Peds Ch 2

Question 1

when does anterior fontanel close

Answer 1

between 9 and 18 months of age

Question 2

when does the posterior fontanel close

Answer 2

by 2-4 months of age

Question 3

when does first tooth erupt

Answer 3

approx 6 months

Question 4

what do the epiglottis and vocal cords look like in a neonate patient

Answer 4

long, omega-shaped epiglottis and the pearly white vocal cords in the neonate.

Question 5

when does the respiratory system begin to develop

Answer 5

begins during week 4 of gestation

Question 6

The critical event in the change from placental to pulmonary gas exchange is the first inspiration, which initiates ….. (3)

Answer 6

• pulmonary ventilation
• promotes the clearance of lung fluid
• triggers the change from the fetal to the neonatal pattern of circulation.

Question 7

transpulmonary distending pressure of first breath

Answer 7

pressure of 40 to 80 cm H2O

Question 8

TTN lasts for how many hours

Answer 8

24 to 72 hours

Question 9

X-ray of TTN

Answer 9

characteristic chest radiographic appearance consisting of:

• increased perihilar markings
• fluid in the interlobar fissures
• streaky linear opacities in the parenchyma

Question 10

With the onset of pulmonary ventilation, ____________ blood flow sharply increases.

Answer 10

pulmonary

Question 11

what happens to PVR & peripheral systemic vascular resistance at the onset of pulmonary ventilation

Answer 11

PVR ↓
↑pulmonary blood

Question 12

____________ causes an immediate closure of the flap valve mechanism of the foramen ovale and reverses the direction of shunt through the ductus arteriosus

Answer 12

increase in systemic afterload

Question 13

what blood gas parameters change immediately after birth

Answer 13

the partial pressure of oxygen in arterial blood (PaO2) and pH are reduced, whereas the PaCO2 is increased immediately after birth

Question 14

what is the principal factor that determines lung compliance?

Answer 14

volume

Question 15

adult total lung capacity vs pediatric

Answer 15

Adults have a much greater total lung capacity (TLC) than infants

Question 16

what relationship converts a small tension into a large pressure gradient

Answer 16

the Laplace relationship

Question 17

how can the neonate ↑ FRC

Answer 17

by exhaling against a closed glottis.

Question 18

who has higher airway resistance, term neonates or preterm?

Answer 18

preterm

Question 19

tracheal compliance in neonates…

Answer 19

is twice that of adults and appears to be a consequence of cartilaginous immaturity

Question 20

where does PaO2 act mainly to control ventilation?

Answer 20

mainly through peripheral chemoreceptors in the carotid and aortic bodies

Question 21

where do PaCO2 and pH act to control ventilation?

Answer 21

on central chemoreceptors in the medulla

Question 22

an infant’s response to hypercapnia is not potentiated by ____________

Answer 22

hypoxia

Question 23

what depresses respiration in the neonate

Answer 23

high concentrations of oxygen

Question 24

t/f periodic breathing is uncommon in neonates

Answer 24

FALSE, its common

Question 25

There is a general consensus that infants may be at risk for postoperative apnea up to ____________

Answer 25

60 weeks after conception

Question 26

how does fetal hemoglobin shift at birth

Answer 26

the increased fetal hemoglobin content shifts the curve to the left of the adult curve

Question 27

Autonomic control of the heart in utero is mediated predominantly through the ____________ nervous system

Answer 27

parasympathetic

Question 28

what extremity is the pediatric blood pressure higher in

Answer 28

blood pressure measured in the lower extremity is less than in the upper extremity in children

Question 29

what kind of infants have reduced blood pressure

Answer 29

infants with birth asphyxia and those who require mechanical ventilation

Question 30

what does the large cardiac output in neonates reflect

Answer 30

their greater metabolic rate (on a weight basis) and oxygen consumption compared with adults

Question 31

at birth, how is the QRS axis

Answer 31

right sided, reflecting the predominant right ventricular intrauterine development

Question 32

when does urine production begin in utero

Answer 32

10-12 weeks of gestation

Question 33

All normal neonates should void by ____________ after birth; otherwise, they should be investigated for anomalies including posterior urethral valves

Answer 33

48 hours

Question 34

fetal blood gas in utero

Answer 34

In utero, the fetus maintains a mild respiratory acidosis, with a similar plasma bicarbonate concentration, but a greater PaCO2 than its mother.

Question 35

Most umbilical venous blood from the placenta passes through the ____________ to the inferior vena cava.

Answer 35

ductus venosus

Question 36

In fetal life, the main serum protein is ____________

Answer 36

alpha- fetoprotein

Question 37

how does phototherapy work

Answer 37

Phototherapy reduces serum bilirubin concentrations by converting bilirubin through structural photoisomerization and photooxidation into excretable products

Question 38

the placenta is impermeable to what 2 hormones

Answer 38

insulin and glucagon

Question 39

The normal range of hemoglobin in the neonate is ____________

Answer 39

14 to 20 g/dL.

Question 40

Infants with anemia of prematurity have an inadequate production of ____________

Answer 40

erythropoietin

Question 41

baby can support head at..

Answer 41

3 months

Question 42

baby can sit alone at...

Answer 42

6 months

Question 43

baby can stand alone at...

Answer 43

12 months

Question 44

kid can balance on one foot at...

Answer 44

3 years