I85PREP
⌘ K
Examen Estatal de Pediatría study materials
Examen Estatal de Pediatría study resources

Examen Estatal de Pediatría practice questions

One question at a time. Build your Examen Estatal de Pediatría understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Pediatría general y crecimiento y desarrollo

A term newborn is examined at 24 hours of life. Which primitive reflex is normally present and consists of extension of the fingers with adduction of the thumb when the palm is stroked?

  1. Babinski sign
  2. Moro reflex
  3. Rooting reflex
  4. Palmar grasp reflex Correct answer.

Explanation

The palmar grasp reflex is elicited by stroking the palm, producing finger flexion that grips the examiner's finger; it is present from birth and fades by 3-6 months. The Moro reflex is a startle response to sudden head extension, and rooting is triggered by perioral stroking.

Question 2Pediatría general y crecimiento y desarrollo

At what age does a typically developing infant usually achieve independent sitting without support?

  1. 14 to 15 months
  2. 2 to 3 months
  3. 6 to 8 months Correct answer.
  4. 11 to 12 months

Explanation

Independent sitting without support is a gross motor milestone typically reached between 6 and 8 months. Earlier sitting requires support, and by 11-12 months most infants are pulling to stand or cruising.

Question 3Pediatría general y crecimiento y desarrollo

A 2-year-old is brought for a routine visit. Which language milestone is most consistent with normal development at this age?

  1. Uses two-word phrases and has roughly 50 words Correct answer.
  2. Speaks in full sentences of five or more words
  3. Tells a short story in sequence
  4. Names three colors correctly

Explanation

By 24 months a child typically combines two words and has a vocabulary of about 50 words. Full sentences, color naming, and narrative speech develop later in the preschool years.

Question 4Pediatría general y crecimiento y desarrollo

A healthy 4-month-old is brought for well-child care. Which feeding statement reflects standard infant nutrition guidance?

  1. Whole cow milk should replace breast milk at 4 months
  2. Exclusive breastfeeding is recommended until about 6 months of age Correct answer.
  3. Solids should be introduced at 2 months to improve sleep
  4. Water should be offered routinely between feeds from birth

Explanation

Exclusive breastfeeding, or iron-fortified formula, is recommended for approximately the first 6 months, with complementary foods starting around 6 months. Cow milk, routine water, and early solids are not advised at 4 months.

Question 5Pediatría general y crecimiento y desarrollo

A 5-year-old has a body mass index at the 90th percentile for age and sex. How is this weight status classified?

  1. Underweight
  2. Obesity
  3. Normal weight
  4. Overweight Correct answer.

Explanation

For children aged 2 years and older, a BMI between the 85th and 94th percentile is classified as overweight, while obesity is at or above the 95th percentile. Below the 5th percentile is underweight.

Question 6Pediatría general y crecimiento y desarrollo

Which measurement is plotted on a growth chart to assess acute nutritional status in a child?

  1. Head circumference-for-age
  2. Height-for-age
  3. Weight-for-length or weight-for-age Correct answer.
  4. Mid-parental height

Explanation

Weight-based indices reflect acute nutritional change because weight responds quickly to intake, whereas height-for-age reflects chronic or long-standing nutrition. Head circumference and mid-parental height assess growth of the head and genetic height potential respectively.

Question 7Pediatría general y crecimiento y desarrollo

A 9-month-old has a hemoglobin of 9.5 g/dL with microcytic indices and a low ferritin. He drinks 900 mL of whole cow milk daily and eats little iron-rich food. What is the most likely cause?

  1. Vitamin B12 deficiency
  2. Iron deficiency anemia from excessive cow milk intake Correct answer.
  3. Physiologic anemia of infancy
  4. Thalassemia trait

Explanation

Excessive cow milk displaces iron-rich foods and impairs iron absorption, producing a microcytic anemia with low ferritin in a toddler. Thalassemia trait would show normal or high ferritin, and physiologic anemia of infancy occurs earlier, at 2-3 months.

Question 8Pediatría general y crecimiento y desarrollo

A 12-month-old is brought for immunization review. Which vaccine is routinely recommended at this age in most national schedules?

