Which organ is the first to become functional in the embryo?

1.   ?    lung
2.   ?    heart
3.   ?    kidney
4.   ?    liver

The structure of the heart and great vessels is complete at what point in gestation?

1.   ?    8 weeks
2.   ?    12 weeks
3.   ?    16 weeks
4.   ?    20 weeks

Ultrasound can detect congenital heart abnormalities by what point in gestation?

1.   ?    8 weeks
2.   ?    12 weeks
3.   ?    16 weeks
4.   ?    20 weeks

The heart begins as a simple tube, and develops five areas of dilation and four areas of constriction; which is NOT one of the 5 dilations?

1.   ?    truncus arteriosus and SVC
2.   ?    truncus arteriosus and bulbus cordis
3.   ?    primitive atrium and ventricle
4.   ?    bulbus cordis and sinus venosus

The truncus arteriosus is the most cephalad, and will form what?

1.   ?    aorta and SVC
2.   ?    aortic root and main PA
3.   ?    right PA and bulbus cordis
4.   ?    left PA and bulbus cordis

True or false: the atrial swelling and the sinus venosus are in the primitive pericardium?

1.   ?    True
2.   ?    False

At what stage do the future septae of the heart develop?

1.   ?    8 - 10 weeks
2.   ?    12 - 14 weeks
3.   ?    16 - 18 weeks
4.   ?    20 - 24 weeks

The bulboventricular part of the heart grows more rapidly than pericardial cavity, forcing the tube to bend down,dorward and to the right: T or F?

1.   ?    True
2.   ?    False

What is the name of the cushion separates the pulmonary and aortic outflow tracts?

1.   ?    bulboconiousus
2.   ?    endocardial
3.   ?    conotruncal

Tissue at the top of the atrium pushes downward (septum primum) the inferior rim forms the ostium primum, which is obliterated. Holes then occur on the upper part of the septum primum, and these form what?

1.   ?    ostium secundum
2.   ?    ostium primum
3.   ?    foramen ovale
4.   ?    christa galli

Another crest of tissue grows downward to partially occlude the ostium secundum (within the septum primum). What is this?

1.   ?    septum primum
2.   ?    septum secundum
3.   ?    foramen ovale

What is another name for the foramen ovale?

1.   ?     ostium primum
2.   ?    ostium secundum

T or F: myocardial maturation continues postnatally for up to 1 year?

1.   ?    True
2.   ?    False

What percentage of fetal versus adult hearts are composed of contractile elements (the non-contractile elements include nuclei, mitochondria, endoplasmic reticulum)?

1.   ?     fetal heart has 60%contractile vs 30% in adult
2.   ?    they are equivalent
3.   ?    fetal heart has 30%contractile vs 60% in adult

The fetal newborn heart is less compliant and less contractile?

1.   ?    True
2.   ?    False

How does the infant heart respond to a sharp increase in preload?

1.   ?    increased CO
2.   ?    decreased CO
3.   ?    cardiac elasticity results in minimal change in CO

Cardiac output in an infant is primarily dependent on BLANK?

1.   ?    Heart rate
2.   ?    Preload
3.   ?    Afterload
4.   ?    Vascular resistance

Compare nutrient sources for the heart (myocardium) in infants versus adults?

1.   ?    Infant 60% FFA and 40% CHO
2.   ?    Adult 60% FFA and 40% CHO
3.   ?    Infant 100% FFA

T or F: The anaerobic newborn heart is less sensitive to hypoxia than the adult heart?

1.   ?    True
2.   ?    False

What is a normal oxygen saturation and PaO2 of the blood coming in to the fetus from the placenta through the umbilical vein?

1.   ?    95 percent O2 sat, PaO2 of 45
2.   ?    45 percent O2 sat, PaO2 of 25
3.   ?    85 percent O2 sat, PaO2 of 55
4.   ?    65 percent O2 sat, PaO2 of 35

What is the typical percent saturation of the blood in the SVC of a fetus?

1.   ?    80 percent
2.   ?    60 percent
3.   ?    40 percent
4.   ?    20 percent

Which is NOT a mechanism by which the fetus is able to thrive in its hypoxic environment?

1.   ?    Lower P50 for fetal Hgb
2.   ?    Preferential shunting, parallel ventricles
3.   ?    More compliant fetal heart
4.   ?    Higher fetal CO

What happens to blood that the fetus gets from the placenta thru the umbilical vein?

1.   ?    90% to fetal liver
2.   ?    50% to IVC, 25% to kidney, 25% liver
3.   ?    50% to IVC, 50% to liver

How long after birth does fetal Hgb normally persist?

