New born screening act

B

Republic Act No. 9288 is officially known by what title?

A. National Blood Services Act of 1994

B. Newborn Screening Act of 2004

C. Expanded Newborn Screening Policy Act

D. Child Youth Welfare Code

C

On what date was Republic Act No. 9288 approved into law by President Gloria Macapagal-Arroyo?

A. February 13, 1998

B. December 3, 1992

C. April 7, 2004

D. October 15, 2014

B

Newborn Screening has been an available service in the Philippines since what year?

A. 1984

B. 1996

C. 2000

D. 2004

B

How many total sections are contained within Republic Act No. 9288?

A. 12 sections

B. 18 sections

C. 24 sections

D. 52 sections

A

According to the law, which week of October is celebrated as "National Newborn Screening Awareness Week"?

A. First week of October

B. Second week of October

C. Third week of October

D. Last week of October

C

Which institution serves as the National Reference Laboratory for Newborn Screening in the Philippines?

A. San Lazaro Hospital Central Laboratory

B. Department of Science and Technology (DOST)

C. University of the Philippines National Institutes of Health (UP NIH)

D. Research Institute for Tropical Medicine (RITM)

C

The Expanded Newborn Screening (ENBS) program increased the screening panel of metabolic disorders from six (6) to more than how many?

A. 12 disorders

B. 20 disorders

C. 28 disorders

D. 50 disorders

A

What is the main clinical consequence if congenital metabolic disorders screened by NBS are left completely untreated?

A. Mental retardation and/or death

B. Acute infectious multi-organ failure

C. Immediate physical musculoskeletal deformities

D. Severe respiratory tract infections

C

Which of the following is NOT one of the original six (6) disorders included in the standard Newborn Screening package prior to expansion?

A. Congenital Hypothyroidism (CH)

B. Galactosemia (GAL)

C. Severe Combined Immunodeficiency (SCID)

D. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency

B

What specific substance accumulates in the body of a patient suffering from Phenylketonuria (PKU)?

A. Galactose-1-phosphate

B. Phenylalanine

C. Thyroid Stimulating Hormone (TSH)

D. Leucine and Valine

C

Congenital Adrenal Hyperplasia (CAH) is an inherited disorder characterized by a deficiency in enzymes necessary for synthesizing which hormone?

A. Insulin

B. Thyroxine

C. Cortisol

D. Growth Hormone

B

What critical clinical complication can arise from severe salt-wasting Congenital Adrenal Hyperplasia (CAH) if it is not detected early?

A. Irreversible blindness

B. Severe cardiac arrest and death within 7-14 days

C. Chronic macrocytic hemolytic anemia

D. Progressive microcephaly

A

What is the clinical consequence of untreated Congenital Hypothyroidism (CH) in early infancy?

A. Severe mental and physical growth retardation (Cretinism)

B. Acute hemolytic crisis upon exposure to mothballs

C. Cataracts and progressive liver cirrhosis

D. Severe combined immunodeficiency syndrome

C

Patients with Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency are prone to hemolytic anemia when exposed to which of the following triggers?

A. High carbohydrate diets

B. Prolonged exposure to extreme cold weather

C. Oxidative drugs, fava beans, and naphthalene (mothballs)

D. Milk and other dairy products containing lactose

B

Galactosemia is an inherited metabolic disorder where the body is unable to break down galactose, a sugar derived primarily from:

A. Table sugar (Sucrose)

B. Milk and dairy products (Lactose)

C. Honey and fruits (Fructose)

D. Grains and starches (Maltose)

A

What is a common clinical sign of untreated Galactosemia that develops due to toxic accumulation of galactose metabolites in the eyes?

A. Cataracts

B. Glaucoma

C. Retinal detachment

D. Nystagmus

B

Maple Syrup Urine Disease (MSUD) is a genetic disorder involving the defective metabolism of which specific group of nutrients?

A. Long-chain fatty acids

B. Branched-chain amino acids

C. Complex carbohydrates

D. Purines and pyrimidines

A

What distinctive symptom gives Maple Syrup Urine Disease (MSUD) its name?

A. A sweet, maple syrup-like odor of the urine and sweat

B. Bright yellow-orange discoloration of the urine sample

C. Sticky, thick crystalline sediment in the newborn diaper

D. A pungent, vinegar-like smell from respiratory secretions

B

When is the ideal time to perform newborn screening collection on a stable infant?

