• a. Hearing aid
• b.
  • Microphone
  • Amplifier
  • Receiver / speaker
  • Microchip / processor
  • Battery / power source
• c.
  • Invisible-in-the-canal (IIC) / Completely-in-the-canal (CIC)
  • Behind-the-ear (BTE)
  • In-the-canal (ITC) / In-the-ear (ITE)

• a. Otoacoustic emission (OAE) testing device.
• b. Inner ear (outer hair cells of the cochlea).
• c. In a healthy cochlea, vibration of the hair cells in response to sound stimulus generates acoustic energy called otoacoustic emissions. A probe placed in the ear canal delivers a click sound stimulus, and the resulting acoustic energy produced by the cochlea is detected and recorded by a microphone within the probe.
• d.
  • Prerequisites: Needs a quiet baby and a clean ear canal free of vernix, fluid, or debris.
  • Limitations:
    • High false-positive rate if performed in the first 24 hours of birth due to vernix/debris in the canal.
    • Only assesses cochlear/pre-neural ear function — does not assess the retrocochlear or central auditory neural pathway.
    • It is a screening test; failed OAE must be confirmed by BERA (Brainstem Evoked Response Audiometry).

• a. Laryngeal mask airway (LMA)
• b. Indications:
  • Difficult airway management (rescue airway)
  • Routine airway management during elective procedures
  • Pre-hospital / emergency resuscitation airway management
• c. Complications:
  • Aspiration of gastric contents
  • Dislodgement / malposition
  • Upper airway / pharyngeal soft tissue trauma, sore throat, or laryngospasm
• d. Contraindications:
  • Complete upper airway obstruction below the glottis
  • Increased risk of aspiration (non-fasted/full stomach patient, intestinal obstruction, upper gastrointestinal bleed, severe GERD)
  • Need for prolonged mechanical ventilation or high peak airway pressures (>20 cm H2O)
  • Suspected or known severe abnormalities in supraglottic anatomy

• Assemble the device correctly.
• With a self-inflating bag, occlude the patient connector / face mask against the palm of your hand and squeeze the bag.
• Look for the following 5 features as you squeeze the bag:
  • a. You should feel pressure against the palm.
  • b. The fish-mouth / non-rebreathing valve should open and close freely.
  • c. The pop-off (pressure-relief) valve should make a hissing sound / open at preset pressure (around 35–40 cm H2O).
  • d. The bag should recoil and reinflate instantly when pressure is released.
  • e. If a pressure manometer is attached, it should register and display the pressure when the bag is squeezed.
• Absence of any of the above features suggests malfunction or leak.

• i. T-piece resuscitator (e.g., Neopuff)
• ii. Controls:
  • Inspiratory peak pressure control (PIP): Sets the amount of pressure delivered during a normal assisted breath.
  • Maximum pressure relief control (Pop-off): Safety feature that prevents the pressure from exceeding a preset value (usually 40 cm H2O, adjustable).
  • PEEP control (on the T-piece cap): Adjusts positive end-expiratory pressure.
• iii.
  • Advantages:
    • Consistent delivery of preset PIP and PEEP.
    • Reliably provides free-flow oxygen (21–100% with blender) and continuous CPAP.
    • Operator does not fatigue from prolonged hand bagging.
  • Disadvantages:
    • Requires a compressed gas source and blender.
    • Requires pressures to be set and checked prior to use.
    • Changing inflation pressure during resuscitation is more difficult.
    • Risk of prolonged inspiratory time if the PEEP cap is held occluded too long.

• a. Transcutaneous bilirubinometer (TcB)
• b. Forehead and upper end of the sternum.
• c.
  • Advantage: Non-invasive, instantaneous, and painless screening tool.
  • Limitation: Inaccurate / cannot be used in babies already receiving or who have received phototherapy (unless the site was shielded during phototherapy), and unreliable at high serum bilirubin levels (>15 mg/dL).

Sound level monitor / Decibel meter (used to monitor ambient noise levels in the neonatal intensive care unit).

Flux meter / Phototherapy radiometer (used to measure irradiance/intensity of phototherapy units).

• a. Single umbilical artery (SUA / 2-vessel umbilical cord)
• b. ii. 1:100 (Option B)
• c. iii. 25% cases (Option C)
• d. Genitourinary system (most common) followed by Cardiovascular and Musculoskeletal systems.

• a. Therapeutic hypothermia (targeted temperature management for neonatal hypoxic-ischemic encephalopathy).
• b. Whole-body cooling device / cooling blanket.
• c. Any 5 of:
  • Sinus bradycardia and delayed intracardiac conduction
  • Prolonged QT interval / ventricular arrhythmias
  • Reduced cardiac output and hypotension
  • Coagulopathy and thrombocytopenia (risk of thrombosis or hemorrhage)
  • Pulmonary hypertension (increased PVR) and decreased surfactant production
  • Leukopenia and increased risk of sepsis
  • Sclerema neonatorum / subcutaneous fat necrosis
  • Electrolyte disturbances (hypokalemia, hypomagnesemia, hyponatremia)
  • Metabolic and lactic acidosis
  • Impaired renal and liver function

• a. Causes of xanthochromia:
  • Subarachnoid hemorrhage
  • Severe hyperbilirubinemia (jaundice)
  • Markedly elevated CSF protein (>150 mg/dL, Froin's syndrome / spinal block)
  • Carotenemia
  • Traumatic tap with delayed processing
• b. Causes of high CSF protein (>350 mg/dL):
  • Tuberculous meningitis (TBM) / fungal meningitis
  • Guillain-Barré syndrome (albuminocytological dissociation)
  • Spinal cord tumors or brain tumors
  • CNS vasculitis / neurosarcoidosis
  • Multiple sclerosis
  • Degenerative neurological disorders
• c. Causes of abnormal / low CSF glucose:
  • Acute bacterial (pyogenic) meningitis
  • Tuberculous meningitis (TBM)
  • Fungal meningitis
  • Neoplasms of the meninges (carcinomatous meningitis)
  • Aseptic/viral meningitis (occasionally mumps, HSV, enterovirus)
  • Subarachnoid hemorrhage
• d. Cloudy CSF:
  • Markedly elevated cell count (pleocytosis) — high WBC count in bacterial/pyogenic meningitis or massive RBC count in intracranial hemorrhage.