Deck 16: Fetal and Newborn Cardiopulmonary Physiology

Question 1

Why are children younger than 10 years of age more likely to develop airway obstruction and atelectasis than older children?

A) They have small tidal volumes compared to those of the adult.
B) Alveolar development is not complete.
C) Canals of Lambert and pores of Kohn are poorly developed in young children.
D) They have an insufficient amount of surfactant.

Answer 1

Canals of Lambert and pores of Kohn are poorly developed in young children.

Question 2

What is the number of vessels in the umbilical cord?

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

Answer 2

3

Question 3

Which of the following are stages of lung development?
I.Embryonic period
II.Pseudoglandular period
III.Vesicular period
IV.Saccular period

A) I, III
B) II, IV
C) I, III, IV
D) I, II, IV

Answer 3

I, II, IV

Question 4

Which of the following organs begin(s) to develop during the fourth week of gestation?
I.Larynx
II.Trachea
III.Bronchi
IV.Lungs

A) I, II
B) III
C) I, II, III, IV
D) II, III

Question 5

As a result of the HbF in the fetus, a PO? of 30 mm Hg corresponds to what level of SaO₂?

A) 60% to 79%
B) 75% to 80%
C) 85% to 90%
D) Same as the adult SaO₂

Question 6

A female infant with an estimated gestational age of 30 weeks was delivered with Apgar scores of 5 and 7 at 1 and 5 minutes, respectively.Over the next hour the infant's respiratory status began to deteriorate, with the infant exhibiting nasal flaring, expiratory grunting, and intercostal retractions.Based on an FIO? of 0.60 via oxygen hood ABG results were as follows: pH = 7.26, PaCO? = 50 mm Hg, and PaO? = 40 mm Hg.A chest x-ray revealed findings consistent with respiratory distress syndrome (RDS): bilateral "ground-glass" appearance and decreased lung volumes.The infant was intubated and placed on mechanical ventilation, and exogenous surfactant was delivered.ABG results after surfactant administration were as follows: pH = 7.36, PaCO? = 37 mm Hg, and PaO? = 78 mm Hg on an FIO? of 0.80.What should be done at this time?

A) Continue monitoring.
B) Readminister surfactant.
C) Decrease ventilator parameters and FIO2.
D) Change to the volume-cycled mode of ventilation.

Question 7

Which of the following values represents the maximum PO₂ of the fetus?

A) 30 mm Hg
B) 40 mm Hg
C) 50 mm Hg
D) 60 mm Hg

Question 8

A premature baby is potentially capable of breathing and may survive with intensive medical care at how many weeks of gestation?

A) 18 weeks
B) 20 weeks
C) 24 weeks
D) 32 weeks

Question 9

What is the narrowest portion of the upper airway in the infant?

A) Trachea
B) Thyroid space
C) Cricoid ring
D) Oropharynx

Question 10

What is the best explanation for the nasal breathing of infants?

A) Large tongue and small oral cavity
B) Large head and small mandible
C) Large head and large oral cavity
D) Large oral cavity and small tongue

Question 11

When is a small amount of surfactant present in infants born prematurely?

A) 20 weeks' gestation
B) 24 weeks' gestation
C) 28 weeks' gestation
D) 35 weeks' gestation

Question 12

What is the incidence of meconium-stained amniotic fluid?

A) 3-5%
B) 5-10%
C) 12%
D) >15%

Question 13

Which of the following are congenital anomalies during the embryonic period?
I.Tracheoesophageal fistula
II.Choanal atresia
III.Pulmonary hypoplasia
IV.Duchenne's disease

A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV

Question 14

Premature detachment of the placenta from the uterine wall is known as what?

A) Placenta previa
B) Placenta marginalis
C) Abruptio placentae
D) Retroplacental hematoma

Question 15

Type II cells begin to synthesize surfactant during which period of lung development?

A) Embryonic period
B) Pseudoglandular period
C) Alveolar period
D) Saccular period

Question 16

Mature surfactant contains the phospholipid phosphatidylglycerol (PG), which is required for normal surfactant function.When does PG appear?

A) 20 weeks' gestation
B) 24 weeks' gestation
C) 28 weeks' gestation
D) 35 weeks' gestation

Question 17

What appears to be the function of the fetal lung fluid?

A) It maintains lung expansion.
B) It helps with the thermoneutral environment.
C) It provides nutrients to the forming parenchyma.
D) It regulates fetal urine output.

