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OSCE in Neonatology A Guide Book
OSCE in NeonatologyA Guide Book
OSCE in Neonatology A Guide Book
Editors-in-Chief
Srinivas MurkiMD DNB DM(Neo)
Senior ConsultantFernandez Hospital
Hyderabad, Telangana, India
Rhishikesh ThakreMD DNB DM(Neo) DCH FCPS FIAP
Consultant NeonatologistDirector
Neo Clinic and HospitalAurangabad, Maharashtra, India
New Delhi | London | PanamaThe Health Sciences Publisher
An Official Publication of Indian Academy of PediatricsNeONAtOLOgy ChAPter
ForewordPraveen Kumar
HeadquartersJaypee Brothers Medical Publishers (P) Ltd4838/24, Ansari road, DaryaganjNew Delhi 110 002, IndiaPhone: +91-11-43574357Fax: +91-11-43574314email: [email protected]
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© 2018, Jaypee Brothers Medical Publishers
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All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. the publisher is not associated with any product or vendor mentioned in this book.Medical knowledge and practice change constantly. this book is designed to provide accurate, authorita-tive information about the subject matter in question. however, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administra-tion, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.this book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.every effort has been made where necessary to contact holders of copyright to obtain permission to repro-duce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.
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OSCE in Neonatology: A Guide Book
First edition: 2018ISBN 978-93-5270-105-6
Printed at
Jaypee Brothers Medical Publishers (P) Ltd
Editorial Board
Chief Academic Editors
Associate Editors
Sandeep Kadam MD DM(Neo)
Senior Neonatal Consultant KEM Hospital and Ratna HospitalPune, Maharashtra, India
Naveen Jain DM (Neo) MD DNB
Associate ProfessorDepartment of Neonatology Kerala Institute of Medical SciencesTrivandrum, Kerala, India
Sanjay Wazir DM(Neo) MD
Director, Department of Neonatology Cloudnine HospitalGurugram, Haryana, India
Naveen Bajaj DM(Neo) MD Consultant Neonatologist Department of NeonatologyDeep HospitalLudhiana, Punjab, India
Suman Rao PN DM(Neo) MD
Professor and Head Department of Neonatology St Johns Medical College HospitalBengaluru, Karnataka, India
OSCE in Neonatology
vi
J Kumutha MD DCH Professor and Head Department of Neonatology Saveetha Medical CollegeChennai, Tamil Nadu, India
Swarna Rekha MD FNNF
Former Professor and HeadDepartment of NeonatologySt Johns Medical College HospitalBengaluru, Karnataka, India
Ranjan Kumar PejaverFRCP FRCPCH (UK) FIAP FNNF
Chief of NeonatologyMeenakshi HospitalsHon Professor, Department of NeonatologyKempegowda Institute of Medical SciencesBengaluru, Karnataka, India
Jayashree Mondkar MD DCH
Professor and Head Department of Neonatology I/C Human Milk Bank Lokmanya Tilak Municipal Medical CollegeMumbai, Maharashtra, India
Ruchi Nanavati MD IBCLC
Professor and Head Department of Neonatology Seth GS Medical College and KEM HospitalMumbai, Maharashtra, India
Editorial Advisory Board
Neonatology Chapter of Academy of Pediatrics
Office Bearers 2017–18
Chairperson : Dr Sanjay WazirHon. Secretary : Dr Naveen BajajTreasurer : Dr Nandkishor KabraJoint Secretary : Dr Rajesh KumarImm. Past Chairperson : Dr Rhishikesh Thakre
Executive MembersEast Zone : Dr Arjit Mohapatra, Dr Vinod KumarWest Zone : Dr Ashish Mehta, Dr Sanjay GhorpadeNorth Zone : Dr Deepak Chawla, Dr Kamal AroraCentral Zone : Dr Basawaraj T, Dr Ravi Shankar KSouth Zone : Dr Suman Rao, Dr VC Manoj
