Question 1

In which infants is the surfactant administered as rescue?

Accepted Answer

C

Question 2

You are caring for an infant with RDS. Nasal CPAP has been used; however, the infant suddenly deteriorates and is demonstrating severe hypoxemia on an FIO₂ of 0.60. What should be done next?

Accepted Answer

Severe hypoxemia in a neonate with RDS is an indication for intubation and mechanical ventilation. Increasing CPAP or FIO₂ may not be sufficient to improve the oxygenation and may worsen the air leak syndrome. Nasal CPAP may not be sufficient in such a scenario.

Question 3

In preterm infants, adequate amounts of surfactant are present; however, it is trapped inside type II cells.

Accepted Answer

True

Question 4

The current standard of care is delivery surfactant replacement to all infants with RDS.

Accepted Answer

The current standard of care for treating respiratory distress syndrome (RDS) in infants is to administer surfactant replacement therapy. This has been shown to improve respiratory function and reduce mortality rates in preterm infants with RDS. Therefore, choice A is the best answer. Choice B is incorrect because surfactant replacement is considered the standard of care and not administering it would be suboptimal.

Question 5

What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn?

Accepted Answer

Transient tachypnea of the newborn (TTN) is a self-limiting condition that results from retained fetal lung fluid. The initial treatment is supportive care with supplemental oxygen as needed to maintain oxygen saturation above 92%. Oxygen with low FIO2 is the best choice as it helps in correcting hypoxemia without causing hyperoxia. Mechanical ventilation with PEEP, bronchodilators, and mucolytics are not indicated in the treatment of TTN.

Question 6

What are the major factors in the pathophysiology of RDS?
I.qualitative surfactant deficiency
II.increased alveolar surface area
III.increased small airways compliance
IV.presence of the ductus arteriosus

Accepted Answer

The major factors in the pathophysiology of Respiratory Distress Syndrome (RDS) include qualitative surfactant deficiency, which leads to increased surface tension and alveolar collapse, and increased small airways compliance, which contributes to airway instability and collapse. The presence of the ductus arteriosus is not directly related to the pathophysiology of RDS but can complicate the clinical picture in neonates with RDS. Increased alveolar surface area is not a factor in RDS; in fact, the disease is characterized by reduced functional surface area due to atelectasis and surfactant deficiency.

Question 7

What radiographic finding is common in infants with transient tachypnea?

Accepted Answer

Hyperinflation is a common radiographic finding in infants with transient tachypnea, due to retained fetal lung fluid leading to decreased lung compliance and increased work of breathing. Other features like low lung volumes, bilateral perihilar lymphadenopathy or mucus plugging are not commonly seen in infants with transient tachypnea.

Question 8

What is the first clinical sign of RDS in the newborn infant?

Accepted Answer

Tachypnea, or rapid breathing, is the first clinical sign of respiratory distress syndrome (RDS) in newborns. This is due to the decreased lung compliance and increased airway resistance that occurs in RDS, making it more difficult for the infant to breathe. Cyanosis may occur later as a result of oxygen saturation dropping, but it is not the first sign. Wheezing may occur in other respiratory conditions but is not a specific sign of RDS. Hypertension may occur in other conditions or may be a complication of RDS, but it is not the first clinical sign.

Question 9

Mothers of infants with transient tachypnea tend to have longer labor intervals and a higher incidence of failure to progress in labor.

Accepted Answer

Transient tachypnea is a condition in newborns that causes rapid breathing and increased heart rate. It is believed to be due to delayed reabsorption of lung fluid. Studies have shown that mothers of infants with transient tachypnea tend to have longer labor intervals and a higher incidence of failure to progress in labor. This may be due to factors such as maternal fatigue or prolonged rupture of membranes, which can lead to increased lung fluid accumulation in the fetus.

Question 10

Which of the following clinical signs is not consistent with the onset of RDS?

Accepted Answer

Cyanosis is not typically present in the early stages of RDS. It usually occurs later, and can be a sign of severe respiratory distress. Grunting, retractions, and nasal flaring are all common signs of RDS at onset.

Question 11

What treatment may improve lung fluid clearance in the infant with transient tachypnea?

Accepted Answer

Frequent turning of the infant helps improve lung fluid clearance by changing the position of the infant and allowing gravity to assist in the clearance of fluid. CPAP, oxygen, and mechanical ventilation may provide respiratory support but do not directly address the clearance of lung fluid.

Question 12

Which of the following treatments is the least useful for the treatment of RDS?

Accepted Answer

Bronchial hygiene techniques are not specifically targeted towards the treatment of RDS and are not typically used as a primary treatment modality for this condition. CPAP is a commonly used treatment for mild to moderate RDS, and surfactant replacement therapy is considered the standard treatment for moderate to severe RDS. High-frequency ventilation may also be used in severe cases of RDS.

Question 13

Which of the following findings on the chest radiograph is not typical for RDS?

Accepted Answer

Hyperinflation is not typically seen in RDS. The other three findings (air bronchograms, diffuse hazy infiltrates, bilateral reticulogranular densities) are all common radiographic findings in RDS.

Question 14

Another name for respiratory distress syndrome (RDS) is:

Accepted Answer

Respiratory distress syndrome is also known as hyaline membrane disease. The other options listed are separate conditions.

