What is the incidence of necrotizing enterocolitis in infants under 1500 grams?

1.   ?    Less than 2%
2.   ?    5 - 6%
3.   ?    10%
4.   ?    15%

Which is NOT one of the prime factors in the pathogenesis of NEC?

1.   ?    Vascular thrombus
2.   ?    Osmotic intestinal load
3.   ?    Infection, usually bacterial
4.   ?    Vulnerable host

The incidence of NEC in formula fed babies is how much higher than that in breast fed babies?

1.   ?    2 times increased
2.   ?    6 times increased
3.   ?    12 times increased

Large doses of what vitamin increase the incidence of NEC?

1.   ?    Vitamin A
2.   ?    Vitamin B 12
3.   ?    Vitamin C
4.   ?    Vitamin E

Administration of what medication to high-risk pregnant mothers reduces the incidence of NEC in their children?

1.   ?    Vitamin A
2.   ?    Indocin
3.   ?    High dose steroids

How does the immune system of the premature infant possibly contribute to the development of NEC?

1.   ?    Deficient IgA
2.   ?    Deficient IgM
3.   ?    Low complement levels
4.   ?    Poor phagocytosis
5.   ?    All of the above

Which of the follow is NOT a means by which the immature gut lining of the premature infant contributes to NEC?

1.   ?    Increased gastric and pancreatic secretions
2.   ?    Poorly developed mucosal cells
3.   ?    Decreased mucus
4.   ?    Immature goblet cells

Which is NOT one of the ‘good’ things in breast milk which may prevent NEC?

1.   ?    Lactobacillus
2.   ?    EGF (epidermal growth factor)
3.   ?    IgA
4.   ?    Oligosaccharides

What is the most common site of NEC?

1.   ?    Descending colon
2.   ?    Proximal ileum
3.   ?    Jejunum
4.   ?    Terminal ileum

Complete intestinal necrosis occurs in what percentage of NEC patients?

1.   ?    Less than 5%
2.   ?    10 - 15%
3.   ?    25%
4.   ?    50%

A single intestinal segment is involved in what percentage of NEC patients?

1.   ?    25%
2.   ?    50%
3.   ?    75%
4.   ?    90%

What is the most common microscopic lesion seen in necrotizing enterocolitis?

1.   ?    Coagulation necrosis of the mucosa
2.   ?    Fibrosis of subserosa
3.   ?    Giant cells in the submucosa
4.   ?    Subserosal edema and monocyte infiltration

Where does pneumatosis intestinalis FIRST occur?

1.   ?    Subserosa
2.   ?    Submucosa
3.   ?    Muscularis

Are bacteria usually found in the wall of the intestine with pneumatosis?

1.   ?    Yes
2.   ?    No

What is the most common symptom of NEC?

1.   ?    Vomiting
2.   ?    GI bleeding
3.   ?    Diarrhea
4.   ?    Abdominal distention

T or F: Infants with absolute granulocyte counts under 1,500 have a worse prognosis with NEC?

1.   ?    True
2.   ?    False

What is the incidence of metabolic acidosis in patients with NEC?

1.   ?    15%
2.   ?    20%
3.   ?    50%
4.   ?    85%

T or F: screening for carbohydrate malabsorption may help identify patients at risk for NEC?

1.   ?    True
2.   ?    False

Pneumatosis is an early or late finding and NEC?

1.   ?    Early
2.   ?    Late

What is the incidence of portal venous gas in NEC?

1.   ?    Less than 5%
2.   ?    10 - 20%
3.   ?    30 - 50%

What proportion of children with NEC have free air?

1.   ?    Less than 5%
2.   ?    10 - 30%
3.   ?    30 - 60%
4.   ?    75%

T or F: About 10 percent of patients with NEC have ascites, and it is a marker for increased mortality.

1.   ?    True
2.   ?    False

Which stage (Bell's stages) of NEC occurs when pneumatosis is first seen?

1.   ?    Stage 1
2.   ?    Stage 2
3.   ?    Stage 3
4.   ?    Stage 4