This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'All of the following therapies may be required in a 1–hour-old infant with severe birth asphyxia except – \nSelect and explain. \nA. Glucose, B. Dexamethasone, C. Calcium gluconate, D. Normal saline', 'role': 'user'}, {'content': "Answer: B \nExplanation: Corticosteroids should not be used' - Paediatrics for doctors - Frankshann & John Vince\n\nManagement Protocol\n\nThe management protocol of babies with asphyxia :\n\n\nOxygen. In the absence of continuous oxygen saturation monitoring, it is reasonable to give nasopharyngeal oxygen (0.5 litre/min) until the baby recovers. If monitoring is available, oxygen is given as appropriate.\nThermal control. Baby's body temperature should be kept in the normal range of 36.5-37.2°C (sometimes the babies become hyperpyrexic).\nCorrection of shock, If peripheral perfusion is poor, it is reasonable to give 20 ml/kg of normal saline initially. If perfusion remains poor, the use of dopamine should be considered.\nFluid balance. Give IV fluids at 2/3 maintenance. Use 10% dextrose.\nMonitor blood glucose with dextrostix and do not let it fall below 2.2 mmol \xa0(explains glucose administration)\nPrevent/control convulsions. In less severely affected babies, phenobarbitone should be given when there is anyuspicion of actual or impending convulsions (phenobarbitone loading dose 20 mg/kg IM or 10mg/kg slowly IV, then 5 mg/kg daily orally).\nTreat hvpocalcaemia if it occurs (or more practically, if the baby has uncontrollable fitting with anormal dextrostix).\n\n(explains calcium gluconate administration)\nNotes:\n\nCorticosteroids should not be used, and although many paediatricians use mannitol, there is no evidence for its effectiveness.\nBabies with severe asphyxia may appear to settle relatively quickly after the resuscitation - but there is likely to be a deterioration after 6-12 hours or so as cerebral oedema develops.", 'role': 'assistant'}]