A neonate born to a mother with opioid use disorder develops excessive high-pitched crying, tremors, fever of 38.6°C (101.5°F), and loose stools at 36 hours of life. What is the most important first-line therapy?
A 29-week premature infant develops persistent oxygen dependence, hypercapnia, wandering atelectasis, and fine, diffuse interstitial opacities on chest radiograph by 4 weeks of age, after initial respiratory distress. What long-term complication is this infant at risk for?
A 35-week preterm infant born by emergency cesarean has persistent hypoglycemia, temperature instability, and is small for gestational age. The mother reports preeclampsia. Laboratory results show polycythemia. Which mechanism best explains the neonate’s elevated hematocrit?
A neonate is born with severe anemia, pallor, tachycardia, poor perfusion, and hypotension. Postnatal labs support profound anemia, and the mother reports decreased fetal movement prior to delivery. Maternal blood testing with acid elution identifies fetal erythrocytes. What is the most likely etiology?
A 25-week preterm infant develops frequent, severe episodes of apnea and bradycardia despite caffeine therapy. Physical exam is otherwise normal. What is the most likely next step?
A premature twin born at 31 weeks is diagnosed with twin anemia-polycythemia sequence (TAPS). Which early neonatal transfusion decision is appropriate for the donor twin found to have severe anemia?
A premature twin born at 31 weeks is diagnosed with twin-to-twin transfusion syndrome (TTTS). Which early neonatal transfusion decision is appropriate for the donor twin found to have hypovolemia and anemia?
A neonate with suspected meconium ileus has a palpable doughy abdomen and a family history of cystic fibrosis. Which gene variant is most likely in this patient?
A term newborn girl is small for gestational age and delivered after a pregnancy complicated by maternal hypertension. On exam, she has visible rib cage, loose skin, and a relatively large head. Which finding is most consistent with asymmetric intrauterine growth restriction?
A 3-week-old preterm infant develops pallor, tachycardia, and hypotension. Laboratory results reveal Hb 6 g/dL and reticulocytosis. Direct antiglobulin test is positive. What is the underlying mechanism?
