When do lobar airways start to form?

1.   ?    By 15 days
2.   ?    By 22 days
3.   ?    By 37 days
4.   ?    By 60 days

The pulmonary artery arises from the branches of which aortic arch?

1.   ?    The 2nd aortic arch
2.   ?    The 4th aortic arch
3.   ?    The 6th aortic arch
4.   ?    The 8th aortic arch

Most major lung anomalies develop within the first ____ days of embryonic development?

1.   ?    50 days
2.   ?    30 days
3.   ?    20 days
4.   ?    10 days

What is NOT one of the three phases of fetal lung development?

1.   ?    Pseudoglandular
2.   ?    Glanular
3.   ?    Canilicular
4.   ?    Saccular

Which stage of lung has squamous Type I and cuboidal Type II cells?

1.   ?    Pseudoglandular
2.   ?    Canilicular
3.   ?    Saccular

At what stage of lung development does surfactant production began?

1.   ?    Pseudoglandular
2.   ?    Canilicular
3.   ?    Saccular

Under what stimulus does fluid absorption occur in the alveoli?

1.   ?    Adrenergic hormones
2.   ?    Dopaminergic hormones
3.   ?    Parasympathetic stimulation

What cells are responsible for surfactant secretion and metabolism?

1.   ?    Type I alveolar cells
2.   ?    Type II alveolar cells
3.   ?    Langerhans cells

T or F: Surfactant is a lipoprotein containing 80 percent phospholipid, and 10 percent each of protein and neutral fats?

1.   ?    True
2.   ?    False

Surface tension tends to collapse or to expand alveoli?

1.   ?    Collapse
2.   ?    Expand

According to Laplace's law, the pressure to collapse the alveoli will be higher or lower for a small alveolus?

1.   ?    Higher pressure in smaller alveoli, larger overdistend
2.   ?    Higher pressure in larger alveoli

Which is NOT correct regarding hyaline membrane disease in a premature infants lung?

1.   ?    Decreased surfactant leads to collapse of smaller alveol
2.   ?    Decreased surfactant casues distention of the larger alveoli
3.   ?    Increased surfactant casues higher opening pressures
4.   ?    Surfactant lowers surface tension
5.   ?    Surfactant is stored in lamellar bodies

What happens to opening pressure in hyaline membrane disease or BPD?

1.   ?    OP is higher
2.   ?    OP is lower
3.   ?    OP is unchanged

Which is NOT an effect of steroids on premature infant lung?

1.   ?    Induce lung maturaton
2.   ?    Increase surfactant synthesis
3.   ?    Reduce surface tension

What is the incidence of hyaline membrane disease at less than 28 weeks gestational age?

1.   ?    60 percent
2.   ?    15 to 20 percent
3.   ?    5 percent

What type of infection is included in the differential diagnosis for hyaline membrane disease?

1.   ?    Grp B strep pneumonia
2.   ?    Fungal pneumonia
3.   ?    Pneumocystis pneumonia
4.   ?    E Coli pneumonia

What are hyaline membranes?

1.   ?    Lipoproteins
2.   ?    Sloughed cellular debris in a protein matrix
3.   ?    Lipoportein and mucopolysaccharides

Which of the following does exogenous surfactant therapy NOT do?

1.   ?    Early improvement in respiratory function
2.   ?    Decreased oxygen and airway pressure requirements
3.   ?    Decreased air leak
4.   ?    Iincreased survival
5.   ?    Decreased incidence of NEC, PDA, intraventricular bleed, and BPD

Is Exosurf surface a bovine, porcine, or synthetic surfactant?

1.   ?    It is porcine
2.   ?    It is synthetic
3.   ?    It is bovine

What is the best predictor for the development of BPD?

1.   ?    O2 dependence for greater than 28 days with XR changes
2.   ?    Gestational age less than 32 weeks
3.   ?    Birth weight less than 1000 gms

Which is NOT a radiographic sign of BPD?

1.   ?    Hyperinflation
2.   ?    Loculated cysts in the parechyma
3.   ?    Multiple fine streaks extending to the periphery

Which is NOT a pathologic change of BPD?

1.   ?    Emphysema
2.   ?    Interstitial edema and fibrosis
3.   ?    Giant cells in peribronchial tissue
4.   ?    Peribronchial muscular thickening
5.   ?    Metaplasia

Vitamin A (reduces or increases) the incidence and severity of BPD in premature infants?