  1. BCG at birth
  2. Measles-mumps-rubella Correct answer.
  3. Rotavirus first dose
  4. Hepatitis B birth dose

Explanation

The first dose of measles-mumps-rubella vaccine is typically given at 12 months, when maternal antibody interference has waned. Hepatitis B birth dose, BCG, and rotavirus are given in the neonatal or early infant period.

Question 9Pediatría general y crecimiento y desarrollo

A 6-year-old with a fever of 39 C for 3 days has injected pharynx, strawberry tongue, and a sandpaper rash with a positive rapid streptococcal test. What is the most appropriate treatment?

  1. Observation without antibiotics
  2. Oral acyclovir
  3. Oral penicillin for 10 days Correct answer.
  4. Topical corticosteroid

Explanation

This is streptococcal pharyngitis with scarlet fever features, and penicillin or amoxicillin for 10 days is the treatment of choice to prevent acute rheumatic fever. Antivirals, steroids, and observation are inappropriate for confirmed streptococcal infection.

Question 10Pediatría general y crecimiento y desarrollo

A 3-year-old presents with a barking cough, hoarse voice, and inspiratory stridor that worsens at night. What is the most likely diagnosis?

  1. Bronchiolitis
  2. Epiglottitis
  3. Foreign body aspiration
  4. Croup (laryngotracheobronchitis) Correct answer.

Explanation

A barking cough with hoarseness and inspiratory stridor in a toddler is characteristic of viral croup. Epiglottitis presents with high fever, drooling, and a muffled voice, while bronchiolitis features wheezing and foreign body usually has sudden onset without fever.

Question 11Pediatría general y crecimiento y desarrollo

A 4-month-old has a respiratory rate of 60/min, subcostal retractions, and diffuse wheezes during winter. Which virus is the most common cause of this presentation?

  1. Epstein-Barr virus
  2. Varicella-zoster virus
  3. Respiratory syncytial virus Correct answer.
  4. Measles virus

Explanation

Bronchiolitis in infants is most often caused by respiratory syncytial virus, producing tachypnea, retractions, and wheezing. Measles, EBV, and varicella do not typically cause this lower respiratory pattern.

Question 12Pediatría general y crecimiento y desarrollo

A 10-year-old with asthma uses a short-acting beta-agonist daily and wakes at night twice a week. How is asthma control classified?

  1. Partly controlled
  2. Well controlled
  3. Not assessable from this information
  4. Uncontrolled Correct answer.

Explanation

Daily reliever use plus nighttime symptoms twice weekly indicates uncontrolled asthma under standard control criteria. Well-controlled asthma requires daytime symptoms twice or less per week, no night waking, and infrequent reliever use.

Question 13Pediatría general y crecimiento y desarrollo

A 2-year-old has a harsh systolic murmur at the left upper sternal border, a fixed split second heart sound, and a history of recurrent respiratory infections. What is the most likely lesion?

  1. Patent ductus arteriosus
  2. Atrial septal defect Correct answer.
  3. Ventricular septal defect
  4. Aortic stenosis

Explanation

A fixed split S2 with a systolic murmur at the upper left sternal border is the hallmark of an atrial septal defect, which may cause recurrent pulmonary infections. A ventricular septal defect produces a holosystolic murmur at the lower left sternal border, and a patent ductus arteriosus gives a continuous murmur.

Question 14Pediatría general y crecimiento y desarrollo

A 6-week-old has poor feeding, tachypnea, and hepatomegaly, and is found to have a large ventricular septal defect. Which physiologic change explains the timing of heart failure at this age?

  1. Rise in systemic vascular resistance
  2. Maturation of the fetal hemoglobin
  3. Fall in pulmonary vascular resistance after birth Correct answer.
  4. Closure of the ductus arteriosus

Explanation

As pulmonary vascular resistance falls after birth, left-to-right shunting across a large ventricular septal defect increases, so heart failure typically appears at 4-8 weeks rather than at birth. Ductal closure and systemic resistance changes do not explain this shunt-dependent timing.

Question 15Pediatría general y crecimiento y desarrollo

A 5-year-old presents with periorbital edema, foamy urine, and proteinuria of 4+ without hematuria or hypertension. What is the most likely diagnosis?

