Neonatology — MCQs

Neonatology Indian Medical PG Practice Questions and MCQs

Question 971: What is the most common cause of seizure in a newborn?

A. Hypoxic-ischemic encephalopathy (Correct Answer)
B. Hypocalcemia
C. Metabolic abnormality
D. Sepsis

Explanation: ***Hypoxic-ischemic encephalopathy*** - This is the **most frequent etiology** of neonatal seizures, particularly in **full-term infants**, due to perinatal events leading to brain injury. - Seizures often manifest within the **first 24-48 hours** of life and can range from subtle to generalized tonic-clonic. *Hypocalcemia* - While a notable cause, **hypocalcemia** is less common than hypoxic-ischemic encephalopathy as the primary cause of neonatal seizures. - Seizures due to hypocalcemia typically appear later, often around **3-7 days of life**, and can be accompanied by jitteriness and apneic spells. *Metabolic abnormality* - Various **inborn errors of metabolism** can cause neonatal seizures, but collectively they are less common than hypoxic-ischemic encephalopathy. - These seizures may be accompanied by other systemic symptoms like **lethargy, feeding difficulties, and organ dysfunction**. *Sepsis* - **Neonatal sepsis** can lead to seizures, often as a complication of central nervous system infection (meningitis) or metabolic derangements. - While serious, sepsis is proportionally **less common** as the sole primary cause compared to hypoxic-ischemic encephalopathy.

Question 972: A newborn is noted to be jaundiced within the first 24 hours of life. What is the most likely cause of this neonatal jaundice?

A. Breast milk jaundice
B. Physiological jaundice
C. Hemolytic disease of the newborn (Correct Answer)
D. Gilbert’s syndrome

Explanation: ***Hemolytic disease of the newborn*** - Jaundice appearing within the first **24 hours of life** is considered pathological and strongly suggests a hemolytic process. - This is often caused by **ABO or Rh incompatibility**, leading to rapid breakdown of red blood cells and increased bilirubin production. *Breast milk jaundice* - Typically presents **after the first 3-5 days** of life and can persist for several weeks. - It is often associated with factors in breast milk that interfere with bilirubin conjugation or excretion. *Physiological jaundice* - Usually appears **after 24 hours of life**, peaking around day 3-5 in term infants. - It results from the normal delay in bilirubin conjugation by an immature liver combined with increased red blood cell turnover. *Gilbert’s syndrome* - An inherited condition causing **intermittent, mild unconjugated hyperbilirubinemia**, typically triggered by stress, fasting, or illness. - While it can manifest at any age, significant jaundice in the first 24 hours of a newborn's life is highly unlikely to be due to Gilbert's syndrome alone and would not cause the rapid onset seen here.

Practice by Chapter

Neonatal Resuscitation

Practice Questions

Care of the Normal Newborn

Practice Questions

Prematurity and Low Birth Weight

Practice Questions

Respiratory Distress Syndrome

Practice Questions

Neonatal Jaundice

Practice Questions

Neonatal Sepsis

Practice Questions

Necrotizing Enterocolitis

Practice Questions

Intraventricular Hemorrhage

Practice Questions

Persistent Pulmonary Hypertension

Practice Questions

Perinatal Asphyxia

Practice Questions

Neonatal Seizures

Practice Questions

Congenital Anomalies

Practice Questions

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