Indian Academy of Pediatrics
Office Bearers 2017
President : Dr Anupam SachdevaPresident Elect, 2017 : Dr Santosh T SoansVice President : Dr Mahaveer Prasad Jain Imm. Past President : Dr Pramod JogSecretary General : Dr Bakul J ParekhTreasurer : D Sandeep Bapu KadamEditor-in-Chief, IP : Dr Dheeraj Shah Editor-in-Chief, IJPP : Dr NC GowrishankarJoint Secretary : Dr Ajay Gambhir
Office Bearers
Contributors
Adhisivam B DCH DNB
Associate ProfessorDepartment of NeonatologyJawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry, IndiaE-mail: [email protected]
AK Rawat MD
Professor and HeadDepartment of PediatricsBundelkhand Medical CollegeSagar, Madhya Pradesh, IndiaE-mail: [email protected]
Amrit Jeevan DCH MD
Surya Mother and Child Super Speciality HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Anil Kumar MD
Consultant NeonatologistCloud Nine HospitalGurugram, Haryana, IndiaE-mail: [email protected]
Anjali Kulkarni MD
Former HeadDepartment of Pediatrics and NeonatologySir HN Reliance Foundation HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Anu Sachdeva MD DNB (Pediatrics)
MNAMS DM (Neonatology)
Assistant ProfessorDepartment of PediatricsAll India Institute of Medical SciencesNew Delhi, IndiaE-mail: [email protected]
Anuradha Murki MS
Assistant ProfessorDepartment of Obstetrics and GynecologyKamineni Academic Institute and Research CenterHyderabad, Telangana, IndiaE-mail: [email protected]
Archana Kadam MD DNB
Developmental PediatricianKEM Hospital and Jehangir HospitalPune, Maharashtra, IndiaE-mail: [email protected]
Ashish Jain DM (Neo) MD
Assistant ProfessorDepartment of NeonatologyMaulana Azad Medical CollegeNew Delhi, IndiaE-mail: [email protected]
Asim Kumar Mallick MD
Professor and In-Charge, Neonatal UnitDepartment of PediatricsNRS Medical College and HospitalKolkata, West Bengal, IndiaE-mail: [email protected]
Atul Kulkarni MD
Assistant ProfessorAshwini Rural Medical College and HospitalSolapur, Maharashtra, IndiaE-mail: [email protected]
Bhavani Kalavalapalli MRCPCH
CCT FRCPCH
Consultant Pediatrician and NeonatologistDirectorInstitute of Diabetes, Endocrinology and Adiposity Centres
OSCE in Neonatology
x Hyderabad, Telangana, IndiaE-mail: [email protected]
Brajesh Jha DM
Senior Resident (Neo)Department of NeonatologyMaulana Azad Medical CollegeNew Delhi, IndiaE-mail: [email protected]
Chandrasekharam
MCH(Paediatric Surgery)
Pediatric SurgeonAnkura HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Deepak Niraj DM (Neo) MD
Senior ConsultantBJ Wadia Children HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Deepak Sharma DNB (Neo) MD
Consultant NeonatologistNeo ClinicJaipur, Rajasthan, IndiaE-mail: [email protected]
Dhanya Dharmapalan MD
Consultant PediatricianApollo HospitalNavi Mumbai, Maharashtra, IndiaE-mail: [email protected]
Dinesh Chirla MD DM MRCPCH
DirectorRainbow Children HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Femitha P DM (Neo) MD
Associate ConsultantDepartment of NeonatologyKerala Institute of Medical SciencesThiruvananthapuram, Kerala, IndiaE-mail: [email protected]
Haribalakrishna Balasubramanian DM (Neo) MD
Surya Children HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Hemasree Kandraju MD DNB(Neo)
Consultant NeonatologistFernandez HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
J Kumutha MD DCH
Professor and HeadDepartment of NeonatologySaveetha Medical CollegeChennai Tamil Nadu, IndiaE-mail: [email protected]
Kanishka Das MS MCH
