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Perinatal Exam – Questions & Precise Solutions (A+)
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Perinatal Exam – Questions & Precise Solutions (A+)22 weeks, 7 days Right Ans - The perinatal period commences at ____
gestation and ends ____ after birth. Perinatal and maternal health are closely
linked.
Changes in the perinatal period Right Ans - - Pulmonary adaptation
- Circulatory changes
- Temperature regulation
- Growth transitions, GI, and urological changes
1, 2 Right Ans - A normal umbilical cord has ____ vein and ____ arteries.
umbilical vein, umbilical arteries Right Ans - The ____ carries oxygenated
blood from the placenta to the fetus. This is a large single vessel. The ______ are
paired and carry deoxygenated blood from the fetus to the placenta.
amniotic fluid, 10 secs Right Ans - At birth, the lungs are filled with ____. In
the first ____ of life, the infant takes its first breath.
CO2, pulmonary vascular resistance, gas exchange Right Ans - Compression
of the umbilical artery/vein during birth causes an increase in _____, triggering
breath at birth. With the first breath, there is a drop in the _____ and an
increase in the surface area available for _____. Over the next 30 seconds, the
pulmonary blood flow increases and is oxygenated as it flows through the
alveoli of the lungs.
Single umbilical artery Right Ans - Occurs in up to 2% of all live born
infants. Can be detected prenatally or on PE of newborn after birth. Believed
to result from either aplasia or atrophy of the 2nd umbilical artery. Seen more
frequently in monoamniotic twins and intrauterine growth restriction
observed 18% of the time.
Monoamniotic twins Right Ans - isolated single umbilical artery is seen
more frequently in _____
renal malformations Right Ans - Isolated single umbilical artery associated
with structural or chromosomal anomalies is usually seen in infants with _____.
,dysmorphic features, abdominal masses, heart disease Right Ans - Pts with
isolated single umbilical artery should be thoroughly examined for ____, _____,
and presence of _____
high risk, 36-37 weeks Right Ans - Women with suspected pregnancies
containing an isolated single umbilical artery are considered ____. They need
higher resolution increased serial US and possible earlier delivery around ____.
respiratory distress syndrome (RDS) Right Ans - One of the most common
symptoms complexes of the newborn. Primarily a disease of preterm infants
within the first 24 hours of life. Occurs in approx 50% of infants born 26-28
weeks. Drops to 20-30% at 30-32 weeks.
diabetic Right Ans - Respiratory distress syndrome can affect term babies,
specifically infants of _____ moms.
steroids, surfactant Right Ans - Introduction of prenatal ___ and exogenous
_____ have improved outcomes in patients with respiratory distress syndrome.
atelectasis, mismatch, pulmonary HTN Right Ans - The lack of surfactant in
RDS and the noncompliant, stiff lungs leads to ____ at the end of expiration in
infants. We will end up with ventilation-perfusion ____. This promotes
hypoxemia, hypercarbia, then persistent _____.
CXR, ABG, and pulse ox Right Ans - Which tests are useful for RDS in pre-
term infants?
Non-cardiopulmonary causes of RDS Right Ans - -
Hyperthermia/hypothermia
- Hypoglycemia
- Drug interactions
- CNS insults
- Polycythemia
- Metabolic acidosis
Cardiopulmonary causes of RDS Right Ans - - Hypoplastic left heart
- Aortic stenosis
- Coarctation of aorta
- Upper airway obstruction
, - Meconium aspiration
- Pneumonia
- Pneumothorax
RDS tx Right Ans - - Thermoregulation, cardio and nutritional support,
early infection care
- Nasal CPAP
- Surfactant replacement
RDS prevention Right Ans - - Prevent prematurity, asphyxia, avoidance of
maternal fluid overload
- Prenatal administration of a single course of STEROIDS to women in preterm
labor between 24-34 weeks
24-34 weeks gestation Right Ans - When should steroids be administered
to pregnant women in pre term labor to prevent RDS?
meconium aspiration syndrome Right Ans - Respiratory disorder that
occurs when a newborn is born through meconium stained amniotic fluid and
whose symptoms cannot otherwise be explained. Results in respiratory
failure, hypoxia, and poor lung compliance. Promotes persistent pulmonary
HTN, airway obstruction, pneumonia, and increased chance of wheezing
episodes in first 6 months of life.
meconium Right Ans - Composed of water and debris from intestinal tract,
skin, lanugo, bile pigments, amniotic fluid, and intestinal secretions. Sterile,
but when aspirated, causes an inflammatory response in infants.
wheezing, 6 Right Ans - Infants born with meconium aspiration syndrome
are more likely to have ____ episodes in the first ____ months of life.
radiography Right Ans - Meconium aspiration syndrome is confirmed via
____.
Meconium aspiration syndrome tx Right Ans - - O2 therapy
- CPAP
- Close monitoring
- Exogenous surfactant
- Inhaled nitrous oxide
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