Question 15

Most infants with transient tachypnea are born premature.

Accepted Answer

Transient tachypnea of the newborn (TTN) is more commonly seen in full-term or late preterm infants, often related to delayed clearance of lung fluid, not prematurity.

Question 16

What is the maximum PIP that should be used with mechanical ventilation of larger premature infants to prevent volutrauma?

Accepted Answer

The maximum PIP that should be used with mechanical ventilation of larger premature infants to prevent volutrauma is 30 cm H2O. Higher pressures could lead to lung injury and further complications.

Question 17

Which of the following factors is associated with an increase in the incidence of RDS?

Accepted Answer

Maternal diabetes is associated with an increase in the incidence of RDS because it may cause the production of larger and more immature fetal lungs, leading to a delay in surfactant production.

Question 18

What treatment is indicated for infants with transient tachypnea requiring higher FIO₂?

Accepted Answer

Continuous Positive Airway Pressure (CPAP) is often used to treat infants with transient tachypnea who require higher levels of oxygen, as it helps keep the alveoli open and improves oxygenation.

Question 19

What diagnostic parameter is most often used to confirm the diagnosis of RDS?

Accepted Answer

Chest radiograph is the most often used diagnostic parameter to confirm the diagnosis of RDS as it can show characteristic findings such as diffuse ground-glass opacities and air bronchograms. Arterial blood gases can also provide information about the severity of the disease, but it is not specific to RDS. Pulmonary function tests and serum enzyme levels are not typically used in the diagnosis of RDS.

Question 20

What is believed to be the cause of transient tachypnea of the newborn (TTN)?

Accepted Answer

Transient tachypnea of the newborn (TTN) is believed to be caused by delayed clearance of fetal lung fluid, leading to increased respiratory effort and tachypnea after birth.

Quiz 31: Neonatal and Pediatric Respiratory Disorders

In which infants is the surfactant administered as rescue?

You are caring for an infant with RDS. Nasal CPAP has been used; however, the infant suddenly deteriorates and is demonstrating severe hypoxemia on an FIO₂ of 0.60. What should be done next?

In preterm infants, adequate amounts of surfactant are present; however, it is trapped inside type II cells.

The current standard of care is delivery surfactant replacement to all infants with RDS.

What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn?

What are the major factors in the pathophysiology of RDS? I.qualitative surfactant deficiency II.increased alveolar surface area III.increased small airways compliance IV.presence of the ductus arteriosus

What radiographic finding is common in infants with transient tachypnea?

What is the first clinical sign of RDS in the newborn infant?

Mothers of infants with transient tachypnea tend to have longer labor intervals and a higher incidence of failure to progress in labor.

Which of the following clinical signs is not consistent with the onset of RDS?

What treatment may improve lung fluid clearance in the infant with transient tachypnea?

Which of the following treatments is the least useful for the treatment of RDS?

Which of the following findings on the chest radiograph is not typical for RDS?

Another name for respiratory distress syndrome (RDS) is:

Most infants with transient tachypnea are born premature.

What is the maximum PIP that should be used with mechanical ventilation of larger premature infants to prevent volutrauma?

Which of the following factors is associated with an increase in the incidence of RDS?

What treatment is indicated for infants with transient tachypnea requiring higher FIO₂?

What diagnostic parameter is most often used to confirm the diagnosis of RDS?

What is believed to be the cause of transient tachypnea of the newborn (TTN) ?

Quiz 31: Neonatal and Pediatric Respiratory Disorders

In which infants is the surfactant administered as rescue?

You are caring for an infant with RDS. Nasal CPAP has been used; however, the infant suddenly deteriorates and is demonstrating severe hypoxemia on an FIO2 of 0.60. What should be done next?

In preterm infants, adequate amounts of surfactant are present; however, it is trapped inside type II cells.

The current standard of care is delivery surfactant replacement to all infants with RDS.

What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn?

What are the major factors in the pathophysiology of RDS? I.qualitative surfactant deficiency II.increased alveolar surface area III.increased small airways compliance IV.presence of the ductus arteriosus

What radiographic finding is common in infants with transient tachypnea?

What is the first clinical sign of RDS in the newborn infant?

Mothers of infants with transient tachypnea tend to have longer labor intervals and a higher incidence of failure to progress in labor.

Which of the following clinical signs is not consistent with the onset of RDS?

What treatment may improve lung fluid clearance in the infant with transient tachypnea?

Which of the following treatments is the least useful for the treatment of RDS?

Which of the following findings on the chest radiograph is not typical for RDS?

Another name for respiratory distress syndrome (RDS) is:

Most infants with transient tachypnea are born premature.

What is the maximum PIP that should be used with mechanical ventilation of larger premature infants to prevent volutrauma?

Which of the following factors is associated with an increase in the incidence of RDS?

What treatment is indicated for infants with transient tachypnea requiring higher FIO2?

What diagnostic parameter is most often used to confirm the diagnosis of RDS?

What is believed to be the cause of transient tachypnea of the newborn (TTN) ?

You are caring for an infant with RDS. Nasal CPAP has been used; however, the infant suddenly deteriorates and is demonstrating severe hypoxemia on an FIO₂ of 0.60. What should be done next?

What treatment is indicated for infants with transient tachypnea requiring higher FIO₂?