Pediatrics 3

Question 1

what is the normal birth weight for a newborn

Answer 1

3.4 kg (7.5 lbs)

Question 2

what is the hole in between the pulmonary artery and aorta in the heart in utero

Answer 2

ductus arteriosis

Question 3

what is the hole between the right atrium and left atrium in utero

Answer 3

foramen ovale

Question 4

what is the hole in the inferior vena cava to the umbilical vein

Answer 4

ductus venosus

Question 5

what are fetal lungs filled with in utero causing a “push back” of pressure to the heart

Answer 5

amniotic fluid

Question 6

what prevents heart failure due to the “push back” of pressure from the lungs to the heart in utero

Answer 6

ductus arteriosis; between pulmonary artery and aorta

Question 7

why is the ductus venosus important

Answer 7

brings in oxygen and nutrient rich blood from the mother into the fetus

Question 8

where does a baby get most of its nutrition from

Answer 8

the placenta

Question 9

what direction does the umbilical vein go? is the blood oxygenated or deoxygenated

Answer 9

from mom towards baby; very oxygenated

Question 10

what direction does the umbilical arteries go? is the blood oxygenated or deoxygenated

Answer 10

from baby towards mom; deoxygenated

Question 11

with the fetal heart, is pulmonary vascular resistance (PVR) high or low

Answer 11

very high (due to amniotic fluid in lungs)

Question 12

Is systemic vascular resistance (SVR) high or low in a fetus

Answer 12

low; due to umbilical cord being a direct line to mother (an open system)

Question 13

what is meconium

Answer 13

bowel movement full of amniotic fluid

Question 14

what causes the ductus arteriosis (PDA) to close

Answer 14

oxygenation and decrease prostaglandins

Question 15

what happens if PDA does not close?

What are 4 symptoms

Answer 15

nonoxygenated blood goes from left atrium to aorta

1. pulmonary edema
2. big heart (left sided failure)
3. CHF (congestive heart failure)
4. Pulmonary Hypertension

Question 16

how is an unclosed PDA treated

Answer 16

1. close via pharmacological means
2. treat symptoms with digoxin and diuretics
3. surgical closure

Question 17

what drugs can help close the PDA

Answer 17

1. NSAIDs; indomethacin and ibuprofen (best choice)
2. corticosteroids (by inhibiting phospholipase A2 production)
3. COX-2 selective inhibition

Question 18

If other structural abnormalities of the heart make maintaining an open PDA beneficial; what drugs can help keep it open

Answer 18

alprostidil = exogenous prostaglandin; keeps PDA open

Question 19

what is PPHN

Answer 19

pulmonary HTN of newborn; blood vessels in the lungs become abnormally narrow

Question 20

How does iNO produce smooth muscle relaxation in blood vessels

Answer 20

activates cGMP

Question 21

what degrades iNO’s normal function by degrading cyclic GMP (resulting in less smooth muscle relaxation)

Answer 21

phosphodiesterase-5 (PDE-5)

Question 22

what can be given to treat pulmonary HTN of a newborn (PPHN)

Answer 22

sildenafil = PDE-5 inhibitor