Neonatology and Perinatology — MCQs

Neonatology and Perinatology Indian Medical PG Practice Questions and MCQs

Question 31: Which of the following statements about the umbilical cord is incorrect?

A. Two arteries and one vein
B. Contains Wharton's jelly
C. Typically 50 to 60 cm long
D. Two veins and one artery (Correct Answer)

Explanation: ***Two veins and one artery*** - This statement is incorrect because the typical umbilical cord contains **two umbilical arteries** and **one umbilical vein**. - **Two veins and one artery** would represent a rare anomaly, often associated with other congenital malformations. *Two arteries and one vein* - This is the **normal anatomical configuration** of the umbilical cord, consisting of **two umbilical arteries** and **one umbilical vein**. - The arteries carry deoxygenated blood and waste products from the fetus to the placenta, while the vein carries oxygenated blood and nutrients from the placenta to the fetus. *Contains Wharton's jelly* - **Wharton's jelly** is a gelatinous substance found within the umbilical cord, surrounding the blood vessels. - Its primary function is to protect the umbilical vessels from compression and knotting, ensuring continuous blood flow. *Typically 50 to 60 cm long* - The average length of a term umbilical cord is indeed between **50 and 60 centimeters**. - Variations in length can occur, with excessively short or long cords potentially leading to obstetric complications.

Question 32: Which among the following is NOT transmitted transplacentally?

A. Herpes
B. CMV
C. IgE (Correct Answer)
D. EB virus

Explanation: ***IgE*** - **IgE antibodies do NOT cross the placenta** due to their molecular structure and lack of specific Fc receptors on placental syncytiotrophoblasts. - Only **IgG** is actively transported across the placenta via FcRn receptors to provide passive immunity to the fetus. - Maternal IgE does not provide passive immunity or transmit allergic predispositions transplacentally. *Herpes* - **Herpes simplex virus (HSV)** transmission is predominantly **intrapartum** (85% of cases) during vaginal delivery through contact with infected genital secretions. - **Congenital (transplacental) HSV** is rare, representing only **5% of neonatal HSV cases**, but can cause severe outcomes including skin lesions, chorioretinitis, and neurological defects. - While transplacental transmission can occur, it is **uncommon** compared to intrapartum transmission. *CMV* - **Cytomegalovirus (CMV)** is the **most common congenital infection** and is readily transmitted transplacentally. - Occurs in **0.5-2% of all live births** and can result from primary or recurrent maternal infection. - **Congenital CMV** can lead to sensorineural hearing loss, intellectual disability, microcephaly, chorioretinitis, and other neurological sequelae. *EB virus* - **Epstein-Barr virus (EBV)** transplacental transmission is **extremely rare** and not well-documented. - Unlike CMV, EBV is **not considered a typical congenital infection**, and most EBV infections occur postnatally through saliva contact. - While there are rare case reports, congenital EBV is not a recognized cause of routine prenatal screening or concern.

Question 33: A pregnant female taking carbimazole may have neonates with various congenital anomalies. Which of the following is the MOST characteristic and well-documented anomaly associated with carbimazole exposure?

A. Scalp defects (Correct Answer)
B. Limb reduction defects
C. Neural tube defects
D. Fetal goiter

Explanation: ***Scalp defects*** - **Aplasia cutis congenita** (congenital scalp defects) is the most characteristic and well-documented anomaly specifically associated with carbimazole exposure during pregnancy, particularly in the first trimester. - This condition involves areas of absent skin, usually on the scalp, which can range from small lesions to large defects. *Neural tube defects* - While significant congenital anomalies, **neural tube defects** are not specifically or primarily linked to carbimazole exposure. - They are more commonly associated with factors like **folate deficiency** or other teratogens. *Limb reduction defects* - **Limb reduction defects** are severe congenital malformations but are not the characteristic anomaly associated with carbimazole. - These defects are more commonly linked to other teratogens or genetic factors. *Fetal goiter* - **Fetal goiter** can occur with carbimazole use due to its antithyroid effects causing fetal hypothyroidism, but it is not considered the "most characteristic" or defining structural anomaly linked to the drug in the same way scalp defects are. - While it's a known side effect impacting thyroid function and development, it's a functional rather than a typically structural malformation.

Question 34: During delayed cord clamping, how much blood is typically transferred to the neonate?

A. 50-100 mL (Correct Answer)
B. 120-150 mL
C. 150-180 mL
D. 100-200 mL

Explanation: ***50-100 mL*** - **Delayed cord clamping (DCC)** allows for the transfer of a significant volume of **placental blood** back to the neonate. - This typically results in an increase of approximately **50-100 mL** of blood volume in the infant, contributing to improved iron stores and hematocrit levels. *120-150 mL* - This volume is generally **higher than the average transfer** seen with standard delayed cord clamping, though individual variations can occur. - While beneficial, such a large transfer might only occur with **prolonged clamping times** or specific neonatal interventions. *150-180 mL* - This range represents a **substantially larger volume** than what is typically transferred during routine delayed cord clamping. - This volume is **uncommon** and might lead to concerns like **polycythemia** if it occurred. *100-200 mL* - While the lower end of this range (100 mL) can sometimes be achieved, 200 mL is generally **considered excessive** for typical delayed cord clamping. - Such a large volume could contribute to **hyperbilirubinemia** and **polycythemia** in the neonate.

Practice by Chapter

Neonatal Resuscitation

Practice Questions

Care of the Normal Newborn

Practice Questions

Low Birth Weight and Prematurity

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Neonatal Infections

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Birth Asphyxia and Hypoxic-Ischemic Encephalopathy

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Neonatal Jaundice

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Respiratory Distress in Newborn

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Congenital Anomalies

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Birth Injuries

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Perinatal Mortality and Morbidity

Practice Questions

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