What is the most common respiratory disorder of the newborn? What is it also known as?

Transient tachypnea of the newborn (TTN) // type II RDS

Which maternal factor is associated with an increased frequency of SIDS?

Nicotine or narcotic use during pregnancy

What is not typical characteristic of use of prophylactic administration of surfactant?

Given to those who have a PaCO2 of 35-45 and an PaO2 of 80 mmHg

What causes TTN to occur?

Thought to be related to retained fetal lung fluid from prolonged labor

The lung responds to trauma and O2 toxicity by releasingchemical mediators that:

cause inflammation and injury to the alveolar-capillary membrane.

Which of the following is not a clinical manifestation of PPHN?

Increase in total lung compliance

Pediatric respiratory disorders typically result from

Airway obstructions caused by viral or bacterial infections

Which of the following is NOT one of the four heart defects in Tetralogy of Fallot?

Transposition of the great arteries

studbud

Neontal and Pediatric Disorders

100 termsStudBud Administration4 plays

Imported from external platform

Flashcards100 cardsFPractice quizPHost liveL

Questions 100

Answers

1
What is the most common newborn abdominal defect that involves the insertion of the umbilical cord?
Omphalocele
Abdominal distention
Gastroschisis
Congential Bowel Herniation
2
What is the most common respiratory disorder of the newborn? What is it also known as?
Transient tachypnea of the newborn (TTN) // type II RDS
Transient tachypnea of the newborn (TTN) // Hyline Membrane Disease
Respiratory Distress Syndrome // type II RDS
Respiratory Distress Syndrome// type I RDS
3
Which of the following is NOT listed as a congenital abnormality affecting respiration?
Cardiac malformations
Airway diseases
Airway diseases
Congenital diaphragmatic hernia
4
Omphalocele is characterized by
Defect separate from the umbilical cord
Bowels covered by membrane
Bowels not covered by membrane
None of the above
5
Which of the following statements accurately describes the clinical manifestations of BPD?
Some premies start with pneumonia/sepsis and require high levels of O2 & MV
All of the above
Chest X-rays show diffuse areas of atelectasis, emphysema, and fibrosis.
Premies do not need O2/MV initially but develop resp distress in 2-3 weeks
6
Congenital tracheal stenosis is a condition where the trachea is:
Narrowed
Collapsed
Inflamed
Dilated
7
Which of the following symptoms accompanying apnea is NOT considered normal?
Bradycardia
Pallor
Hypotonia
All of the above
8
Which maternal factor is associated with an increased frequency of SIDS?
High socioeconomic status
Asian or Caucasian descendant
Nicotine or narcotic use during pregnancy
Age over 30 years
9
For vigorous infants with MAS, which of the following is an appropriate treatment option?
Intubation
HFOV and CPAP
HFNC and HFOV
CPAP and Bulb Syringe
10
What is not typical characteristic of use of prophylactic administration of surfactant?
Given within 30 minutes of birth
Given to those with low birthweight (<1500g)
Given to those who have a PaCO2 of 35-45 and an PaO2 of 80 mmHg
Given to infants with known surfactant deficiency
11
Which type of apnea involves no effort to breathe?
Central
Mixed
None of the above
Obstructive
12
Which of the following is NOT a treatment option for PPHN?
High frequency ventilation
Inhaled nitric oxide
Antihistamines
Correction of underlying cause
13
What does a baby who presents with umbilical arterial pH of 7.12, APGAR of 3 & aspirated meconium from trachea have?
gastroesophageal reflux disease
congenital diaphragmatic hernia
Bronchopulmonary dysplasia
Meconium aspiration syndrome
14
Which symptom is NOT associated airway disease with internal obstruction?
Expiratory wheeze
Inspiratory stridor
Patchy infiltrates
Accessory muscle use
15
Which of the following is a prophylactic measure for bronchiolitis?
Steroids
Active immunization
Passive immunization
Antibiotics
16
