Neonatal Sepsis

NEONATAL SEPSIS

Q. 1 A newborn is noted to be jaundiced at 3 days of age. Which of the following factors is associated with an increased risk of neurologic damage in a jaundiced newborn?
 A Increased attachment of bilirubin to binding sites caused by drugs such as sulfisoxazole 
 B Hyperalbuminemia
 C Neonatal sepsis
 D Maternal ingestion of Phenobarbital during pregnancy
Q. 1 A newborn is noted to be jaundiced at 3 days of age. Which of the following factors is associated with an increased risk of neurologic damage in a jaundiced newborn?
 A Increased attachment of bilirubin to binding sites caused by drugs such as sulfisoxazole 
 B Hyperalbuminemia
 C Neonatal sepsis
 D Maternal ingestion of Phenobarbital during pregnancy
Ans. C

Explanation:

Neonatal sepsis

• Significant unconjugated serum bilirubin levels in full-term newborn infants can lead to diffusion of bilirubin   into   brain   tissue   and   to   neurologic damage.

• Sulfisoxazole and other drugs compete with bilirubin for binding sites on albumin; therefore, the presence of these drugs can cause dislocation, not increased affinity, of bilirubin to tissues.

• Administration of phenobarbital has been used to induce glucuronyl transferase in newborn infants and can reduce, rather than exacerbate, neonatal jaundice.

• Other factors that reduce the amount of unconjugated bilirubin bound to albumin (and therefore cause an increase in free unconjugated bilirubin) include hypoalbuminemia and certain compounds (e.g., nonesterified fatty acids, which are elevated during cold stress) that compete with bilirubin for albumin binding sites


Q. 2

Neonatal sepsis may present with fever or hypothermia. Most common cause of neonatal sepsis in hospital in India is:

 A

Escherichia coli

 B

Klebsiella  

 C

Staph aureus

 D

Listeria monocytogenes

Q. 2

Neonatal sepsis may present with fever or hypothermia. Most common cause of neonatal sepsis in hospital in India is:

 A

Escherichia coli

 B

Klebsiella  

 C

Staph aureus

 D

Listeria monocytogenes

Ans. B

Explanation:

In general, the two groups of pathogens most frequently encountered are gram-positive cocci, such as beta-hemolytic streptococci, and enteric organisms, such as Escherichia coli and Klebsiella species, and Haemophilus influenzae. Listeria monocytogenes also causes sepsis and meningitis in neonates. In hospitals, Klebsiella pneumoniae is the most common.

 

 

 

Ref: Essential paediatrics by OP Ghai, 6th edition, Page 433.

 


Q. 3

All of following are true about neonatal sepsis except-

 A

Preterni babies are predisposed to sepsis

 B

Late initiation of breast feeding is a predisposition

 C

Most common transmission of infection is through nursery personel

 D

Premature rupture of membranes predisposes to sepsis

Q. 3

All of following are true about neonatal sepsis except-

 A

Preterni babies are predisposed to sepsis

 B

Late initiation of breast feeding is a predisposition

 C

Most common transmission of infection is through nursery personel

 D

Premature rupture of membranes predisposes to sepsis

Ans. C

Explanation:

Ans. is ‘c’ i.e., Most common transmission of infection is through nursery personal

o Early onset sepsis is caused by organisms prevalent in the maternal genital tract.

o Late onset sepsis is caused by organisms of the external environment of home or hospital and the infection is transmitted most frequently by the hands of the care-provider.

Predisposing factors for neonatal sepsis

1) For early onset sepsis

o Low birth weight or prematurity                              o Maternal fever

o Prolonged rupture of membrane                              o Difficult or prolonged labor

  • Foul smelling liquor                                    o Meconium aspiration
  • Multiple per vaginum examination

2) For late onset sepsis

  • Low birth weight                                                                                 o Lack of breast feeding
  • Superficial infections (pyoderma, umblical sepsis)                                  o Aspiration of feeds

o Disruption of skin integrity with needle pricks and use of iv fluids.

Note‑

Option ‘C’ is also partially correct —> most common mode of infection transmission for late onset neonatal sepsis is through the hands of nursery personel, but it is not the most common mode of transmission for overall sepsis, i.e. early plus late neonatal sepsis.


Q. 4

Most common cause of Neonatal sepsis in hospital in India is –

 A

Escherichia coli

 B

Klebsiella

 C

Staph aureus

 D

Listeria monocytogen

Q. 4

Most common cause of Neonatal sepsis in hospital in India is –

 A

Escherichia coli

 B

Klebsiella

 C

Staph aureus

 D

Listeria monocytogen

Ans. B

Explanation:

Ans. is ‘b’ i.e., Klebsiella

o Most common cause of neonatal sepsis in hospitals in India is   —> Klebsiella

o Most common cause of neonatal sepsis in hospitals across the world is —> E. coli

o Most common cause of overall neonatal sepsis —> Group B streptococci


Q. 5

True about neonatal sepsis:

 A

Early sepsis is due to organism in maternal genital tract

 B

Environmental factors cause late sepsis

 C

Late sepsis is due to organism in maternal genital tract

 D

a and b

Q. 5

True about neonatal sepsis:

 A

Early sepsis is due to organism in maternal genital tract

 B

Environmental factors cause late sepsis

 C

Late sepsis is due to organism in maternal genital tract

 D

a and b

Ans. D

Explanation:

Ans is ‘a’ i.e., Early sepsis is due to organism in maternal genital tract & ‘b’ i.e., Environmental factors cause late sepsis

Early onset sepsis is caused by organisms prevalent in the maternal genital tract.

Late onset sepsis is caused by organisms of the external environment of home or hospital and the infection is transmitted most frequently by the hands of the care-provider


Q. 6

Least observed laboratory finding in Neonatal Sepsis is –

 A

↑ C-reactive protein

 B

Neutrophilia

 C

Increased ESR

 D

Increased Immature Neutrophils

Q. 6

Least observed laboratory finding in Neonatal Sepsis is –

 A

↑ C-reactive protein

 B

Neutrophilia

 C

Increased ESR

 D

Increased Immature Neutrophils

Ans. B

Explanation:

Ans. is ‘b’ i.e., Neutrophilia


Q. 7

Neonatal sepsis and meningitis most common cause –

 A

Streptococcus pyogenes

 B

Streptococcus agalactacea

 C

Enterococcus fecalis

 D

Staphylococcus aureus

Q. 7

Neonatal sepsis and meningitis most common cause –

 A

Streptococcus pyogenes

 B

Streptococcus agalactacea

 C

Enterococcus fecalis

 D

Staphylococcus aureus

Ans. B

Explanation:

Ans. is ‘b’ i.e., Streptococcus agalactiae


Q. 8

Early neonatal sepsis occurs within (hours) –

 A

8

 B

12

 C

36

 D

72

Q. 8

Early neonatal sepsis occurs within (hours) –

 A

8

 B

12

 C

36

 D

72

Ans. D

Explanation:

Ans. is ‘d’ i.e., 72 hours



Leave a Reply

%d bloggers like this:
Malcare WordPress Security