1.   ?    Reduces
2.   ?    Increased
3.   ?    No changes

An oxygen consumption of greater than what percent indicates increased work of breathing in BPD?

1.   ?    75 percent
2.   ?    50 percent
3.   ?    25 percent

Which statemment regarding BPD is NOT true?

1.   ?    5% incidence of blindness
2.   ?    5% incidence of deafness
3.   ?    50% incidence of moderate lung dysfunction
4.   ?    25% incidence of severe lung dysfunction

Restriction of FIO2 to less than what percent clearly decreases the incidence of retinopathy of prematurity?

1.   ?    75%
2.   ?    50%
3.   ?    35%

What is the incidence of various grades of retinopathy of prematurity in infants less than 1250 grams?

1.   ?    65 percent
2.   ?    30 percent
3.   ?    15 percent

What percent of infants with retinopathy of prematurity will have either profound visual loss or blindness?

1.   ?    38 percent
2.   ?    18 percent
3.   ?    8 percent

When should neonates be checked for retinopathy of prematurity?

1.   ?    2 weeks
2.   ?    4 weeks
3.   ?    6 weeks
4.   ?    8 weeks

What percent of infants less than 1500 grams have intraventricular hemorrhage?

1.   ?    About 75%
2.   ?    About 50%
3.   ?    About 25%
4.   ?    About 10%

Describe stage IV retinopathy of prematurity?

1.   ?    demarcation of the line between the vascular tissue and the avascular retina
2.   ?    elevation or ridge between the vascular tissue and the avascular retina
3.   ?    a ridge with extraretinal fibrovascular proliferation, neovascularization into the vitreous humor
4.   ?    retinal detachment

Which is NOT a risk factor for intraventricular hemorrhage?

1.   ?    Pneumothorax
2.   ?    Hypothermia
3.   ?    PDA
4.   ?    Congenital heart disease
5.   ?    Mechanical ventilation
6.   ?    Hypo or Hypertension

What is the definition of grade 3 intraventricular hemorrhage?

1.   ?    only in the germinal matrix
2.   ?    blood in the ventricles but no enlargement of them
3.   ?    blood in the ventricles with enlargement
4.   ?    blood extending into the parenchyma of the brain

50 percent of intraventricular hemorrhages occur by what day of life; what percent occur by the end of one-week?

1.   ?    90%
2.   ?    70%
3.   ?    60%

T or F: It takes about 6 weeks after intraventricular hemorrhage to get enlargement of the ventricles?

1.   ?    True
2.   ?    False

What is the overall incidence of hydrocephalus after intraventricular hemorrhage?

1.   ?    14 percent
2.   ?    24 percent
3.   ?    34 percent
4.   ?    44 percent

What is the overall mortality for intraventricular hemorrhage?

1.   ?    50 percent
2.   ?    30 percent
3.   ?    10 percent

What is the most common cause of pneumonia and bronchiolitis in infants under a year of age?

1.   ?    Respiratory syncytial virus
2.   ?    Streptococcus
3.   ?    Staphylococcus

If an infant has had RSV, can they get the disease again?

1.   ?    Yes
2.   ?    No

How is RSV transmitted?

1.   ?    Contact with nasal secretions
2.   ?    Airborne route
3.   ?    Bloodborne

What is the incubation period for RSV?

1.   ?    4 to 7 days
2.   ?    7 to 14 days
3.   ?    14 to 28 days

What is the most common reason for admission to the hospital for a patient with RSV?

1.   ?    Hypoxemia
2.   ?    Empyema
3.   ?    High uncontrolled fever

Which is NOT a treatment of RSV?

1.   ?    Ribavirin inhaled aerosol
2.   ?    Supplemental O2
3.   ?    Steroids

What is the most common cause of diarrhea in children and United States?

1.   ?    Rotavirus
2.   ?    Adenovirus
3.   ?    Norwalk Virus

Which is NOT true of Rotavirus?

1.   ?    Peak season is between December and April
2.   ?    Fecal oral transmission
3.   ?    Peak ages: 6 to 24 months
4.   ?    Invades jejunal mucosal cells
5.   ?    Dx by antibody titer

Does Norwalk virus affect older or younger patients then rotavirus?

1.   ?    Younger
2.   ?    Older