What are the two types of trauma that can lead to ventilator-associated lung injury (VALI) in the context of BPD?
Inflammation and alveolar damage
Shear injury and oxygen radicals
Oxygen toxicity and barotrauma
Atelectrauma and volutrauma
17
Congenital heart diseases are divided into which two classes?
Genetic and Acquired
Obstructive and Non-obstructive
Primary and Secondary
Cyanotic and Acyanotic
18
What is the most common cause of noisy breathing in infancy?
Laryngomalacia
Laryngeal webs
Tracheal stenosis
Tracheomalacia
19
Which of the following is NOT a clinical manifestation of epiglottitis?
Barking cough
Difficulty swallowing/drooling
High fever
Stridor
20
Which of the following conditions is characterized by muscle weakness due to dying motor neurons?
Congenital myasthenia gravis
Tetralogy of Fallot
Myotonic dystrophy
Spinal muscular atrophy
21
What is not a clinical manifestation of TTN?
pH and pCo2 usually normal
Decrease heart rates (60-100)
Chest X-Ray with hyperinflation, Perihilar streaking, Pleural effusions
Rapid breathing during first hours after birth
22
Hospitalization for croup is indicated if the patient has:
All of the above
Stridor at rest and cyanosis on room air
Harsh breath sounds
Suprasternal retractions
23
Which of the following is NOT listed as a pediatric respiratory disorder?
Sudden infant death syndrome (SIDS)
Tetralogy of Fallot
Bronchiolitis
Gastroesophageal reflux disease (GERD)
24
Which following is an alternative cause of apnea in premature infants that should be ruled out prior to diagnosing AOP?
All of the above
Infection
Metabolic disorder
Maternal Drugs
25
What precaution should be taken when administering surfactant therapy for RDS?
All of the above
Adjust FiO2 to avoid O2 toxicity
Be prepared to adjust MV settings due to increased compliance
adjust FiO2 appropriately to avoid O2 toxicity
26
What does the X-ray of a patient with croup typically show?
Thumb sign
Overriding aorta
Steeple sign
Hyperinflation
27
Which of the following is the first non-animal-derived surfactant in the US?
Curosurf (poractant alfa)
Surfaxin (lucinactant)
Infasurf (calfactant)
Survanta (beractant)
28
What is not a major factor that contributes to RDS?
Abcence of Ductus Arteriosus
Increased small airway compliance
Surfactant deficiency (quality)
Decreased alveolar surface area
29
What causes TTN to occur?
Thought to be caused by increased surfactant caused from prolonged labor
Though to be related to retained CO2 due to undeveloped lungs
None of the above
Thought to be related to retained fetal lung fluid from prolonged labor
30
PPHN is present when the PVR/SVR ratio is:
<1
>1
=1
None of the above
31
A definitive diagnosis of RDS is confirmed via chest X-Ray with the appearance of all of the following except for:
Low lung volumes
Radioluncent appearance
Air bronchograms
Diffuse, hazy reticulogranulardensities
32
Which of the following is NOT a factor that can cause BPD?
Oxygen requirement/toxicity / Mechanical Ventilation
Severe RDS in first weeks of life/ Malnutrition
Precipitous delivery
Immature lung development / Genetics
33
What is the primary cause of sudden infant death syndrome?
Genetic link
Apnea of Prematurity
There is no known cause
Immaturity of the respiratory center
34
Prior to birth, what are indications that an infant is at right risk for MAS?
Known presence of thick meconium
Fetal tachycardia (HR>160)
All of the above
Absent fetal cardiac accelerations during labor
35
Which of the following is not a common symptom of GERD in children?
Frequent or persistent cough
Barking cough
Refusing to eat or difficulty eating(choking or gagging while feeding)
Frequent or recurrent vomiting
36
The lung responds to trauma and O2 toxicity by releasingchemical mediators that:
reduce the work of breathing by dilating the airways.
enhance the production of surfactant to improve lung compliance.
promote healing and repair of the lung tissue.
cause inflammation and injury to the alveolar-capillary membrane.
37
Which of the following is NOT a physical exam finding indicative of congenital diaphragmatic hernia?