  1. Acute post-streptococcal glomerulonephritis
  2. Urinary tract infection
  3. Hemolytic uremic syndrome
  4. Minimal change nephrotic syndrome Correct answer.

Explanation

Nephrotic syndrome in young children, most often minimal change disease, presents with heavy proteinuria, hypoalbuminemia, and edema without hematuria or hypertension. Post-streptococcal glomerulonephritis and hemolytic uremic syndrome typically include hematuria, hypertension, or renal failure.

Question 16Pediatría general y crecimiento y desarrollo

A 3-year-old presents with colicky abdominal pain, vomiting, and a palpable sausage-shaped mass, and passes red currant jelly stool. What is the most likely diagnosis?

  1. Hirschsprung disease
  2. Intussusception Correct answer.
  3. Meckel diverticulum
  4. Pyloric stenosis

Explanation

Intermittent colicky pain, a sausage-shaped abdominal mass, and currant jelly stool form the classic triad of intussusception in a toddler. Pyloric stenosis causes nonbilious projectile vomiting in younger infants, and Hirschsprung disease causes delayed meconium and constipation.

Question 17Pediatría general y crecimiento y desarrollo

A 3-week-old firstborn male has projectile nonbilious vomiting after feeds and a palpable olive-shaped mass in the epigastrium. Which laboratory abnormality is expected?

  1. Hypochloremic hypokalemic metabolic alkalosis Correct answer.
  2. Hyperkalemic metabolic acidosis
  3. Normal electrolytes with elevated transaminases
  4. Hyperchloremic metabolic acidosis

Explanation

Pyloric stenosis causes loss of gastric hydrochloric acid, leading to hypochloremic, hypokalemic metabolic alkalosis with paradoxical aciduria. Acidosis and transaminase elevation are not typical.

Question 18Pediatría general y crecimiento y desarrollo

A 7-year-old has a 3-day history of fever, sore throat, and a diffuse maculopapular rash, with tender enlarged cervical nodes and palatal petechiae. Which diagnosis should be considered given the constellation?

  1. Streptococcal impetigo
  2. Roseola infantum
  3. Kawasaki disease
  4. Epstein-Barr virus infectious mononucleosis Correct answer.

Explanation

Fever, pharyngitis, tender cervical lymphadenopathy, and palatal petechiae suggest infectious mononucleosis, commonly due to Epstein-Barr virus. Kawasaki disease requires prolonged fever with mucocutaneous changes, and roseola affects younger infants with rash after defervescence.

Question 19Pediatría general y crecimiento y desarrollo

A 4-year-old has a petechial rash, platelet count of 15,000/mcL, and otherwise normal blood counts. What is the most likely diagnosis?

  1. Acute lymphoblastic leukemia
  2. Immune thrombocytopenic purpura Correct answer.
  3. Hemophilia A
  4. Disseminated intravascular coagulation

Explanation

Isolated thrombocytopenia with petechiae and normal red and white cell counts in a well-appearing child suggests immune thrombocytopenic purpura. Leukemia usually causes additional cytopenias, hemophilia causes bleeding with normal platelets, and disseminated intravascular coagulation shows coagulopathy.

Question 20Pediatría general y crecimiento y desarrollo

A 10-year-old with sickle cell disease has fever of 39 C, cough, and chest pain with a new infiltrate on chest radiograph. What is the most important initial management step?

  1. Oral iron supplementation
  2. Prompt antibiotics and evaluation for acute chest syndrome Correct answer.
  3. Observation at home with analgesics
  4. Routine transfusion for all febrile episodes

Explanation

Fever with respiratory symptoms and a new infiltrate in sickle cell disease suggests acute chest syndrome, which requires prompt antibiotics, oxygen, and often transfusion. Iron supplementation and outpatient observation are inappropriate for this acute complication.

Question 21Pediatría general y crecimiento y desarrollo

A 2-year-old is noted to have bowing of the legs, widening of the wrists, and delayed tooth eruption. Which deficiency is most likely?

