NZREX Paediatrics and Obstetrics

Question 1

In NZ, what is the recommended immunisation schedule milestone at 6 weeks of age?

Accepted Answer

First doses of rotavirus, DTaP-IPV-HepB/Hib, and pneumococcal conjugate vaccines

Answer

No immunisations are given until 3 months in NZ

Answer

Only BCG vaccine is given at 6 weeks

Answer

MMR vaccine is given at 6 weeks

Question 2

A child presents to a NZ ED with croup. What is the initial management?

Accepted Answer

Oral dexamethasone (single dose 0.15-0.6 mg/kg) and nebulised adrenaline if severe stridor at rest

Answer

Immediate intubation for all cases

Answer

Antibiotics as first-line treatment

Answer

Steam inhalation only

Question 3

In NZ paediatric practice, what are the red flag features of a febrile child that suggest serious bacterial infection?

Accepted Answer

Non-blanching rash, bulging fontanelle, altered consciousness, prolonged capillary refill (>3 seconds), and inconsolable crying

Answer

Fever above 37.5°C in any child

Answer

Runny nose and cough with mild fever

Answer

Fever that responds to paracetamol

Question 4

What is the APGAR score used for in NZ neonatal assessment, and what are its five components?

Accepted Answer

Assessment of newborn wellbeing at 1 and 5 minutes — Appearance (colour), Pulse, Grimace (reflex), Activity (tone), Respiration

Answer

A measure of gestational age at birth

Answer

A score for the mother's post-delivery recovery

Answer

A classification of birth weight categories

Question 5

In NZ, what is the management of neonatal jaundice?

Accepted Answer

Assess total serum bilirubin, plot against treatment thresholds based on gestational age and hours of life, and treat with phototherapy if above the threshold

Answer

All jaundiced babies require exchange transfusion

Answer

Jaundice in newborns is always pathological and requires antibiotics

Answer

No treatment is ever needed — neonatal jaundice always resolves spontaneously

Question 6

A woman presents to a NZ maternity unit at 32 weeks gestation with preterm contractions. What is the key pharmacological intervention to improve neonatal outcomes?

Accepted Answer

Antenatal corticosteroids (betamethasone) to promote fetal lung maturity

Answer

IV antibiotics to prevent neonatal sepsis

Answer

Oxytocin to accelerate delivery

Answer

Oral iron supplements to prevent neonatal anaemia