A. Immediately within the first hour of birth

B. After 24 hours of life up to 3 days of life

C. Exactly 7 days after delivery

D. At the infant's first 1-month pediatric checkup

A

Why must a newborn be ideally fed before a screening sample for metabolic disorders like PKU or MSUD is collected?

A. To allow dietary proteins and sugars to accumulate in the blood for accurate detection

B. To prevent the infant from crying excessively during the heel prick procedure

C. To ensure that the hematocrit levels drop to an acceptable testing baseline

D. To clear out maternal antibodies remaining in the newborn circulation

B

If a newborn is admitted to an intensive care unit (ICU), what is the maximum recommended period within which they must undergo screening?

A. Within 24 hours of life regardless of medical state

B. Within 7 days of life

C. Only after they are completely discharged from the hospital

D. Exactly 14 days after birth

C

What specific anatomical site is universally recommended for capillary blood collection during newborn screening?

A. The tip of the index finger

B. The earlobe

C. The lateral or medial plantar surface of the heel

D. The umbilical cord vein

C

What device is used to perform the puncture on the newborn's heel?

A. A surgical scalpel blade

B. A venipuncture needle (21 gauge)

C. A sterile heel lancet (not exceeding 2.0 mm depth)

D. A reusable automatic spring-loaded finger stick device

B

Before puncturing the newborn's heel, what step can be taken to increase local blood flow and facilitate sample collection?

A. Squeezing and milking the leg vigorously

B. Warming the heel with a warm, moist towel for a few minutes

C. Applying a cold ice pack to induce vasoconstriction

D. Elevating the newborn's lower extremities above the heart

B

What should be done to the very first drop of blood that appears after the heel puncture?

A. Collected directly onto the filter paper card

B. Wiped away with a clean, dry sterile gauze or cotton ball

C. Smeared onto a glass slide for differential counting

D. Diluted immediately with a drop of normal saline solution

B

What type of card is used to collect the blood spots for Newborn Screening?

A. Plastic-coated capillary storage card

B. DOH-approved absorbent filter paper card

C. Vacuum-sealed liquid anticoagulated card

D. Chromatographic glass microfiber matrix card

B

How should the blood be applied to the filter paper circles to ensure a valid collection?

A. Layered repeatedly on both sides of the paper using multiple drops

B. Allowed to soak through completely from one side to fill the circle naturally with a single large drop

C. Smeared in a circular motion using a glass capillary tube

D. Dripped from a distance of at least 5 inches to avoid touching the paper

A

What can happen if you touch the pre-printed circles on the filter paper card with your bare fingers before or after collection?

A. The sample can be contaminated with skin oils and sweat, altering test results

B. The filter paper will lose its physical absorbency entirely

C. The baby will be at high risk for cross-contamination infections

D. The chemical preservatives on the card will neutralize the blood proteins

B

What is the correct way to dry a collected newborn screening filter paper card?

A. Direct exposure to sunlight on a flat surface

B. Air-dried horizontally for at least 3 to 4 hours at room temperature

C. Placed inside a laboratory incubator set at 56°C

D. Dried quickly using a handheld electric blow dryer

B

Which of the following describes an invalid newborn screening sample that must be rejected by the laboratory?

A. The blood spot is completely dry before packaging

B. The blood spot appears scratched, layered, or has insufficient volume to fill the circle

C. The circle is uniformly saturated from both front and back sides

D. The sample was collected exactly 48 hours after birth

B

Who holds the primary responsibility to inform parents or legal guardians about the availability, purpose, and benefits of Newborn Screening?

A. The administrative hospital billing officer

B. Any healthcare practitioner who delivers or assists in the delivery of the newborn

C. Only the licensed medical technologist running the assay

D. The local civil registrar office upon birth registration

B

Under Section 6 of R.A. 9288, a parent or legal guardian may refuse newborn screening for their child based on what specific grounds?

A. Financial incapacity or lack of insurance coverage

B. Religious beliefs or grounds

C. Personal convenience or lack of transportation

D. Absence of a family history of genetic disorders

B

If a parent refuses to allow newborn screening based on religious grounds, what documentation is legally required from the healthcare provider?

A. A formal court order from a regional trial court judge

B. A signed refusal documentation that shall be made part of the newborn’s medical record

C. A psychiatric clearance certificate for the mother

D. A notification letter sent directly to the Department of Justice

C

Which government department serves as the lead agency for implementing the Newborn Screening Program in the Philippines?