Decreased breath sounds
Increased breath sounds
Displaced heart sounds
Scaphoid abdomen
38
Which of the following is NOT a home treatment for bronchiolitis?
Humidification
IV hydration
Decongestants
Avoid second hand smoke and other airway irritants
39
Which of the following is not a clinical manifestation of PPHN?
Increase in total lung compliance
Hypoxemia out of proportion to suspected lung disease
Rapid changes in O2 saturation occur without changes inFiO2
Pre and post ductal saturation difference of >5%
40
Laryngomalacia is the congenital softening of tissues in which part of the airway?
Above the vocal cords
Below the vocal cords
Trachea
Bronchi
41
Subglottic hemangiomas grow rapidly for how long before they start to shrink?
24-30 months
12-18 months
6-12 months
18-24 months
42
What is the usual duration for TTN to clear up?
72-96 hours
24-48 hours
48-72 hours
12-24 hours
43
Pediatric respiratory disorders typically result from
Neuromuscular diseases
Congenital heart defects
Airway obstructions caused by viral or bacterial infections
Genetic mutations
44
Which of the following is NOT one of the four heart defects in Tetralogy of Fallot?
Pulmonary stenosis
Overriding aorta
Ventricular septal defect
Transposition of the great arteries
45
Which of the following factors does NOT contribute to the production of surfactant?
Lung maturity
Adequate fetal perfusion
maternal factor that impairs blood flow to the fetus
First delivery for infant
46
Croup is also known as:
Laryngotracheobronchitis
Epiglottitis
Bronchiolitis
Reactive airway disease
47
Tracheomalacia is characterized by
Narrowed tracheal lumen
Floppy tracheal walls
Rigid tracheal walls
Thickened tracheal walls
48
Under what conditions is rescue therapy with surfactant typically given?
To infants with clinical evidence of RDS
Usually is administered within 12 hours after birth
All of the above
To preterm infants requiring intubation and mechanical ventilation
49
Which of the following is NOT a lung malformation that can be seen with newborns?
Bronchopulmonary dysplasia
Lobar emphysema (or congenital lobaremphysema or CLE)
Lung sequestration (akabronchopulmonary sequestration or BPS)
CPAM
50
What strategies are employed to prevent the development of BPD?
Early use of surfactant therapy
All of the above
Maintain appropriate PEEP
Maintain appropriate tidal volume
51
Cystic fibrosis (CF) is caused by a mutation in a protein that controls the movement of which ion?
Calcium
Potassium
Sodium
Chloride
52
What is not a recommended treatment options for RDS?
Bronchodilator administration
High Frequency Oscillatory Ventilation
Mechanical ventilation
Surfactant replacement therapy (SRT)
53
What is the primary content of meconium that can lead to MAS?
Aspirated Surfactant
Aspirated Blood
Aspirated Amniotic fluid
Aspirated Fetal intestinal content
54
What produces surfactant? What is the purpose of surfactant?
Type II Alveolar Cells (pneumocytes) / Reduce alveolar surface tension
Type I Alveolar Cells (pneumocytes) / Increase Alveolar Pressure
Type II Alveolar Cells (pneumocytes) / Increase alveolar pressure required
Type I Alveolar Cells (pneumocytes) / Reduce alveolar surface tension
55
What are the three primary problems that can result in MAS?
Surfactant deficiency, decreased alveolar surface area, and increased R(aw)
Apnea of prematurity, persistent pulmonary hypertension of the newborn,
Meconium obstruction, lung tissue damage, and pulmonary hypertension
Bronchopulmonary dysplasia, sudden infant death syndrome, and GERD
56
Which medications are most commonly used to treat AOP?
Antihistamines and Antichollernergic agents
Ibuprofen and Beta Blockers
All of the above
Cafcit and Methylxanthines-theophylline
57
Gastroschisis is characterized by
All of the above
Defect involving the umbilical cord
Bowels not covered by membrane
Bowels covered by membrane
58
Interrupted aortic arch is a condition where:
The aorta is narrowed
The aorta is transposed with the pulmonary artery