ProfessorDepartment of Pediatric SurgerySt John’s HospitalBengaluru, Karnataka, IndiaE-mail: [email protected]
Kanithi Ravishankar DM (Neo) MD
DirectorSowmya Children’s HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
LS Deshmukh DM (Neo) MD
Professor and HeadDepartment of NeonatologyGovernment Medical College and HospitalAurangabad, Maharashtra, IndiaE-mail: [email protected]
Madhavi Shelke MD
Fellowship in Pediatric NeurologyConsultant Pediatric NeurologistICON Centre for Child NeurodevelopmentAurangabad, Maharashtra, IndiaE-mail: [email protected]
Contributors
xiMadhavi V MD
Clinical GeniticistFernandez HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Mangala Bharathi S MD DM(Neo) DNB
Associate ProfessorDepartment of NeonatologyInstitute of Child Health and Hospital for ChildrenMadras Medical CollegeChennai, Tamil Nadu, IndiaE-mail: [email protected]
Manigandan Chandrasekaran MD
Department of NeonatologySaveetha Medical CollegeChennai, Tamil Nadu, India
Mehul Shah MD (Ped) DCH (Bom) MD
(USA) DABPN (USA)
Consultant Pediatric NephrologistApollo Health City and Little Stars Childrens HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Mohit Sahni MBBS DCH DNB(Ped)
Fellowship Neonatology and Neonatal Cardiology Sydney (Australia) and Toronto (Canada) Director NICU and AccedemicsConsultant Neonatologist and Neonatal CardiologistNirmal Hospital Pvt Ltd.Surat, Gujarat, IndiaE-mail: [email protected]
Monika Kaushal DM (Neo) MD
Visiting Fellowship RCPCH
HeadDepartment of Pediatrics and NeonatologyZulekha HospitalDubai, UAEE-mail: [email protected]
Murlidhar D Mahajan MD DCH
DNB MNAMS
Consulting Metabolic SpecialistJupiter Hospital Mumbai, Maharashtra, IndiaE-mail: [email protected]
N Chandra Kumar MD DNB
MNAMS DM (Neonatology) DNB (Neo)
DirectorCloud NineChennai, Tamil nadu, IndiaE-mail: [email protected]
Nageshwar Rao DM MD
ChiefDivision of Pediatric CardiologyCare HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Nandkishor S Kabra DM (Neo)
MD (Ped) DNB (Ped) MSc (Clinical
Epidemiology)
Director, Neonatal Intensive Care UnitSurya Children’s Medicare Pvt LtdMumbai, Maharashtra, IndiaE-mail: [email protected]
Naveen Bajaj DM (Neo) MD
Consultant NeonatologistDepartment of NeonatologyDeep HospitalLudhiana, Punjab, IndiaE-mail: [email protected]
Naveen Jain DM (Neo) MD DNB
Associate ProfessorDepartment of NeonatologyKerala Institute of Medical SciencesThuruvananthapuram, Kerala, IndiaE-mail: [email protected]
Nitasha Bagga MD
ConsultantRainbow Children HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
OSCE in Neonatology
xii Pankaj Bhansali MD
Consultant NephrologistNiramay Children HospitalAurangabad, Maharashtra, IndiaE-mail: [email protected]
Pradeep Suryawanshi MD DCH
(Sydney)
Fellowship in Neontal Perinatal Medicine (Australia)Professor and HeadDepartment of NeonatologyBVU Medical CollegePune, Maharashtra, IndiaE-mail: [email protected]
Pradnya Deshmukh MS (Ophth)
Associate ProfessorDepartment of OphthalmologyMGM College and HospitalAurangabad, Maharashtra, IndiaE-mail: [email protected]
Prashant P Patil MD (Peds) PDCC ESPE
Consultant Pediatric and Adolescent Endocrinologist and DiabetologistRainbow Pediatric Multispeciality ClinicMumbai, Maharashtra, IndiaE-mail: [email protected]
Prashantha YN MD DM
Senior ResidentDepartment of NeonatologySt John’s Medical College HospitalBengaluru, Karnataka, India
Preetha Joshi MD
Fellowship in NICU, University of Sydney and HamiltonFellowship in PICU, Critical Care TransportCardiac ICU, University of Sydney and TorontoPediatric and Neonatal IntensivistKokilaben Dhirubhai Ambani HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Premal Naik MS DNB (Ortho)