  1. Vitamin A deficiency
  2. Vitamin D deficiency Correct answer.
  3. Vitamin K deficiency
  4. Vitamin C deficiency

Explanation

Rickets from vitamin D deficiency causes defective mineralization with bowing of weight-bearing bones, wrist widening at the growth plates, and delayed dentition. Vitamin C deficiency causes scurvy with bleeding gums, and vitamin K deficiency causes bleeding.

Question 22Pediatría general y crecimiento y desarrollo

A newborn is small for gestational age with a head circumference also below the 3rd percentile, and the mother reports heavy alcohol use during pregnancy. Which finding best supports a diagnosis of fetal alcohol syndrome?

  1. Macrocephaly with frontal bossing
  2. Smooth philtrum with thin upper lip and short palpebral fissures Correct answer.
  3. Single transverse palmar crease isolated
  4. Polydactyly

Explanation

Fetal alcohol syndrome features characteristic facial dysmorphology including a smooth philtrum, thin vermilion border, and short palpebral fissures, together with growth restriction and neurodevelopmental impairment. Macrocephaly and polydactyly are not part of the phenotype.

Question 23Pediatría general y crecimiento y desarrollo

A 14-year-old girl has not yet had menarche and lacks breast development at age 14. Which evaluation is most appropriate initially?

  1. Recheck in 2 years
  2. Reassure that delayed puberty is normal at this age
  3. Start combined oral contraceptives
  4. Measure follicle-stimulating hormone and karyotype Correct answer.

Explanation

Absence of breast development by age 14 warrants evaluation for hypogonadism, including gonadotropins and karyotype to assess conditions such as Turner syndrome. Reassurance or hormonal therapy without diagnosis is inappropriate.

Question 24Pediatría general y crecimiento y desarrollo

A 9-year-old girl presents with breast budding and pubic hair. Which statement about normal pubertal timing in girls is correct?

  1. Thelarche is usually the first sign, around 8 to 13 years Correct answer.
  2. Menarche typically precedes thelarche
  3. Pubic hair always appears before breast development
  4. Growth spurt occurs after menarche in most girls

Explanation

In girls, breast budding (thelarche) is normally the first pubertal sign, occurring between about 8 and 13 years, followed by pubic hair and later menarche. The pubertal growth spurt usually precedes menarche.

Question 25Pediatría general y crecimiento y desarrollo

A 15-month-old has not yet begun to walk and cannot say any words. Which action is most appropriate?

  1. Perform a developmental assessment and refer for early intervention Correct answer.
  2. Order only an audiogram and no further evaluation
  3. Reassure the parents that all children develop at their own pace
  4. Wait until 24 months before any evaluation

Explanation

Absence of walking at 15 months and no words are red flags for developmental delay, warranting structured developmental assessment and early intervention referral. Reassurance or isolated testing delays appropriate support.

Question 26Pediatría general y crecimiento y desarrollo

A 2-year-old child is brought to the clinic for a routine check-up. The mother reports that the child can kick a ball, climb stairs with help, and say about 50 words. Which developmental milestone is most concerning for delay at this age?

  1. Climbing stairs with help
  2. Saying 50 words
  3. Kicking a ball
  4. Using two-word phrases Correct answer.

Explanation

By 2 years of age, most children use two-word phrases. The absence of this milestone suggests expressive language delay and warrants further evaluation. The other listed skills are typically present by 2 years.

Question 27Pediatría general y crecimiento y desarrollo

During a health supervision visit for a 6-month-old infant, the mother asks about starting solid foods. The infant is breastfed and has good head control. Which recommendation is most appropriate?

  1. Give whole cow's milk as the primary drink
  2. Start with strained fruits and vegetables
  3. Continue exclusive breastfeeding until 12 months
  4. Introduce iron-fortified infant cereal as the first solid food Correct answer.

Explanation

At around 6 months, breast milk alone no longer meets iron needs, so iron-fortified cereal is recommended as an early solid food. Fruits and vegetables can follow, but cereal is preferred initially for iron. Cow's milk should be avoided before 12 months.

Question 28Pediatría general y crecimiento y desarrollo

A 10-year-old boy is brought for a routine physical. His height is at the 50th percentile and weight at the 95th percentile. His BMI is at the 95th percentile for age and sex. According to standard growth charts, how is his weight status classified?