1.   ?    10 weeks of life
2.   ?    3 months of life
3.   ?    6 months
4.   ?    there is minimal fetal Hgb in a term newborn

What portion of blood in the fetal IVC comes from the lower body versus the more saturated ductus venosus?

1.   ?    half from each
2.   ?    1/3rd lower body, 2/3rd ductus venosus
3.   ?    2/3rd lower body, 1/3rd ductus venosus
4.   ?    90% from lower body

T or F: Two-thirds of the blood flow to the lower body in a fetus comes from the right ventricle. The left ventricle perfuses brain and upper body?

1.   ?    True
2.   ?    False

What percentage of right ventricular output (the predominant ventricle in the fetus) goes through the low resistance PDA, shunted past the lungs?

1.   ?    almost 98%
2.   ?    about 80%
3.   ?    about 50%
4.   ?    less than 30%

In the fetus, what percentage of left ventricular blood flow goes on down the descending aorta?

1.   ?    90 percent
2.   ?    75 percent
3.   ?    50 percent
4.   ?    10 percent or less

T or F: the circulatory system switches from series to parallel shortly after birth?

1.   ?    True
2.   ?    False

Functionally and structurally, when does a PDA normally close?

1.   ?    Functionally about 12 hrs, structurally 2 – 3 weeks
2.   ?     Functionally about 1 week, structurally 2 – 3 weeks
3.   ?     Functionally about 12 hrs, structurally 72 hours

What is the single most important stimulus to closure of the ductus?

1.   ?    Pressure changes
2.   ?    Increased pulmonic resistance
3.   ?    O2 tension
4.   ?    Flow velocity

True or false: both fetuses and premature infants have a increased ductal constriction response to oxygen?

1.   ?    True
2.   ?    False - decreased

At birth, the pulmonary blood flow (increases or decreases), and the pulmonary resistance (increases or decreases)?

1.   ?    decrease and increase
2.   ?    decrease and decrease
3.   ?    increase and increase
4.   ?    increase and decrease

Pulmonary artery pressure normalizes at what time in the postnatal period?

1.   ?    24 hours
2.   ?    3 to 5 days
3.   ?    6 to 8 weeks
4.   ?    4 to 6 months

Pulmonary vessels in the fetus and newborn are more sensitive to pH or PaO2?

1.   ?    pH
2.   ?    Oxygen tension

Leukotrienes cause pulmonary vasoconstriction or vasodilation in hypoxic newborn animals?

1.   ?    dilation
2.   ?    constriction
3.   ?    neither

True or false: The parasympathetic nervous system is fully developed at birth, but the sympathetic system takes up to 4 - 6 months to mature?

1.   ?    True
2.   ?    False

Direct arterial line pressure measurements are higher or lower than the indirect cuff measurements?

1.   ?    lower
2.   ?    higher

What is the best measurement of oxygen supply and demand to the tissues?

1.   ?    pulmonary capillary wedge pressure
2.   ?    PaO2
3.   ?    cardiac output
4.   ?    mixed venous O2

CO x Art -Venous O2 difference = what?

1.   ?    cardiac index
2.   ?    mixed venous O2
3.   ?    oxygenation index
4.   ?    oxygen consumption

Which is NOT a cause of increased mixed venous O2?

1.   ?    sepsis
2.   ?    anesthesia or paralysis
3.   ?    decreased cardiac output
4.   ?    persistent fetal circulation

T or F: Decreased mixed venous O2 is associated with decreased cardiac output?

1.   ?    True
2.   ?    False

True or false: dobutamine is mostly a beta 1 stimulant?

1.   ?    True
2.   ?    False

Amrinone is what kind of inotropic agent?

1.   ?     nonsympathomimetic inotrope
2.   ?    sympathomimetic inotrope

Nipride will do what to intracranial pressure?

1.   ?    decrease
2.   ?    increase
3.   ?    no change

Which is a side effect of prostaglandin E?

1.   ?    late apnea
2.   ?    retrograde amnesia
3.   ?    arrythmia
4.   ?    metabolic acidosis

Which is the correct formula calculate the bicarbonate deficit?

1.   ?     weight (kg) x base deficit x 0.5
2.   ?     weight (kg) x base deficit x 0.3
3.   ?     weight (kg) x base deficit

Which is a recognized side effect of THAM?

1.   ?    hyperglycemia in premature infants
2.   ?    hypoglycemia in premature infants
3.   ?    acute tubular necrosis
4.   ?    hepatotoxicity in premature infants

Which is NOT a contraindication to the use of THAM?

1.   ?    chronic respiratory acidosis
2.   ?    uremia
3.   ?    hypernatremia
4.   ?    anuria

T or F: Calcium chloride x 4 equals the dose of calcium gluconate?

1.   ?    True
2.   ?    False