Department of OrthopedicsSmt SCL HospitalSmt NHL Municipal Medical CollegeAhmedabad, Gujarat, IndiaE-mail: [email protected]
Rahul Bhamkar MD
Associate ConsultantSir HN Reliance Foundation HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Rajesh Kumar DM (Neo) MD
Director and Chief NeonatologistRani HospitalRanchi, Jharkhand, IndiaE-mail: [email protected]
Rajiv Sharan DNB MNAMS
Consultant PediatricianTata Motors HospitalJamshedpur, Jharkhand, IndiaE-mail: [email protected]
Raktima Chakrabarti MD
Fellowship in Neonatology (Germany)
Consultant Pediatrician and NeonatologistEscape, Nirvana CountryGurugram, Haryana, IndiaE-mail: [email protected]
Ramani Ranjan DCH MD
Fellowship in NeonatalogySpecialist in Pediatrics and NeonatologyTata Main HospitalJamshedpur, Jharkhand, IndiaE-mail: [email protected]
Rhishikesh Thakre MD DNB
DM(Neo) DCH FCPS FIAP
Consultant NeonatologistDirectorNeo Clinic and HospitalAurangabad, Maharashtra, IndiaE-mail: [email protected]
Contributors
xiiiRoopa Bellad MD DCH
ProfessorDepartment of PediatricsJawaharlal Nehru Medical CollegeBelgaum, Karnataka, IndiaE-mail: [email protected]
Sandeep Kadam MD DM (Neo)
Senior Neonatal ConsultantKEM Hospital and Ratna HospitalPune, Maharashtra, IndiaE-mail: [email protected]
Sandeep Patil MD DM(Neo)
Consultant Neonatologist“Care” Advanced Neonatal CenterNanded, Maharashtra, IndiaE-mail: [email protected]
Sanjay Wazir DM (Neo) MD
DirectorDepartment of NeonatologyCloudnine HospitalGurugram, Haryana, IndiaE-mail: [email protected]
Smruti Patel MD
Fellowship in Pediatric CardiologyPediatric CardiologistFortis Hospital, Deep HospitalLudhiana, Punjab, IndiaE-mail: [email protected]
Snehal Kulkarni MD DNB (Card) FACC
ChiefDivision of Pediatric CardiologyKokilaben Dhirubhai Ambani HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Snehal Thakre MS (Ophthal) DNB
ProfessorDepartment of OphthalmologyMGM Medical College and HospitalAurangabad, Maharashtra, IndiaE-mail: [email protected]
Srinivas Murki MD DNB DM(Neo)
Senior ConsultantFernandez HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Suman Rao PN DM (Neo) MD
Professor and HeadDepartment of NeonatologySt John’s Medical College HospitalBengaluru, Karnataka, IndiaE-mail: [email protected]
Surg Cmde Sheila S Mathai, VSM DM (Neo) MD DNB
Professor and HeadDepartment of PediatricsArmed Forces Medical CollegePune, Maharashtra, IndiaE-mail: [email protected]
Tanushri Mukherjee DCH DNB
IAP Neonatology FellowshipClinical AssociateDepartment of NeonatologyKokilaben Dhirubhai Ambani HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Tejopratap Oleti DM (Neo) MD
Consultant NeonatologistFernandez HospitalHyderabad, Telangana, IndiaE-mail: [email protected]
Umesh Vaidya MD
HeadDepartment of NeonatologyKEM HospitalPune, Maharashtra, IndiaE-mail: [email protected]
Vaman V Khadilkar MD DNB MRCP
(UK) DCH (London)
Consultant Pediatrician, Adolescent Endocrinologist and DiabetologistJehangir Hospital, Pune Bombay Hospital, Mumbai HeadDivision of Pediatric Endocrinology
OSCE in Neonatology
xiv Bharati Vidyapeeth Medical CollegePune, Maharashtra, IndiaE-mail: [email protected]
VC Manoj MD
Associate Professor and HeadDepartment of NeonatologyJubilee Mission Medical CollegeThrissur, Kerala, IndiaE-mail: [email protected]
Vijay Yewale MD
Consultant PediatricianApollo HospitalNavi Mumbai, Maharashtra, IndiaE-mail: [email protected]
Vikram Hirekerur MD DCH DNB
Associate ProfessorAshwini Rural Medical College and HospitalSolapur, Maharashtra, IndiaE-mail: [email protected]
