WorksheetsMCQs on Neonatal Jaundice
Total questions: 15
Worksheet time: 11mins
Q1. Regarding physiological jaundice in a term newborn:
A. Jaundice usually appears after the first 24 hours of life.
B. Peak serum bilirubin levels are usually reached between the 3rd and 5th day of life.
C. Conjugated bilirubin is the predominant form of bilirubin elevation.
D. Jaundice persisting beyond 14 days in a term infant is considered physiological.
E. Increased enterohepatic circulation contributes to physiological jaundice.
Q2. The following are features suggestive of pathological neonatal jaundice:
A. Onset of jaundice within the first 24 hours of life.
B. A rise in total serum bilirubin of more than 0.5 mg/dL per hour.
C. Presence of conjugated hyperbilirubinaemia.
D. Jaundice resolving by the third day of life.
E. Persistence of jaundice beyond 14 days in a term infant.
Q3. Regarding bilirubin-induced neurological dysfunction (BIND):
A. Unconjugated bilirubin can cross the blood-brain barrier.
B. Acute bilirubin encephalopathy may present with lethargy and poor feeding.
C. Kernicterus is a reversible condition if detected early.
D. Sensorineural hearing loss is a recognised sequela of kernicterus.
E. Conjugated bilirubin is primarily responsible for bilirubin neurotoxicity.
Q4. Regarding phototherapy in neonatal jaundice:
A. It converts bilirubin into water-soluble photoisomers.
B. Blue-green light with a wavelength of approximately 460–490 nm is most effective.
C. Eye protection should be used during conventional phototherapy.
D. Phototherapy is effective in treating conjugated hyperbilirubinaemia.
E. Increasing the exposed skin surface area improves the efficacy of phototherapy.
Q5. Regarding prolonged neonatal jaundice:
A. Jaundice lasting more than 14 days in a term infant is considered prolonged.
B. Pale stools and dark urine suggest cholestatic liver disease.
C. Breast milk jaundice is a cause of prolonged unconjugated hyperbilirubinaemia.
D. Biliary atresia should be excluded in infants with conjugated hyperbilirubinaemia.
E. All infants with prolonged jaundice require exchange transfusion.
SBA 1. A 12-hour-old term newborn is noted to have jaundice. The baby is otherwise well and feeding adequately.
What is the most appropriate interpretation of this finding?
A. Physiological jaundice
B. Breast milk jaundice
C. Pathological jaundice requiring urgent evaluation
D. Breastfeeding jaundice
E. Prolonged neonatal jaundice
SBA 2. A 4-day-old term newborn presents with jaundice. The total serum bilirubin is above the phototherapy threshold but below the exchange transfusion threshold. The baby is feeding well and has no signs of acute bilirubin encephalopathy.
What is the most appropriate management?
A. Reassurance and discharge home
B. Exchange transfusion
C. Intravenous immunoglobulin
D. Phototherapy
E. Phenobarbitone therapy
SBA 3. A 3-week-old term infant is brought to the clinic with persistent jaundice. Examination reveals pale stools and dark urine. The infant is otherwise stable.
What is the most likely diagnosis?
A. Physiological jaundice
B. Breast milk jaundice
C. ABO incompatibility
D. Biliary atresia
E. G6PD deficiency
SBA 4. A newborn with severe unconjugated hyperbilirubinaemia develops lethargy, poor feeding, and generalized hypotonia.
What is the most likely diagnosis?
A. Neonatal sepsis
B. Acute bilirubin encephalopathy
C. Neonatal hepatitis
D. Hypoglycaemia
E. Intracranial haemorrhage
SBA 5. A baby with haemolytic disease of the newborn develops rapidly rising bilirubin levels despite intensive phototherapy. The bilirubin level has reached the exchange transfusion threshold.
What is the next best step in management?
A. Continue phototherapy alone
B. Stop phototherapy and observe
C. Exchange transfusion
D. Oral hydration only
E. Repeat bilirubin level after 24 hours
SBA 6. A healthy 5-day-old exclusively breastfed infant develops jaundice. The baby has lost 12% of birth weight and has reduced urine output. Investigations exclude haemolysis and infection.
What is the most likely cause of jaundice?
A. Breast milk jaundice
B. Breastfeeding jaundice
C. Biliary atresia
D. Crigler–Najjar syndrome
E. Neonatal hepatitis
SBA 7. Which of the following investigations is most important in distinguishing unconjugated from conjugated hyperbilirubinaemia in a jaundiced newborn?
A. Full blood count
B. Blood culture
C. Serum bilirubin fractionation
D. Direct Coombs test
E. Reticulocyte count
SBA 8. Which of the following is a recognized long-term complication of kernicterus?
A. Congenital heart disease
B. Sensorineural hearing loss
C. Nephrotic syndrome
D. Visual impairment due to cataracts
E. Cleft palate
SBA 9. The primary mechanism by which phototherapy reduces serum bilirubin levels is:
A. Increased renal excretion of conjugated bilirubin
B. Reduced bilirubin production
C. Conversion of bilirubin into water-soluble photoisomers
D. Increased hepatic glucuronidation
E. Suppression of haemolysis
SBA 10. A newborn develops jaundice on day 3 of life. The baby is active, feeding well, and has no hepatosplenomegaly. Investigations are normal and bilirubin levels are below treatment thresholds.
What is the most likely diagnosis?
A. Physiological jaundice
B. Neonatal hepatitis
C. Rh isoimmunization
D. Biliary atresia
E. Neonatal sepsis