Question 18

Which of the following are important functions of the amniotic fluid?
I.It protects the fetus from trauma.
II.It allows the fetus to move.
III.It helps control the temperature of the fetus.
IV.It protects the fetus from infection.

A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV

Question 19

Fetal Hb is the predominant form of Hb in the fetus.It is about 90% of the total Hb at 24 weeks of gestation.When is HbF replaced by HbA?

A) At 40 weeks of gestation
B) At first month of life
C) At second month of life
D) At 6-12 months of life

Question 20

By which age is alveolar development usually complete?

A) 7 years
B) 8 years
C) 9 years
D) 10 years

Question 21

Infants born by cesarean section may experience retention of fetal lung fluid.What is the name of the condition that can result in short-term respiratory distress?

A) Transient tachypnea of the newborn
B) Respiratory distress syndrome
C) Persistent pulmonary hypertension
D) Hyaline membrane disease

Question 22

Which of the following are common signs of respiratory distress in the infant?
I.Inspiratory nasal flaring
II.Expiratory nasal flaring
III.Expiratory grunting
IV.Paradoxical breathing

A) I, III, IV
B) II, III, IV
C) I, IV
D) I, II, III, IV

Question 23

Which of the following are defects associated with tetralogy of Fallot?
I.Pulmonary stenosis
II.VSD
III.Right ventricular hypertrophy
IV.Overriding or dextroposition of the aorta

A) I, II
B) II, III, IV
C) I, II, III, IV
D) I, III, IV

Question 24

Which of the following conditions could delay the closure of the ductus arteriosus?
I.Hypoxia
II.Hypoglycemia
III.Hyperthermia
IV.Acidosis

A) I, II, III
B) I, II, III, IV
C) I, III
D) I, IV

Question 25

Which of the following statements are consistent with PPHN?
I.It presents within 12 hours after birth.
II.It causes respiratory distress, often unresponsive to oxygen therapy.
III.Some infants may require extracorporeal life support (ECLS).
IV.Nitric oxide therapy is an alternative treatment.

A) I, II, III
B) I, II, III, IV
C) I, III
D) I, IV

Question 26

Which of the following are therapeutic strategies to close a PDA?
I.Indomethacin
II.Surgical closure
III.Aspirin
IV.Surgical creation of a VSD

A) I, II
B) II, III, IV
C) I, II, III, IV
D) I, III, IV

Question 27

Which of the following are characteristics of epiglottitis?
I.It is a life-threatening bacterial infection.
II.The onset is abrupt and associated with a high fever.
III.Complete airway obstruction can occur within hours.
IV.Immediate endotracheal intubation or tracheostomy may be necessary.

A) I, II, III, IV
B) III, IV
C) I, II, III
D) I, II, IV

Question 28

Which of the following conditions decreases an infant's ability to generate heat?
I.Hyperglycemia
II.Hypoxia
III.Acidosis
IV.Hypoglycemia

A) I, II, III
B) II, III, IV
C) I, II, III, IV
D) II, IV

Question 29

What percentage of babies are born with some congenital heart defect?

A) 1%
B) 2%
C) 5%
D) 10%

Question 30

When does the ductus arteriosus anatomically close?

A) 1 to 2 weeks
B) 2 to 4 weeks
C) 4 to 6 weeks
D) 2 months

Question 31

What is the name of the structure that allows passage of blood from the pulmonary artery into the descending aorta?

A) Foramen ovale
B) Ductus venosus
C) Ductus arteriosus
D) Ostium secundum

Question 32

What is the most important means of heat production in the newborn infant?

A) Shivering
B) Head bobbing
C) Brown fat metabolism
D) Lipolysis

Question 33

Which of the following statements are true of croup?
I.It is the most common cause of upper airway obstruction in children.
II.It is a viral infection.
III.It develops over several days.
IV.The obstruction is occasionally severe enough to require an artificial airway.

A) I, II, III, IV
B) III, IV
C) I, II, III
D) I, II, IV

Question 34

What is the most common type of congenital heart defect?

A) ASD
B) VSD
C) PDA
D) Tetralogy of Fallot

Question 35

What percentage of the blood in the pulmonary artery enters the pulmonary circulation to perfuse the lungs in utero?

A) 10%
B) 13-25%
C) 30%
D) 38-40%

Question 36

What is the most common cyanotic congenital heart defect?

A) ASD
B) VSD
C) Tetralogy of Fallot
D) Transposition of the great arteries