Vinay Joshi DM (Neo) MD
Fellowship in PICU and PCICU, University of Toronto, CanadaFellowship in Neonatal and Perinatal Medicine, University of New South Wales, Sydney, AustraliaPediatric Intensivist and NeonatologistKokilaben Dhirubahai Ambani HospitalMumbai, Maharashtra, IndiaE-mail: [email protected]
Yogesh Waikar MD DNB MNAMS
PGCC
Fellow in Pediatric Gastroenterology and Liver TransplantConsultant Pediatric Gastroenterologist and HepatologistPedgihep ClinicsNagpur, Mahrashtra, IndiaE-mail: [email protected]
Foreword
Neonatal intensive care has always been a highly technology-dependent specialty. With exponential advancements in medical equipment and laboratory in recent years, the clinical skills of eliciting history, doing a systematic but meaningful examination and synthesizing the data to reach at a pathophysiological diagnosis have further dwindled. The goal behind publication of this book is to facilitate a structured and systematic approach to clinical evaluation, examination and skills essential for care of the sick newborn. In addition, the book also offers very useful and practical information about imaging, medications and vital statistics related to India’s newborn. Divided into theme-based sections, several topics of practical and clinical relevance have been covered with focus on essential clinical skills.
Over the last decade, the Neonatology Chapter of Indian Academy of Pediatrics has taken great strides and done phenomenal work towards training and education of postgraduates, fellows and nurses in the field of neonatology. The dynamic, committed and highly motivated leadership of this chapter has mastered the art of organizing high quality workshops and conferences with pure academic focus in a short span of time. They have excelled in producing and publishing a number of hugely popular resources for everyone working for the care of newborns. OSCE in Neonatology: A Guide Book is another unique effort to help the postgraduates and fellows in honing their skills in neonatal medicine. OSCEs are an essential and very effective method of teaching, learning and evaluating neonatology. The book should serve as a useful resource for examiners.
I am confident this book will become an essential resource for all students, house officers, postgraduates, fellows and clinicians working in SNCUs and NICUs. The contributions of more than 60 trained neonatologists, should be able to guide readers towards optimal and rational utilization of available resources translating into better and cost-effective clinical care.
My best wishes for the success of OSCE in Neonatology: A Guide Book.
Praveen KumarProfessor, Neonatal Unit
Department of PediatricsPost Graduate Institute of Medical Education and Research
Chandigarh, India
We take great pleasure and pride in offering the OSCE in Neonatology: A guide book. Clinical medicine is the core of patient care. History, physical examination, ordering tests and their interpretation form the foundation of this clinical medicine. Knowing the family and establishing rapport with the parents would also add value to the clinical care. In the present technology- driven neonatal care, there is tendency to ignore the core concepts and order of tests and investigations even before a detailed evaluation of the newborn. In this book, we have provided a structured approach to the newborn care with special emphasis on history, examination, interpretation of laboratory tests and tried to bridge the gap between bench and bedside.