  1. Overweight
  2. Underweight
  3. Obese Correct answer.
  4. Normal weight

Explanation

A BMI at or above the 95th percentile for age and sex defines obesity in children and adolescents. Overweight is defined as BMI between the 85th and 94th percentiles. Normal weight is between the 5th and 84th percentiles.

Question 29Pediatría general y crecimiento y desarrollo

A 15-month-old girl is brought to the clinic because she has not yet started walking. She was born at term and has no significant medical history. On examination, she can pull to stand and cruise along furniture. Which statement about her gross motor development is most accurate?

  1. She likely has cerebral palsy and should undergo brain imaging
  2. Walking independently is expected by 12 months, so her delay requires immediate referral
  3. She should be referred for physical therapy because she is not walking by 15 months
  4. Cruising and pulling to stand at 15 months is within the normal range of gross motor development Correct answer.

Explanation

The normal age for independent walking ranges from 9 to 18 months. Pulling to stand and cruising at 15 months is within normal limits. Referral is not indicated unless other signs of delay are present.

Question 30Pediatría general y crecimiento y desarrollo

A 3-year-old boy is brought for a well-child visit. His parents report that he speaks in short sentences, can undress himself, and rides a tricycle. He does not yet know his own name or gender. Which developmental domain is most likely delayed?

  1. Language
  2. Cognitive-social Correct answer.
  3. Fine motor
  4. Gross motor

Explanation

By 3 years, children typically know their name, age, and gender, which are cognitive-social milestones. The inability to do so suggests a delay in this domain. The other skills mentioned are appropriate for age.

Question 31Neonatología

¿Cuál es la frecuencia respiratoria normal de un recién nacido a término durante las primeras horas de vida?

  1. 70 a 90 respiraciones por minuto
  2. 20 a 30 respiraciones por minuto
  3. 30 a 40 respiraciones por minuto
  4. 40 a 60 respiraciones por minuto Correct answer.

Explanation

El recién nacido a término presenta respiraciones más rápidas y superficiales que el adulto, con un rango aceptado de 40 a 60 por minuto en reposo. Frecuencias superiores a 60 sostenidas sugieren taquipnea patológica.

Question 32Neonatología

Un recién nacido a término presenta ictericia visible en las primeras 24 horas de vida. ¿Cuál es la conducta más adecuada?

  1. Estudio inmediato de bilirrubinas y causas de hemólisis Correct answer.
  2. Iniciar fototerapia ambulatoria sin laboratorio
  3. Observación domiciliaria con control en una semana
  4. Suspender la lactancia materna durante 48 horas

Explanation

La ictericia que aparece antes de las 24 horas es siempre patológica y obliga a medir bilirrubinas y descartar hemólisis o infección. Nunca debe manejarse de forma expectante.

Question 33Neonatología

¿Cuál es el peso promedio al nacer de un recién nacido a término adecuado para la edad gestacional?

  1. 2.500 a 3.900 gramos Correct answer.
  2. 2.000 a 2.300 gramos
  3. 1.500 a 2.000 gramos
  4. 4.500 a 5.000 gramos

Explanation

El peso promedio al nacer a término se sitúa entre 2.500 y 3.900 gramos, con una media cercana a 3.200-3.400 gramos. Valores por debajo de 2.500 g definen bajo peso y por encima de 4.000 g macrosomía.

Question 34Neonatología

En la reanimación neonatal, ¿cuál es la primera maniobra tras el nacimiento si el recién nacido no respira y el líquido amniótico es claro?

  1. Compresiones torácicas coordinadas
  2. Aspiración traqueal sistemática
  3. Secado, estimulación táctil y apertura de la vía aérea Correct answer.
  4. Ventilación con presión positiva inmediata

Explanation

El algoritmo neonatal inicia con calor, secado, estimulación y posicionamiento de la vía aérea durante los primeros 30 segundos. La ventilación se valora según la respuesta y la frecuencia cardíaca.

Question 35Neonatología

¿Qué hallazgo define la enfermedad de membrana hialina en la radiografía de tórax?

