Deck 40: Chronic Lung Disease of Infancy

Question 1

If a patient has severe CLDI, what cardiac problem may be identified on the chest radiograph?

A) Pneumomediastinum
B) Cardiac tamponade
C) Change in point of maximum impulse
D) Cor pulmonale

Answer 1

Cor pulmonale

Question 2

Which of the following is the major anatomic pathology associated with CLDI?

A) Extensive pulmonary fibrosis
B) Extensive airway injury
C) Alveolar hypoplasia
D) Dextrocardia

Answer 2

Alveolar hypoplasia

Question 3

Diagnostic criteria for the diagnosis of mild CLDI in an infant less than 32 weeks includes:

A) need for <30% oxygen at 36 weeks' PMA or discharge, whichever comes first.
B) breathing room air at 36 weeks' PMA or discharge, whichever comes first.
C) need for 30% oxygen and/or PPV or NCPAP at 36 weeks' PMA or discharge, whichever comes first.
D) breathing room air by 56 days' postnatal age or discharge, whichever comes first.

Answer 3

breathing room air at 36 weeks' PMA or discharge, whichever comes first.

Question 4

An infant with severe CLDI has developed cor pulmonale. What can be given to promote pulmonary vasodilation?

A) Furosemide (Lasix)
B) Inhaled nitric oxide (iNO)
C) Inhaled albuterol
D) FIO₂ >50%

Question 5

What is the most common chronic lung disease of premature infants?

A) CLDI
B) Asthma
C) Cystic fibrosis
D) TTN

Question 6

What is the most significant treatment of the neonate for the prevention of CLDI?

A) Corticosteroids
B) Diuretic therapy
C) Vitamin E therapy
D) Exogenous surfactant

Question 7

Which of the following ventilator parameters have been linked to the development of CLDI?
1) High peak inspiratory pressure
2) Overdistention of the lungs
3) Tidal volumes <5 mL/kg
4) High mean airway pressure

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 8

Which nutrient is essential for maintaining the epithelial cells of the tracheobronchial tree?

A) Vitamin A
B) Vitamin C
C) Carbohydrates
D) Proteins

Question 9

What is the single most important causative factor associated with the development of chronic lung disease of infancy (CLDI)?

A) Prematurity
B) Transient tachypnea of the newborn (TTN)
C) Asthma
D) Laryngotracheobronchitis

Question 10

Which of the following can increase an infant's likelihood of developing CLDI?

A) Birth weight >3000 g
B) Overfeeding
C) Use of beta₂-agonists
D) Postnatal bacterial sepsis

Question 11

A patient with classic stage II CLDI will have which of the following chest radiograph findings?

A) Ground-glass granular pattern
B) Emphysematous bullae
C) Honeycomb appearance
D) Patchy opaque areas of atelectasis next to areas of dark translucency

Question 12

Which of the following clinical manifestations are associated with CLDI?
1) Hyperresonant lungs
2) Wheezes and crackles
3) Nasal flaring
4) Intercostal retractions

A)1, 3
B)2, 4
C)1, 2, 4
D)2, 3, 4

Question 13

Which of the following is consistent with stage II of CLDI?
1) Occurs 4 to 10 days after birth.
2) Occurs 11 to 30 days after birth.
3) Extensive atelectasis.
4) Alternating areas of atelectasis and emphysema.

A)2, 3
B)1, 4
C)2, 3, 4
D)1, 3, 4

Question 14

What changes result when stress fractures of the capillary endothelium and basement membranes develop during mechanical ventilation?

A) Fluid leakage into alveolar spaces
B) Bronchospasm
C) Pulmonary embolism
D) TTN

Question 15

A neonate is reported to have classic stage IV CLDI with emphysematous lung changes. What pulmonary function test finding(s) would confirm this?
1) Increased RV/TLC ratio
2) Increased FRC
3) Decreased VC
4) Increased RV

A)3, 4
B)1, 2
C)2, 3, 4
D)1, 2, 4

Question 16

What agent can be administered postnatally to a preterm infant to help reduce lung inflammation and the incidence of CLDI?

A) Vitamin D
B) Bronchodilators
C) Ribavirin (Virazole)
D) Corticosteroids