The book has chapters on focused history, focused examination, emergency room assessment and stabilization, case scenarios, drugs, equipment, interpreting tests/results and counseling, which provide insights into clinical approach. We sincerely hope the book adds to the armamentarium of postgraduates, fellows, and students of neonatology to sharpen the skills and provide a rational clinical approach.
We are grateful to all our authors for their valuable contributions without which this book would not have seen the light of the day. We would appreciate and look forward to your feedback and comments.
We thank the office bearers of IAP Neonatology Chapter for having the faith in us. We appreciate all the support of Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Ritu Sharma (Director–Content Strategy), Ms Sunita Katla (PA to Group Chairman and Publishing Manager), Mr Manish Pahuja (General Manager–Production) for all their support to work in this project and make it a success. Without their cooperation, we could not have completed this project.
Preface
Srinivas MurkiMD DNB DM(Neo)
Rhishikesh ThakreMD DNB DM(Neo) DCH FCPS FIAP
ContentsChapter 1. Focused History Taking ...................................................1
Instructions to Facilitator ...........................................................................1Preterm Admission at Birth .......................................................................1Feeding History Taking ...............................................................................2Inadequate Breast Milk ...............................................................................4Respiratory Distress .....................................................................................4Shock .................................................................................................................5Hypoglycemia ................................................................................................5Jaundice ...........................................................................................................6
Chapter 2. Focused Clinical Examination ..........................................8Well Baby Examination ...............................................................................8Breastfeeding .............................................................................................. 10Weight, length and Occipitofrontal Circumference (OFC) Measurement .............................................................................................. 11Capillary Refill Time ................................................................................... 13Blood Pressure Measurement by Oscillometry ............................... 14Developmental Dysplasia of Hip .......................................................... 14Jaundice ........................................................................................................ 16Moro Examination ..................................................................................... 17Popliteal Angle ............................................................................................ 18Heel to Ear Examination .......................................................................... 19Scarf Sign ...................................................................................................... 19Assessment of Shoulder Tone ............................................................... 20Palmar Grasp Reflex .................................................................................. 22Plantar Grasp Reflex .................................................................................. 23Asymmetric Tonic Neck Reflex .............................................................. 24Denver Developmental Screening Test (DDST)-II .......................... 25Respiratory Distress Scoring .................................................................. 26Evaluate for Systemic Causes of Poor Weight Gain ....................... 29Check for Adequacy of Ventilator Settings ....................................... 29Check for Adequacy of Bubble CPAP Settings ................................ 30Assessing Fontanel ................................................................................... 30Hammersmith Neonatal Neurological Examination ..................... 31New Ballard Score ...................................................................................... 33
Chapter 3. Emergency Assessment/Stabilization ............................40Identifying a Sick Newborn .................................................................... 35Assess for Jaundice Severity .................................................................. 36Respiratory Distress .................................................................................. 37Shock .............................................................................................................. 39Hypoglycemia ............................................................................................. 40Seizures ......................................................................................................... 41Abnormal Movements (not Seizures) ................................................. 42
OSCE in Neonatology
xx Assessing Hydration ................................................................................. 43Excessive Crying ......................................................................................... 45Vomiting ........................................................................................................ 46Previous Sibling Unexpected Death ................................................... 47Cough in a Neonate .................................................................................. 48Case Studies: Jaundice ............................................................................. 49Case Studies: Respiratory Distress ....................................................... 53Case Studies: Sick Newborn ................................................................... 56
Chapter 4. Case Studies .................................................................67Cardiology ................................................................................................... 64Electrolyte Disturbances ......................................................................... 68Infections in the Newborn ...................................................................... 73Musculoskeletal .......................................................................................... 78Jaundice ........................................................................................................ 82Inborn Errors of Metabolism .................................................................. 89Nutrition and Growth ............................................................................... 94Nephrology .................................................................................................. 97Emergency and Critical Care ................................................................101Necrotizing Enterocolitis .......................................................................104Adopted Baby ...........................................................................................106Gastroesophageal Reflux ......................................................................107Thyroid Disorders in the Newborn ....................................................110Retinopathy of Prematurity Screening ............................................113Statistics ......................................................................................................120