A. Department of Science and Technology (DOST)

B. Department of Social Welfare and Development (DSWD)

C. Department of Health (DOH)

D. Department of the Interior and Local Government (DILG)

B

The advisory body that creates policies, coordinates, and monitors the implementation of R.A. 9288 is known as the:

A. Philippine National AIDS Council (PNAC)

B. Advisory Committee on Newborn Screening (ACNBS)

C. Newborn Screening Reference Center Board (NSRCB)

D. National Institutes of Health Technical Working Group

B

Who serves as the permanent Vice-Chairperson of the Advisory Committee on Newborn Screening?

A. The Secretary of Health

B. The Executive Director of the National Institutes of Health (NIH) Philippines

C. The President of the Philippine Pediatric Society

D. The Director of the Bureau of Health Facilities and Services

B

How many times a year is the Advisory Committee on Newborn Screening (ACNBS) legally mandated to meet?

A. Once a year

B. Twice a year

C. Four times a year (quarterly)

D. Twelve times a year (monthly)

B

Which central repository is tasked with creating and maintaining a centralized registry of all newborns screened, along with a network of newborn screening centers?

A. PhilHealth IT Department

B. Newborn Screening Reference Center (NSRC)

C. National Epidemiology Bureau

D. Food and Drug Administration (FDA)

B

What is the role of the Philippine Health Insurance Corporation (PhilHealth) in the Newborn Screening Program?

A. Running the analytical mass spectrometry equipment

B. Including the cost of newborn screening in its Newborn Care Package benefits

C. Regulating the professional licenses of medical technologists

D. Formulating the clinical treatment guidelines for PKU patients

B

What is the term for a medical center equipped with a newborn screening laboratory that receives, processes, and releases results of NBS samples?

A. Newborn Screening Continuity Clinic (NBSCC)

B. Newborn Screening Center (NSC)

C. Clinical Genetics Center (CGC)

D. Center for Health Development (CHD)

B

Special specialized clinics established in strategic regions to provide long-term medical follow-up, management, and counseling for patients diagnosed with metabolic conditions are called:

A. Newborn Screening Centers (NSC)

B. Newborn Screening Continuity Clinics (NBSCC)

C. Comprehensive Health Intervention Units (CHIU)

D. National Reference Laboratories (NRL)

B

What happens to a sample when the preliminary newborn screening result is "positive" or "reactive"?

A. The infant is immediately declared cured of the condition

B. The newborn must be recalled immediately for confirmatory diagnostic testing

C. The laboratory discards the record to maintain absolute data privacy

D. The child is placed in a long-term quarantine facility

A

Which of the following conditions, if left unmanaged, leads to the accumulation of toxic compounds that damage the brain, causing a "mousy" or musty odor?

A. Phenylketonuria (PKU)

B. Congenital Hypothyroidism (CH)

C. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency

D. Congenital Adrenal Hyperplasia (CAH)

B

In the abbreviation "G6PD", what does the "D" specifically stand for?

A. Disease

B. Deficiency

C. Dysfunction

D. Diagnosis

A

Why is a standard alcohol pad used to clean the infant's heel allowed to air dry completely before making the puncture?

A. Wet alcohol can hemolyze the blood sample and invalidate the test

B. Alcohol prevents the blood from drying on the filter paper card later

C. Residual alcohol acts as a chemical barrier that stops the lancet from penetrating

D. Wet alcohol causes a severe chemical burn on the newborn's skin matrix

A

When filling out the demographic data on the newborn screening filter paper card, which information is crucial for accurately interpreting hormone levels?

A. The newborn's birth weight and gestational age/date of birth

B. The educational background of the parents

C. The permanent address of the attending midwife

D. The newborn's future planned pediatric clinic

A

If a screening center detects a critical or life-threatening result (such as MSUD or salt-wasting CAH), within what timeframe should tracking and recall ideally begin?

A. Immediately or within 24 hours

B. Within 2 weeks of sample arrival

C. At the end of the calendar month

D. During the next regional newborn screening audit

B

What specialized nutritional treatment is required for a child diagnosed with Phenylketonuria (PKU)?