  1. Neumotórax a tensión unilateral
  2. Patrón en vidrio esmerilado con broncograma aéreo Correct answer.
  3. Hiperinsuflación con aplanamiento diafragmático
  4. Infiltrado lobar con derrame pleural

Explanation

La enfermedad de membrana hialina muestra un patrón reticulogranular difuso con broncograma aéreo por déficit de surfactante. La imagen suele acompañarse de volúmenes pulmonares disminuidos.

Question 36Neonatología

Un recién nacido de 3 días, alimentado con lactancia materna exclusiva, presenta pérdida de peso del 9% respecto al nacimiento. ¿Cuál es la interpretación más adecuada?

  1. Deshidratación grave que exige hospitalización
  2. Signo de sepsis neonatal temprana
  3. Pérdida fisiológica dentro de lo esperado Correct answer.
  4. Indicación absoluta de fórmula suplementaria

Explanation

La pérdida fisiológica de peso puede alcanzar hasta el 10% en los primeros días, con recuperación hacia la segunda semana. Solo pérdidas mayores o signos clínicos de deshidratación requieren intervención.

Question 37Neonatología

¿Cuál es la causa más frecuente de sepsis neonatal de inicio temprano?

  1. Listeria monocytogenes
  2. Staphylococcus epidermidis
  3. Streptococcus agalactiae del grupo B Correct answer.
  4. Candida albicans

Explanation

El estreptococo del grupo B es el principal agente de sepsis neonatal temprana en gestantes colonizadas. La transmisión ocurre por vía vertical durante el parto.

Question 38Neonatología

Un recién nacido pretérmino de 30 semanas presenta apnea recurrente. ¿Cuál es el mecanismo fisiopatológico principal de la apnea del prematuro?

  1. Déficit de hierro cerebral
  2. Inmadurez del control respiratorio central Correct answer.
  3. Fibrosis pulmonar progresiva
  4. Obstrucción mecánica de la vía aérea superior

Explanation

La apnea del prematuro se debe sobre todo a inmadurez del centro respiratorio bulbar y de la respuesta a la hipoxia. Suele responder a estimulación y metilxantinas.

Question 39Neonatología

¿Qué parámetro define la hiperbilirrubinemia neonatal que requiere exanguinotransfusión en un recién nacido a término sano con ictericia grave?

  1. Bilirrubina total de 10 mg/dL
  2. Presencia de ictericia en las palmas
  3. Niveles que superan el umbral de fototerapia intensiva según nomograma Correct answer.
  4. Bilirrubina total de 15 mg/dL

Explanation

La indicación de exanguinotransfusión se establece por niveles de bilirrubina que superan el umbral definido en el nomograma según edad y factores de riesgo. La clínica aislada no sustituye la medición seriada.

Question 40Neonatología

¿Cuál es el principal factor de riesgo de enterocolitis necrosante en el recién nacido pretérmino?

  1. Peso elevado al nacer
  2. Policitemia leve
  3. Prematuridad e inmadurez intestinal Correct answer.
  4. Alimentación con leche materna

Explanation

La enterocolitis necrosante se asocia a inmadurez de la barrera intestinal, isquemia y colonización bacteriana en el prematuro. La alimentación con leche materna es un factor protector.

Question 41Neonatología

En un recién nacido con sospecha de atresia esofágica, ¿qué signo clínico es más característico en las primeras horas?

  1. Sialorrea abundante y regurgitaciones con la primera toma Correct answer.
  2. Distensión abdominal con ausencia de meconio
  3. Ictericia precoz
  4. Soplo cardíaco sistólico

Explanation

La atresia esofágica impide el paso de saliva y alimento, produciendo sialorrea y regurgitación inmediata con las tomas. La radiografía con sonda enrollada confirma el diagnóstico.

Question 42Neonatología

¿Cuál es la dosis inicial recomendada de vitamina K intramuscular en un recién nacido a término para prevenir la enfermedad hemorrágica?

  1. 0,5 mg
  2. 1 mg Correct answer.
  3. 0,1 mg
  4. 5 mg

Explanation

La profilaxis con 1 mg de vitamina K intramuscular al nacer previene la enfermedad hemorrágica del recién nacido. En prematuros se ajusta según peso.

Question 43Neonatología

Un recién nacido presenta hipotonía, llanto débil y fisuras palpebrales oblicuas. ¿Qué entidad debe sospecharse?