Chapter 5. Drugs ......................................................................... 127Adenosine...................................................................................................124Adrenaline ..................................................................................................125Magnesium Sulfate .................................................................................125Erythromycin .............................................................................................125lyophilized Amphotericin ....................................................................126Amphotericin ............................................................................................127Calcium Gluconate ..................................................................................128Thiamine .....................................................................................................128Pyridoxine ...................................................................................................128Anti-D ...........................................................................................................128Dextrose ......................................................................................................129Diazoxide ....................................................................................................129Milrinone .....................................................................................................130Fluconazole ................................................................................................132Fosphenytoin ............................................................................................132Intravenous Immunoglobulin (IVIG) .................................................133linezolid .....................................................................................................133low Molecular Weight Heparin ..........................................................134Nitric Oxide ................................................................................................135Normal Saline ............................................................................................136Dexamethasone .......................................................................................136Betamethasone ........................................................................................137
Contents
xxiPropranolol ................................................................................................138Phenobarbitone .......................................................................................139Probiotics ....................................................................................................139Sildenafil ......................................................................................................140Vancomycin................................................................................................141Alpostin .......................................................................................................142
Chapter 6. Instruments ............................................................... 147Bilirubinometer .........................................................................................143FiO2 monitor ..............................................................................................144Fluxmeter ....................................................................................................144Neonatal Incubator .................................................................................145Infusion Pump ...........................................................................................146Multichannel (Multi-parameter) Monitor ........................................147Phototherapy Unit ...................................................................................148Pulse Oximeter ..........................................................................................148Radiant Warmer ........................................................................................149Self-inflating Bag and Mask..................................................................150Syringe Pump ............................................................................................151Weighing Machine ..................................................................................152
Chapter 7. Imaging ..................................................................... 158Interpretation of Chest X-ray/Abdomen .........................................153Neonatal Cranial Ultrasound ...............................................................171Echocardiogram .......................................................................................176Magnetic Resonance Imaging ............................................................179
Chapter 8. Interpretation ............................................................ 186Arterial Blood Gas ....................................................................................186Capnography .............................................................................................191C-reactive Protein ....................................................................................192Cardiotocography ....................................................................................193Denver Developental Screening Test-II Interpretation of Reports ......................................................................197Neonatal Electroencephalogram .......................................................200Genetics .......................................................................................................210Intrauterine Growth Chart ....................................................................219Hepatobiliary Case Studies ..................................................................220Jaundice Evaluation ................................................................................224Microerythrocyte Sedimentation Rate ............................................227Neurology Case Studies.........................................................................227Partograph ................................................................................................232Peripheral Smear .....................................................................................234Pulse Oximeter Predischarge ...............................................................239Shake Test ...................................................................................................240Neonatal Surgery .....................................................................................241
Chapter 9. Observed Station ........................................................ 249Neonatal Resuscitation ..........................................................................249Phenobarbital Administration ...........................................................251
OSCE in Neonatology
xxii Unexplained Birth Asphyxia ................................................................252Counseling .................................................................................................253Sudden Neonatal Death in Unit .........................................................254Sudden Death of a Newborn in the Unit .........................................255Previous Sibling Unexpected Death .................................................255Consent for a New Drug or Trial .........................................................256Consent for Therapeutic Hypothermia ............................................257Death of ElBW Baby ...............................................................................258Death of a Baby after a Prolonged Hospital Stay .........................259Death of Baby Operated for Diaphragmatic Hernia ....................260
Chapter 10. miscellaneous ............................................................ 262India Demographics Spots ...................................................................262Spots .............................................................................................................269
Index .................................................................................................... 281
