Physiologic Adaptation to Extrauterine Life

Question 1

Surfactant decreases surface tension of air spaces

Answer 1

prevents collapse at end expiration and allowing easy ventilation (compliance)

Question 2

Produced by Type II cells and made of 90% lipid (_____ and ______l) and 10% protein and 90% recycled by macrophages

Answer 2

Surfactant

phosphotidylcholine, phosphatidylglycerol

Question 3

Surfactant deficiency

Answer 3

leads to diffuse microatelectasis, macromolecular pulmonary edema (proteinaceous hyaline membranes) and poor compliance

Question 4

Recall that ______ does NOT cross placenta but glucose does!

Answer 4

insulin

Question 5

Babies of DM mothers will be _____ and may have hypoglycemic crash at birth

Answer 5

hyperinsulinemic

Treat: feed if possible, IV glucose if can’t feed/not improved with feeding/if glucose is very low (

Question 6

There is risk of permanent _____ with episodes of seizures due to hypoglycemia so goal is to not let that happen in hyperinsulinemic

Answer 6

brain injury

Question 7

KEY POINTS: Neonatal period is most hazardous of next 40+ years;

Lung inflation is key to everything!

“normal newborn” is a retrospective diagnosis, transitioning newborn should be regarded as recovering pts

Answer 7

KEY POINTS: Neonatal period is most hazardous of next 40+ years;

Lung inflation is key to everything!

“normal newborn” is a retrospective diagnosis, transitioning newborn should be regarded as recovering pts

Question 8

Recognizing Abnormal Transition in Term Infants

Answer 8

Pale or poor skin perfusion
jitteriness
Prolonged or excessive respiratory distress