reports that she is breastfeeding her son about 7 times per day. She also states that her son had two wet diapers and two bowel movements yesterday. He was born at 38 weeks' gestation and weighed 3500 g (7.7 lb); he currently weighs 3000 g (6.6 lb). His newborn screening was normal. His temperature is 37°C (98.6°F), pulse is 180/min, and blood pressure is 75/45 mm Hg. Physical examination shows scleral icterus, widespread jaundice, and dry mucous membranes. The remainder of the examination shows no abnormalities. Serum studies show: Bilirubin Total 9 mg/dL Direct 0.7 mg/dL AST 15 U/L ALT 15 U/L Which of the following is the most appropriate next step in the management of this patient?

Three weeks after birth, an infant girl develops episodes of apnea. She has become increasingly lethargic over the past two days, and experienced two episodes of apnea lasting 10 seconds each within the last day. She was born at 31 weeks of gestation and weighed 1600-g (3-lb 8-oz). Apgar scores were 4 and 7 at 1 and 5 minutes, respectively. She takes no medications. Her temperature is 36.7°C (98.0°F), pulse is 185/min, respirations are 60/min and irregular, and blood pressure is 70/35 mm Hg. She appears pale. Physical examination shows no abnormalities. Laboratory studies show a hemoglobin of 6.5 g/dL, a reticulocyte count of 0.5%, and a mean corpuscular volume of 92 μm3. Leukocyte count, platelet count, total bilirubin and indirect bilirubin are all within reference range. Which of the following is the most likely underlying mechanism of this patient's anemia?

A 3-week-old boy is brought to the emergency department by his parents because of a 3-day history of progressive lethargy and difficulty feeding. He was born at term and did not have difficulty feeding previously. His temperature is 39.4°C (103°F), pulse is 220/min, respirations are 45/min, and blood pressure is 50/30 mm Hg. Pulse oximetry on 100% oxygen shows an oxygen saturation of 97%. Examination shows dry mucous membranes, delayed capillary refill time, and cool skin with poor turgor. Despite multiple attempts by the nursing staff, they are unable to establish peripheral intravenous access. Which of the following is the most appropriate next step in management?