III: Neonates

Question 1

_____ apnea: requires PEEP to stablish lung inflation and begin regular respirations

Answer 1

secondary

Question 2

_____ apnea: stimulation easily initiates a cry

Answer 2

primary

Question 3

Absorption of lung fluid around birth involves _____ channels that may be stimulated by _______.

Answer 3

ENaC; cortisol

Question 4

After birth, ______ alveolar oxygen _____ pulmonary vascular resistance and _____ pulmonary blood flow.

Answer 4

increased; decreases; increases

Question 5

Cord clamping increases _______, which increases ______ in the aorta.

Answer 5

SVR, pressure

Question 6

Define the normal blood pressure for a neonate.

Answer 6

60-90/30-60

Question 7

Define the normal repiratory rate for a neonate.

Answer 7

40-60/minute

Question 8

Describe the CXR in the context of surfactant deficiency.

Answer 8

Ground glass or whiteout appearance

Question 9

During labor, ______ increases to move fluid out of the lungs

Answer 9

Transpulmonary pressure

Question 10

Fetal pulmonary epithelium actively secretes _____ ions.

Answer 10

chloride

Question 11

In calcium homeostasis, neonate ___ levels increase and peak at 48 hours, while ____ levels increase immediately after birth and then fall

Answer 11

PTH; calcitonin

Question 12

Name the 5 parameters measured in Apgar scores.

Answer 12

HR, respirations, tone, response to suction, color

Question 13

Name the Apgar criteria for color.

Answer 13

0/pale, 1/acrocyanosis, 2/completely pink

Question 14

Name the Apgar criteria for HR.

Answer 14

0/absent, 1/HR below 100, 2/HR above 100

Question 15

Name the Apgar criteria for respirations.

Answer 15

0/absent, 1/irregular or gasping, 2/regular and crying

Question 16

Name the Apgar criteria for response to suction.

Answer 16

0/none, 1/grimace, 2/cough/sneeze/cry

Question 17

Name the Apgar criteria for tone.

Answer 17

0/limp, 1/some flexion, 2/active motion

Question 18

Name the normal heart rate for a neonate at 1 hour after birth.

Answer 18

120-140

Question 19

Name the three types of pulmonary hypertension in order of decreasing reversibility.

Answer 19

Constricted pulmonary vessels, abnormal pulmonary vascular musculature, Hypoplastic pulmonary vasculature

Question 20

Umbilical vein shunting to the IVC occurs via the _______.

Answer 20

Ductus venosus

Question 21

What is a distinct method by which neonates protect against hypothermia?

Answer 21

Non-shivering thermogenesis (brown fat)

Question 22

What is the diagnosis? Jitteriness and seizures 24-48 horus after birth

Answer 22

Hypocalcemia

Question 23

What is the diagnosis? Jitteriness, lethargy, irritability, apnea, seizures

Answer 23

Neonatal hypoglycemia

Question 24

What is the effect on pulmonary vasculature? Acidosis

Answer 24

constriction

Question 25

What is the effect on pulmonary vasculature? Alveolar expansion

Answer 25

dilation

Question 26

What is the effect on pulmonary vasculature? Endothelin

Answer 26

constriction

Question 27

What is the effect on pulmonary vasculature? Leukotrienes

Answer 27

constriction

Question 28

What is the effect on pulmonary vasculature? NO

Answer 28

dilation

Question 29

What is the effect on pulmonary vasculature? Oxygen

Answer 29

dilation

Question 30

What is the effect on pulmonary vasculature? Prostacyclin

Answer 30

dilation

Question 31

What is the most common cause of oligohydramnios causing pulmonary hypoplasia?

Answer 31

Premature membrane rupture

Question 32

What is the physiologic limit of fetal lung maturity?

Answer 32

22-24 weeks gestation

Question 33

Which diagnosis? Differential oxygen saturation of right arm and other extremities

Answer 33

Ductus arteriosus shunt

Question 34

Which diagnosis? Failure of fluid absorption leading to retained fetal lung fluid

Answer 34

Transient Tachypnea of the Newborn

Question 35

Which diagnosis? High pulmonary vascular resistance following birth that may result in persistent right to left shunts

Answer 35

Persistent Pulmonary Hypertension of the Newborn