A. A high-protein diet rich in dairy products and meat

B. A lifelong, strictly managed low-phenylalanine formula diet

C. Continuous intramuscular injections of thyroxine hormone

D. Complete avoidance of all dietary carbohydrates and sugars

B

What is the permanent treatment for an infant diagnosed with Congenital Hypothyroidism (CH)?

A. Dietary restriction of milk sugars

B. Daily oral administration of levothyroxine (thyroid hormone replacement)

C. Regular blood transfusions to treat hemolytic anemia

D. Surgical removal of the adrenal glands

B

The Expanded Newborn Screening (ENBS) panel covers which major category of disorders that includes organic acidemias and urea cycle defects?

A. Hemoglobinopathies

B. Inborn Errors of Metabolism (IEM)

C. Severe Combined Immunodeficiencies

D. Infectious Congenital Syndromes

B

Who serves as the permanent Chairperson of the Advisory Committee on Newborn Screening?

A. The President of the Philippines

B. The Secretary of Health

C. The Chancellor of UP Manila

D. The Executive Director of the UP NIH

B

Which of the following professional organizations is explicitly listed as a member of the Advisory Committee on Newborn Screening?

A. Philippine Medical Association

B. Philippine Pediatric Society

C. Philippine Association of Medical Technologists (PAMET)

D. Integrated Midwives Association of the Philippines

B

What fund source covers the processing costs, sample transport, education, and follow-up expenses of the newborn screening program?

A. The National AIDS Special Fund

B. The Newborn Screening Fee collected at facilities

C. Direct personal monthly taxation of the local municipality

D. Private corporate philantropic grants

B

What tool or method is highly utilized in Expanded Newborn Screening to analyze multiple metabolic disorders simultaneously from a single blood spot?

A. Gel Electrophoresis

B. Tandem Mass Spectrometry (MS/MS)

C. High-Performance Liquid Chromatography (HPLC)

D. Polymerase Chain Reaction (PCR)

A

In an infant with Congenital Adrenal Hyperplasia (CAH), excess production of androgens can lead to what physical manifestation in female newborns?

A. Ambiguous or virilized genitalia

B. Severe lower limb shortening

C. Complete absence of external skin pigmentation

D. Congenital cataracts in both eyes

A

Why is it important to prevent the filter paper card from touching or absorbing water after the blood spots have been collected?

A. Water can elute or wash away the essential blood components needed for analysis

B. Moisture causes the card to expand and break inside the laboratory scanner

C. Water exposure creates an artificial positive result for G6PD deficiency

D. Moisture activates viral particles within the filter paper fibers

B

Which entity oversees the operations of the Center for Health Development (CHD) networks in implementing newborn screening at the regional level?

A. PhilHealth Regional Offices

B. Department of Health (DOH) Central Office

C. National Institutes of Health Administration

D. Local Government Units (LGU)

B

What is the legal obligation of local health facilities (hospitals, lying-ins, health centers) regarding newborn screening under R.A. 9288?

A. They can choose to offer it optionally if funding allows

B. They must integrate newborn screening into their standard delivery service packages

C. They are only required to screen male infants or first-born children

D. They must refer all infants to a tertiary hospital in Manila for collection

B

What should the medical practitioner do if a blood spot sample is reported as "insufficient" or "invalid" by the Newborn Screening Center?

A. Assume the infant is healthy and take no further action

B. Immediately recall the baby to collect a repeat specimen card

C. Wait until the child is 6 months old to see if symptoms appear

D. Report the family to the municipal social welfare development office

B

Which condition results in an inability to properly metabolize the sugar found in human breast milk and commercial dairy formulas?

A. Phenylketonuria (PKU)

B. Galactosemia (GAL)

C. Maple Syrup Urine Disease (MSUD)

D. Congenital Adrenal Hyperplasia (CAH)

A

What physical danger exists if an infant with an invalid or delayed screening result goes undetected for a disorder like MSUD?

A. Severe metabolic crisis, seizures, coma, and rapid neurological decline

B. Transplacental cross-infection of nearby family members

C. Sudden irreversible loss of skeletal muscle mass in the upper limbs

D. Acute respiratory failure triggered by high altitude exposure

B

The term "Inborn Errors of Metabolism" refers to conditions caused by a structural or functional defect in what biological components?

A. Plasma antibodies

B. Metabolic enzymes or cellular transport proteins

C. Extracellular matrix collagen fibers

D. White blood cell surface antigens

B

When sending filter paper cards to the Newborn Screening Center via courier, how should they be safely packaged to avoid cross-contamination?