  1. Síndrome de aspiración meconial
  2. Parálisis braquial obstétrica
  3. Síndrome de Down Correct answer.
  4. Hipotiroidismo congénito

Explanation

La combinación de hipotonía, rasgos faciales característicos y fisuras oblicuas sugiere trisomía 21. Se confirma con cariotipo o estudio genético.

Question 44Neonatología

¿Cuál es el signo radiológico precoz de la displasia broncopulmonar en el prematuro?

  1. Derrame pleural masivo
  2. Cardiomegalia aislada
  3. Imágenes quísticas y áreas de hiperinsuflación Correct answer.
  4. Neumotórax espontáneo bilateral

Explanation

La displasia broncopulmonar evoluciona con cambios quísticos, áreas de hiperinsuflación y fibrosis tras la fase aguda. Estas lesiones reflejan daño pulmonar crónico por ventilación y oxígeno.

Question 45Neonatología

¿Cuál es la conducta inicial ante un recién nacido con sospecha de cardiopatía congénita cianótica y saturaciones bajas que no mejoran con oxígeno?

  1. Alta domiciliaria con control
  2. Iniciar antibióticos y observación
  3. Prostaglandina E1 y ecocardiograma urgente Correct answer.
  4. Transfusión de hematíes inmediata

Explanation

La cianosis que no responde al oxígeno sugiere cortocircuito derecho-izquierdo o ductus-dependiente. La prostaglandina E1 mantiene el ductus y el ecocardiograma define la anatomía.

Question 46Neonatología

¿Qué prueba se utiliza como cribado neonatal de hipoacusia en el recién nacido?

  1. Potenciales evocados auditivos automatizados Correct answer.
  2. Electroencefalograma
  3. Prueba de tamiz metabólico
  4. Ecografía transfontanelar

Explanation

Las otoemisiones acústicas o los potenciales evocados automatizados detectan hipoacusia en el neonato. Se realizan antes del alta o en la primera semana.

Question 47Neonatología

Un recién nacido de madre diabética presenta macrosomía y, a las pocas horas, temblores e hipoglucemia. ¿Cuál es el mecanismo principal de la hipoglucemia?

  1. Hiperinsulinismo fetal por hiperglucemia materna Correct answer.
  2. Insuficiencia adrenal
  3. Déficit de glucagón congénito
  4. Aumento del glucógeno hepático

Explanation

La hiperglucemia materna estimula el páncreas fetal y produce hiperinsulinismo, que persiste tras el parto y causa hipoglucemia. El control glucémico materno reduce esta complicación.

Question 48Neonatología

¿Cuál es el tratamiento de elección en un recién nacido con hipoglucemia sintomática persistente?

  1. Administración de insulina
  2. Glucosa oral exclusiva
  3. Infusión intravenosa de glucosa y ajuste según controles Correct answer.
  4. Suspender la alimentación enteral

Explanation

La hipoglucemia sintomática requiere glucosa intravenosa para corregir de forma rápida y controlada. Se ajusta la velocidad de infusión según las glucemias seriadas.

Question 49Neonatología

¿Cuál es el agente causal más frecuente de conjuntivitis neonatal purulenta de aparición entre el segundo y el quinto día de vida?

  1. Virus del herpes simple
  2. Staphylococcus aureus
  3. Chlamydia trachomatis
  4. Neisseria gonorrhoeae Correct answer.

Explanation

La conjuntivitis gonocócica aparece en los primeros días y es una urgencia por riesgo de perforación corneal. La clamidia suele manifestarse más tarde, entre la primera y la segunda semana.

Question 50Neonatología

¿Qué hallazgo ecográfico es característico de la hemorragia intraventricular grave en el prematuro?

  1. Quiste de plexos coroideos aislado
  2. Calcificaciones periventriculares difusas
  3. Ausencia de cisterna magna
  4. Ventriculomegalia con sangre en el sistema ventricular Correct answer.

Explanation

La hemorragia intraventricular grave muestra sangre en los ventrículos y puede dilatarlos, con riesgo de hidrocefalia. La ecografía transfontanelar es el método de elección para su seguimiento.