CH 23 WALSH

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1. An infant brought to the neonatal intensive care unit B. insert an oral

presents with cyanosis and upperairway obstruction airway
relieved by crying with improvement in color. Suspect-
ing choanal atresia, the best action is to
A. inster a no. 8 french suction catheter to verify the
diagnosis
B. insert an oral airway
C. start nasal continuous positive airway pressure
D. provide heated humidity
E. stimulate the infant to induce crying

2. Complications related to chronic upper airway ob- B. I, II, IV

scruction from anatomical malformations result in
which of the following?
I. chronic hypoxia and CO2 retention
II. pulmonary hypertension and cor pulmonale
III. hyperventilation and acidosis
IV. failure to thrive
V. congestive heart failure

A. I, III
B. I, II, IV
C. I, II, III, V
D. II, III, IV
E. II, IV, V

3. the most common tracheosophageal fistula and B. esophageal

esophagel atresia lesion is classified as which type? atresia with dis-
A. esophageal atresia with a long gap tal tracheoe-
B. esophageal atresia with distal tracheoesophgeal sophagel fistula
fistula
C. H-type trachesophageal fistula
D. esophageal atresia with proximal fistula
E. esophageal atresia with proximal and distal tra-
cheosophagel fistula

4. a drooling newborn infant with polyhydraminios in D. esophageal

utero and suspected kidney and cardiac anormalies is atresia with
admitted to the NICU and presents with coughing, res-
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piratory distress and cyanosis during feedings. The tracheoe-
most likely diagnosis is sophageal fistula
A. gastroschisis
B. Tetralogy of Fallot
C. pulmonary sequestration
D. esophageal atresea with tracheoesophageal fistula
E. choanal atresia

5. Which of the following are true concerning a congen- A. I, II, IV

ital diaphramatic hernia?
I. pulmonary hypoplasia is present in both lungs
II. persistent pulmonary hypertension is the main
complication
III. Surgical correction results in complete reversal of
the respiratory disress
IV. CDH formation is a defect that occurs very early in
gestational age
V. the right lung is not usually affected

A. I, II, IV
B. I, III, IV, V
C. I, IV, V
D. I, III, IV, V
E. II, III, V

6. A 3200 g term infant male is born to a healthy mother. D. insert an oral

Apgar scores are 7 and 5 with the infant gasping suction catheter to
and heart rate decreasing to 90. Physical examination vent the stomach
reveals cyanosis, a scaphoid abdomen and visible tra-
cheal deviation to the right. Consider this information,
the only appropriate action would be to:
A. get a blood gas
B. bag mask ventilate
C. suction and stimulate vigorously
D. insert an oral suction catheter to vent the stomach
E. vigorously stimulate and give 100% O2 blowby

7. Considering a likley diagnosis of congenital diaphrag- B rapid rate and

matic hernia, which of the following would be an ap- low pressures

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propriate decision concerning ventilator strategy?
A. hypoxic gases
B. rapid rate and low pressures
C. high pressure and long inflation times
D. slow rate and short inflation times
E. low pressures with high PEEP

8. A female infant was born with a large gastroichisis B. a decrease in

anomaly. The reduction surgery will most liley affect pulmonary compli-
the respiratory system by causing: ance
A. an increase in airway resistance
B. a decrease in pulmonary compliance
C. a decrease in transpulmonary pressure
D. an increase in the respiratory time constant
E. B and D

9. When comparing gastoschisis and omphalocele, C. omphalocele is

which of the following is true? a midline defect,
A. they are both full thickness defects of the abdomi- whereas a gas-
nal wall tochisis is a lateral
B. they are both commonly associated with other wall defect.
anomalies
C. omphalocele is a midline defect, whereas a gas-
toschisis is a lateral wall defect.
D. An omphalocele is covered by epidermal tissue
E. gastroschisis requires surgical reductions that of-
ten must be performed in several stages whereas om-
phalocele is completed in a single surgery.

10. Pectus excavatum may be associated with shich of E. all of the above
the following?
A. secondary scoliosis
B. decreased exercise capacity
C. Ehlers Danlos syndrome
D. decreased self esteem
E. all of the above

11. Although the lung bud anomalies have different A. becomes obvi-
histopathology, clinical presentation usually: ous int the early
A. becomes obvious in the early newborn period and newborn period
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is manifested by respiratory distress
B. becomes obvious in the early newborn period and
is manifested by recurrent pulmonary infections
C. develops later in childhood and is characterized by
severe respiratory distress
D. remains undetected until adolescence or early
adulthood
E. presents as severe respiratory distress requiring
mechanical ventilation

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