A. Stacked raw together with wet blood spots facing each other

B. Alternated or separated so that dry blood spots do not contact adjacent cards directly

C. Dissolved in a liquid preservative buffer tube before shipping

D. Placed inside a single, tightly compressed vacuum-sealed wet bag

A

What happens if a newborn screening sample is collected too early, such as 12 hours after birth, before adequate milk feeding has occurred?

A. It may lead to a false-negative result for protein-dependent metabolic disorders

B. The test will automatically show a false-positive result for G6PD deficiency

C. The red blood cells will completely dissolve within the lancet device

D. The baby will suffer from prolonged arterial bleeding at the puncture site

D

What specialized center provides comprehensive clinical management and genetic counseling services for patients with confirmed metabolic conditions?

A. Clinical Human Genome Center (CHGC)

B. Newborn Screening Reference Center (NSRC)

C. Center for Health Development (CHD)

D. Newborn Screening Continuity Clinic (NBSCC) / Continuity Clinic Network

B

Which structural group of disorders involves defects in the synthesis or structure of the oxygen-carrying protein in red blood cells?

A. Organic Acidemias

B. Hemoglobinopathies (such as Thalassemia)

C. Fatty Acid Oxidation Disorders

D. Urea Cycle Disorders

B

If an infant has a confirmed diagnosis of G6PD Deficiency, what should the family receive from the medical facility to ensure safe care?

A. A lifetime prescription for blood thinners

B. A comprehensive list of prohibited oxidative drugs and chemicals to avoid

C. A mandatory isolation clearance form

D. A referral for surgical bone marrow replacement

What physical action during collection can cause hemolysis of red blood cells or dilute the sample with tissue fluids?

A. Allowing the blood to drop freely onto the card

B. Forcefully squeezing or "milking" the infant's heel area around the puncture

C. Keeping the infant's leg in a dependent position below the body line

D. Warming the heel prior to making the lancet puncture

B

In newborn screening protocols, what does the abbreviation "NSRC" mean?

A. National Newborn Screening Registration Council

B. Newborn Screening Reference Center

C. National Welfare Center for Sick Children

D. Neonatal Screening Regulatory Commission

B

What is the primary purpose of executing a thorough program evaluation of the newborn screening system as mandated by the guidelines?

A. To increase the retail processing price of the filter paper cards

B. To assess procedures, operational arrangements, performance of implementers, and fund management

C. To replace all local hospital medical directors with genetic specialists

D. To reduce the screening panel back down to the original six disorders

B

Which component of the newborn screening system is responsible for ensuring positive patients are successfully tracked, managed, and referred to specialists?

A. The hospital billing department

B. The Newborn Screening Centers and regional Continuity Clinics

C. The local civil registrar office

D. The private health insurance underwriting board

A

Why should the filter paper card never be dried near an artificial heat source such as a radiator or autoclave?

A. Excessive heat can denature the blood proteins and alter delicate enzyme activity

B. The pre-printed text on the card will become unreadable by the staff

C. Heat changes the fiber configuration of the card, causing it to shrink drastically

D. It creates an environmental biohazard risk within the clinical laboratory area

B

What is the role of the National Institutes of Health (NIH) Philippines in the Newborn Screening Program?

A. Direct deployment of local municipal midwives

B. Overseeing operations and coordinating with the Newborn Screening Reference Center

C. Formulating corporate medical insurance underwriting laws

D. Providing direct financial loans to the parents of diagnosed infants

B

If an infant is confirmed to have Maple Syrup Urine Disease (MSUD), what happens if they inadvertently ingest regular infant formula or breast milk containing leucine?

A. They will exhibit transient skin rashes that disappear within 48 hours

B. They will experience rapid accumulation of toxic ketoacids, leading to severe brain injury or death

C. They will immediately develop temporary visual cataracts that resolve spontaneously

D. They will suffer from a mild hemolytic crisis that is manageable with oral fluids

B

Under R.A. 9288, newborn screening is defined as a procedure intended for what level of healthcare intervention?

A. Tertiary surgical cure

B. Early detection and management of congenital disorders (Preventive Public Health Strategy)

C. Post-natal palliative treatment for incurable genetic syndromes

D. Antenatal in-utero gene mapping and correction