The left ventricle is underdeveloped
There is a gap in the aorta
59
Which of the following is not an example of an internally obstructive airway disease?
Laryngomalacia
Tracheomalacia
Tracheal stenosis
Plureititis
60
What is not a clinical manifestations of MAS?
Irregular densities on chest x-ray with areas of density and hyperlunciency
Hypoxemia and mixed acidosis on ABG
Gasping respirations, tachypnea, Grunting and retractions
Paradoxal breathing / Cheyne-Strokes Breathing
61
Which of the following conditions are indicative of a non-vigorous infant?
Depressed respirations
All of the above
Depressed muscle tone
HR <100
62
What is the typical duration of apnea in premies that is considered normal?
20-25 seconds
5-10 seconds
10-15 seconds
15-20 seconds
63
How is surfactant administered?
Intramuscular
Via direct introduction to the trachea
Intravenously
Via Direct introduction into the terminal bronchioles
64
What is the common denominator in PPHN?
return to fetal circulation caused by high pulmonary vascular resistance
Results in V/Q mismatches
They all result in ataxic breathing for the newborn
There is no common denominator as they are all of complex causes
65
In premature animals, what happens to tidal volume (VT) and respiratory rate (RR) when FiO2 is less than room air?
VT decreases, RR increases
VT and RR increase
VT increases, RR decreases
VT and RR decrease
66
What is the leading cause of death in cystic fibrosis patients?
Pancreatic insufficiency
Heart failure
Liver disease
Complications of lung disease
67
Laryngeal web limits the volume of air flowing in and out of which structure?
Bronchi
Larynx
Alveoli
Trachea
68
Mixed apnea starts as which type and becomes which type?
Obstructive, Central
Central, Obstructive
Obstructive, Mixed
Central, Mixed
69
What is the leading cause of death among infants under 1 year old in the U.S.?
Sudden infant death syndrome (SIDS)
Cystic fibrosis
Epiglottitis
Bronchiolitis
70
How do you treat MAS in a severely depressed infants with thick meconium?
Intubate and direct suction to ETT using meconium aspirator
Intubate and increase FIO2 to increase oxygenation
Intubate and increase PEEP
All of the above
71
Tracheal-esophageal fistula is associated with which condition?
VATER or VACTERL association
PPHN
CLE
CPAM
72
Which of the following is NOT a recommended treatment for GERD?
Large, infrequent meals
Hold baby upright for 30 minutes after feeding
Elevate the head of the crib or bed
Thicken bottle feedings with cereal
73
What is the recommended CPAP setting for the treatment of RDS?
8-10 cmH2O
5-7 cmH2O
10-12 cmH2O
12-15 cmH2O
74
What is not a treatment used to TTN?
CPAP if higher FiO2 is needed
Changing positions to speed lung clearance
Oxygen therapy-usually low FiO2 by oxyhood or cannula
Immediate Mechanical Ventilation: PC-CMV or VC-IRV
75
Which infant characteristic at birth is associated with an increased frequency of SIDS?
High Apgar score
Female gender
Premature Birth
First in birth order of a multiple birth
76
Which respiratory disorder is associated with GERD?
Croup
Epiglottitis
Bronchiolitis
Reactive airway disease
77
What is the result of ineffective surfactant in RDS?
Hypoxemia and Acidosis occurs/ worsens
Increase surface tension in alveoli/ Collapsed Alveoli/Cap Fluid in Alveoli
Impaired Gas Exchange, Increased WOB, PVR Increases
All of the above
78
Which of the following is not a recommended prevention method for SIDS?
ID infants at high risk
Avoid breastfeeding
Remove soft objects fromsleeping environment
Lay infants on back or side forfirst 6 mos
79
What does the lateral neck X-ray of a patient with epiglottitis typically show?
Thumb sign
Steeple sign
Overriding aorta
Hyperinflation
80
What should never be done to a suspected epiglottitis patient?
Intubate the patient
Stick anything in the mouth or retract the tongue
Administer antibiotics
Provide oxygen therapy
81
Bronchiolitis is usually caused by which virus?
Adenovirus
Influenza
GERD
Respiratory syncytial virus (RSV)
