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Test 14: Congenital Disorders

  1. How many infants are born with a congenital disorder?
    • 1%
    • 3%
    • 5%
    • 10%
  2. Which infants should be examined after delivery for a structural congenital disorder?
    • Postterm infants
    • Infants with 3 vessels in their umbilical cord
    • Infants that have a low Apgar score
    • All infants
  3. When should you anticipate the birth of an infant with a congenital disorder?
    • In patients younger than 35 years
    • In patients who received penicillin during early pregnancy
    • In patients with poorly controlled diabetes
    • In patients who smoked cigarettes during their pregnancy
  4. How should you manage an infant with a clubbed foot?
    • Refer the infant to an orthopaedic clinic within the first 72 hours after delivery.
    • Refer the infant to a level 3 hospital for surgical correction.
    • Ask the mother to bring the infant back at 2 weeks for a further examination.
    • A clubbed foot corrects spontaneously and, therefore, does not need to be treated.
  5. Dislocation of the hip should be diagnosed by:
    • Taking an X-ray of the hips of all infants
    • By inspecting the infant for a mass in the groin
    • By performing an Apt test on all infants before discharge
    • By doing a Barlow’s test on all infants after delivery
  6. How should you manage an infant with a dislocated hip?
    • Nurse the infant in double nappies.
    • Refer the infant as soon as possible to an orthopaedic clinic for splinting.
    • Examine the infant again in 2 weeks to determine whether the hip has returned to normal.
    • Strap the hip to prevent pain.
  7. An undescended testis in a term infant:
    • Is normal.
    • Often descends spontaneously by 3 months.
    • Needs urgent surgical correction.
    • Indicates that the infant has ambiguous genitalia.
  8. Infants with a hypospadias should be:
    • Circumcised
    • Referred to a level 3 hospital for urgent surgery
    • Referred to a urology clinic
    • Booked for a follow-up examination at 5 years
  9. Infants with ambiguous genitalia:
    • Should all be brought up as females
    • Should be referred to a plastic surgery clinic when they are 1 month old
    • Should be seen again at 6 months when it is easier to decide whether they are male or female
    • Should be referred urgently to a level 3 hospital for further investigation
  10. An inguinal hernia:
    • Is common in preterm infants.
    • Transilluminates well.
    • Should be referred for surgical correction when the infant is 3 months old.
    • Is usually seen in girls.
  11. Infants that appear normal but have a single umbilical artery:
    • Have Down syndrome.
    • Should be carefully examined for other abnormalities.
    • Can be discharged as these are common minor abnormalities that cause no problem.
    • Should be referred urgently to a genetics clinic for chromosome analysis.
  12. How should infants with a cleft lip be managed?
    • These infants should be referred to a plastic surgeon.
    • The cleft lip can be stitched closed at 6?months by a medical officer at a level 2 hospital.
    • The cleft lip closes spontaneously and, therefore, does not need treatment.
    • Nothing can be done and most of these infants die in the first few months.
  13. Oesophageal atresia should be suspected if:
    • Intra-uterine growth restriction is diagnosed
    • Oligohydramnios was present during the pregnancy
    • Polyhydramnios was present during the pregnancy
    • The mother develops hypertension during pregnancy
  14. How does oesophageal atresia often present in the newborn infant?
    • A distended abdomen and a double bubble on X-ray
    • The infant dribbles saliva and a nasogastric tube cannot be passed into the stomach.
    • An infant vomits bile.
    • The infant has a hoarse cry.
  15. Vomiting green bile after delivery suggests a diagnosis of:
    • Oesophageal atresia
    • Duodenal atresia
    • An absent anus
    • Meningomyelocoele
  16. What is the immediate management of a meningomyelocoele?
    • Cover it with sterile gauze.
    • Leave it exposed.
    • Paint it with gentian violet.
    • Apply surgical spirits.
  17. Down syndrome is due to:
    • An extra chromosome 13
    • An extra chromosome 18
    • An extra chromosome 21
    • A missing chromosome 22
  18. Which of the following is a sign of Down syndrome?
    • Small eyes
    • No anus
    • Convulsions
    • Hypotonia (floppy)
  19. Infants born with the fetal alcohol syndrome often have:
    • An upward slant of the eyes
    • A long, smooth upper lip
    • Hydrocephalus
    • Single palmar creases
  20. When speaking to parents of an infant with a congenital disorder, it is best:
    • To tell them as soon as possible
    • To wait until all the results of the special investigations are available
    • Not to allow them to see the infant until they have had a chance to get over the shock
    • To let them discover for themselves that their infant is abnormal