NPS NPS Neonatal Physiology and Pathophysiology 2

Question 1

Why are preterm neonates at increased risk for hypoglycemia compared to term infants?

Accepted Answer

Limited glycogen stores and immature gluconeogenesis

Answer

Preterm neonates have limited hepatic glycogen stores, immature gluconeogenic enzymes, and high glucose utilization by the rapidly growing brain.

Question 2

Patent ductus arteriosus (PDA) in a preterm neonate creates a left-to-right shunt. Which organ is MOST at risk from increased blood flow?

Accepted Answer

Lungs

Answer

Left-to-right PDA shunting increases pulmonary blood flow, causing pulmonary edema, worsening respiratory failure, and increased risk of BPD.

Question 3

Retinopathy of prematurity (ROP) development is primarily driven by which pathophysiological mechanism?

Accepted Answer

Hyperoxia causing cessation of retinal vascularization followed by hypoxia-driven neovascularization

Answer

Hyperoxia stops normal retinal vessel growth; when oxygen is reduced, VEGF-driven pathological neovascularization occurs, which can cause retinal detachment.

Question 4

A neonate has persistent metabolic acidosis with an elevated anion gap. Which condition should be suspected?

Accepted Answer

Inborn error of metabolism

Answer

An elevated anion gap metabolic acidosis in a neonate raises concern for inborn errors of metabolism (e.g., organic acidemias, maple syrup urine disease, or congenital lactic acidosis).

Question 5

Which physiological change explains the normal 'physiological jaundice' seen in healthy term newborns at 2–5 days of life?

Accepted Answer

Breakdown of fetal RBCs releasing unconjugated bilirubin exceeding immature hepatic conjugation capacity

Answer

Physiological jaundice results from increased breakdown of short-lived fetal RBCs combined with immature hepatic UDP-glucuronosyltransferase activity and increased enterohepatic recirculation.

NPS - Neonatal Pediatric Specialist Practice Test

NPS - Neonatal Pediatric Specialist Practice Test

NPS NPS Neonatal Physiology and Pathophysiology 2