82
Which of the following is not an acyanotic congenital heart defect?
Right ventricular hypertrophy
Patent ductus arteriosus
Left ventricular outflow obstructions
Atrial septal defect
83
What is the goal of initial treatment for congenital diaphragmatic hernia?
ventilation & oxygenation,while preventing gas insufflations of intestines
Nothing, The condition is lethal provide comfort care
Surgical removal of the diaphragm
ECMO
84
Which of the following is NOT a cause of external compression of the airway?
Vascular rings
Neck/thoracic masses
Bronchopulmonary dysplasia
Hemangiomas
85
Fetal asphyxia causes pulmonary vasospasm which can lead to?
persistent pulmonary hypertension (PPH)
COPD
All of the above
Bronchial Spasms
86
Which of the following is not a lung parenchymal disease that affects newborns?
Bronchopulmonary dysplasia (BPD)
Respiratory distress syndrome (RDS)
Meconium aspiration syndrome (MAS)
Pulmonary Embolism
87
What are the surfactant administrations classifications?
Maintenance Therapy and Emergent Therapy
Maintenance Therapy
Prophylactic administration / Rescue therapy
Rescue therapy and Maintenance therapy
88
Which of the following is not a clinical manifestation of croup?
X-Ray shows signs of atelectasis in apices of lungs
dyspnea, cyanosis,exhaustion, agitation
nasal congestion with fever andcoughing
I and E stridor and barkingcough
89
Which of the following sequences correctly represents the progression of lung injury in BPD?
Alveolar damage → atelectrauma → volutrauma → hyperoxia → inflammation
Inflammation→ oxygen toxicity → atelectrauma→ volutrauma → lung dysfunction
Hyperoxia-lung injury→ inflammation→alveolar damage→ lung dysfunction→death
Lung dysfunction → hyperoxia → inflammation → atelectrauma → volutrauma
90
Coarctation of the aorta involves:
A hole between the heart's ventricles
Transposition of the great arteries
An underdeveloped left heart
A narrowing of the aorta
91
What is a disease of term/near term infants where meconium is aspirated into central airways? What can cause this?
Bronchopulmonary Dysplasia // Perinatal depression/asphyxia
Bronchopulmonary Dysplasia// Depression and Anxiety
Meconium aspiration syndrome (MAS) // depression and Anxiety
Meconium aspiration syndrome (MAS) // Perinatal depression/asphyxia
92
What is the incidence of RDS in the US per year? What is another name for RDS? What is RDS?
40K/Hyaline membrane disease/Lung Parenchymal Disease from premature birth
40K/ Transient tachypnea /Lung Parenchymal Disease from CO2 exposure
60K/Hyaline membrane disease/Lung Parenchymal Disease from premature birth
60K/Transient tachypnea /Lung Parenchymal Disease from CO2 Exposure
93
Which of the following is NOT a treatment option for cystic fibrosis?
Inhaled antibiotics
High-dose insulin therapy
Pancreatic enzyme supplements
Regular chest physical therapy
94
Which medication is used to reduce the severity of symptoms in mild to moderate cases of croup
Antihistamines
Bronchodilators
Budesonide
Antibiotics
95
Which of the following is not a form of PPHN?
Increased muscle wall thickness
Increased lung compliance
Decreased cross-sectional area ofpulmonary vessels
Vascular spasm
96
What is the first sign of RDS that usually occurs soon after birth?
Paradoxical breathing
Grunting
Retractions
Tachypnea
97
Which of the following is a clinical manifestation of bronchiolitis?
Inflammation and obstruction of small bronchiand bronchioles
All of the above
I and E wheezing, dyspnea,tachypnea, slight fever and cough
Chest X-ray shows areas of hyperinflation and consolidation
98
What are the initiating factors of BPD?
Volutrauma
Atelectrauma
All of the above
Oxygen toxicity
99
What is the most common cause of epiglottitis?
Streptococcus pneumoniae
Respiratory syncytial virus (RSV)
Haemophilus influenzae type B (HiB)
Parainfluenza virus
100
The presence of central cyanosis indicates what
Severe Alkalosis
Proper Perfusion
Severe Hypoxemia
Impending Doom

Neontal and Pediatric Disorders Flashcards | StudBud