quiz 4

Question 1

What is the primary action of adenosine in the treatment of supraventricular tachycardia (SVT)?

Answer 1

Transiently blocking conduction through the AV node

Adenosine acts primarily by interrupting reentrant pathways involving the AV node, making it effective for SVT management.

Question 2

How do ACE inhibitors like enalapril lower blood pressure?

Answer 2

By blocking the enzyme ACE, preventing conversion of angiotensin I to angiotensin II

This action reduces vasoconstriction and decreases sodium and water retention.

Question 3

How do neonates predominantly increase cardiac output after birth?

Answer 3

By increasing heart rate

Neonates have limited ability to increase stroke volume due to immature myocardial fibers.

Question 4

What are complications of Lasix (furosemide) therapy?

Answer 4

Complications include:
* Electrolyte disturbances (hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia)
* Ototoxicity
* Nephrocalcinosis
* Dehydration and metabolic alkalosis

Furosemide acts on the Na⁺-K⁺-2Cl⁻ transporter, leading to significant electrolyte and water loss.

Question 5

What potential side effect is associated with non-selective beta blockers such as propranolol?

Answer 5

Wheezing

This occurs due to β2 receptor blockade, leading to bronchospasm, especially in infants with reactive airway disease.

Question 6

What is the most life-threatening side effect of NSAIDs given for treatment of PDA?

Answer 6

Bleeding

NSAIDs inhibit prostaglandin synthesis, which is essential for normal platelet function, increasing the risk of bleeding.

Question 7

What is the antidote for a heparin overdose?

Answer 7

Protamine sulfate

Protamine sulfate neutralizes the anticoagulant effects of heparin.

Question 8

What should be monitored closely in an infant started on propranolol?

Answer 8

Blood sugar

Propranolol can impair glycogenolysis and gluconeogenesis and mask symptoms of hypoglycemia.

Question 9

What medication should be used cautiously in a baby with significant hyperbilirubinemia?

Answer 9

Furosemide

Furosemide can displace bilirubin from albumin-binding sites, increasing the risk of kernicterus.

Question 10

What lab value needs to be monitored closely after starting Enalapril?

Answer 10

Potassium

ACE inhibitors can cause hyperkalemia due to suppression of aldosterone.

Question 11

What effect does Clopidogrel bisulfate (Plavix) have on the body?

Answer 11

Suppress platelet aggregation

Clopidogrel irreversibly inhibits the P2Y12 component of ADP receptors on platelets.

Question 12

What lab value should be prioritized in an infant receiving a heparin drip?

Answer 12

PTT

PTT is used to monitor therapeutic levels of heparin.

Question 13

What is the most appropriate starting dose of IV furosemide in neonates?

Answer 13

1 mg/kg/dose

Initial dosing should be conservative to mitigate risks of electrolyte loss.

Question 14

What type of drugs are filtered at the glomerulus?

Answer 14

Free

Only unbound (free) drugs can be filtered; those bound to albumin cannot pass through.

Question 15

Where does the majority of sodium and water reabsorption occur in the nephron?

Answer 15

Proximal tubule

Approximately 65–70% of sodium and water reabsorption occurs here.

Question 16

What advantage does Aldactazide offer over Lasix?

Answer 16

Is potassium sparing

Aldactazide combines spironolactone with hydrochlorothiazide, helping to preserve potassium.

Question 17

What is preload?

Answer 17

The volume of blood returning to the heart that fills the ventricles at the end of diastole

Improving preload can be done by administering fluid boluses or blood products.

Question 18

When adjusting digoxin doses in neonates, what should the dose be based on?

Answer 18

Patient response

Clinical response and signs of toxicity are the guiding factors for dosing adjustments.

Question 19

What is the reversal agent for benzodiazepine intoxication?

Answer 19

Flumazenil

Flumazenil is used to reverse the effects of benzodiazepines.

Question 20

What can serum levels be misleading in neonates?

Answer 20

Altered distribution and renal clearance

Serum levels in neonates may not accurately reflect drug concentrations due to physiological differences.

Question 21

What should be adjusted based on clinical response rather than serum level alone?

Answer 21

Digoxin

Clinical response is a more reliable indicator of digoxin effectiveness than serum levels.

Question 22

What is the reversal agent for benzodiazepine overdose?

Answer 22

Flumazenil

Flumazenil is a specific antagonist that reverses the effects of benzodiazepines.

Question 23

True or False: Naloxone is used to reverse benzodiazepine overdose.

Answer 23

False

Naloxone is specifically for opioid overdose, not benzodiazepines.

Question 24

What is the relationship between maternal HIV RNA viral load and perinatal transmission risk?

Answer 24

Stronger correlation with transmission risk

Maternal viral load at delivery is the strongest predictor of HIV transmission to the infant.

Question 25

Fill in the blank: The amount of risk for transmission of HIV from mother to infant at delivery is related to _______.

Answer 25

HIV RNA viral load ## Footnote High maternal viral load increases the risk of HIV transmission during delivery.

Question 26

What can reduce the risk of perinatal HIV transmission if the maternal viral load is high?

Answer 26

Cesarean section ## Footnote A C-section can lower transmission risk but only if the viral load is elevated.

Question 27

Which agent is not a reversal agent for CNS depression?

Answer 27

Phenobarbital ## Footnote Phenobarbital may worsen CNS depression instead of reversing it.

Question 28

What is the role of ART compliance during pregnancy concerning HIV transmission?

Answer 28

Important throughout pregnancy ## Footnote While ART compliance is crucial, the viral load at delivery is the immediate risk factor.