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Respiratory Distress in the Newborn

Quiz by Eric Zwemer

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4 questions
Show answers
  • Q1
    You are called to a delivery of a 33-week infant. Maternal history is significant for gestational hypertension, with otherwise normal prenatal labs and ultrasound. The infant is born via C-section, fluid is notable for meconium staining. On exam, the infant is AGA. Which of these factors does not increase the likelihood for respiratory distress in this infant?
    prematurity
    maternal gestational hypertension
    C-section
    meconium-stained amniotic fluid
    30s
  • Q2
    A newborn girl born at 39 weeks gestation presents with tachypnea in the first few hours of life. Her prenatal history is unremarkable and Apgars were 8 and 9 at 1 and 5 minutes after birth. On exam, the infant has retractions, nasal flaring, with tachypnea, without any other abnormal exam findings. Chest x-ray is done. She is placed on supplemental O2 via NC for 48 hours and then weans to RA. She is now breathing comfortably on RA. Based on her findings and hospital course, what is the most likely diagnosis?
    Transient tachypnea of the newborn (TTN)
    Pneumonia
    respiratory distress syndrome (RDS)
    meconium aspiration syndrome
    30s
  • Q3
    A 4 hour-old infant born at 32 weeks develops tachypnea, grunting, retractions, and nasal flaring. You suspect RDS. What is the next best step in management of this infant?
    Administer CPAP
    Start infant on antibiotics prior to any other intervention
    Intubate immediately regardless of severity since infant is likely to require surfactant
    Administer surfactant immediately, then determine need for CPAP or intubation
    30s
  • Q4
    A term infant is born via NSVD after a long labor with ROM of 30 hours. Maternal GBS status is unknown. At birth, he is tachypneic and requires supplemental oxygen. On exam, the infant is afebrile, tachypneic, and has bilateral crackles on respiratory exam. He continues to have an oxygen requirement many hours after birth. Based on this infant’s risk factors, what is the most likely diagnosis?
    Pneumonia
    Meconium aspiration syndrome
    RDS
    TTN
    30s

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