Exam 41: Congenital Diaphragmatic Hernia

Which of the following are major pathologic and structural changes associated with a CDH? 1) Increased numbers of bronchial generations and alveoli 2) Complete lung collapse 3) Atelectasis 4) Mediastinal shift

A newborn infant shows respiratory distress upon delivery. He is observed to have a scaphoid abdomen. Auscultation reveals diminished breath sounds with heart sounds on the right side of the chest. What is the infant's most likely diagnosis?

If inhaled nitric oxide (iNO) does not work, what treatment might be required for a patient with a CDH and significant pulmonary hypoplasia?

What effect would a substantial left-sided CDH have on pulmonary function test findings?

Which of the following anatomic alterations is not typically found in a patient with a congenital diaphragmatic hernia?

When does respiratory distress normally develop in a newborn with a CDH?

Why would bag and mask ventilation be contraindicated in resuscitation of a neonate with CDH?

Which of the following auscultation findings would be associated with a CDH? 1) Bilateral bruits 2) Apical heartbeat heard over the unaffected side 3) Absent breath sounds over the affected area 4) Bowel sounds over the affected area

An infant with a CDH also has pulmonary hypertension. Which of the following can be administered to relieve this problem?

What initial ventilator setting(s) would be recommended for a newborn with a CDH? 1) PEEP of 5 to 8 cm H₂O 2) FIO₂ of 1.0 3) Peak inspiratory pressure of <30 cm H₂O 4) Respiratory rate of 40 to 50 breaths/min

What is the medical term for the condition associated with some cases of CDH in which the heart is pushed to the right side of the chest?

What pulmonary change is associated with a Bochdalek's hernia?

What happens as an infant with a CDH creates an increased negative inspiratory pressure in order to breathe?

Which of the following is described as abnormal elevation of an intact diaphragm into the chest cavity?

The prognosis of an infant with a diaphragmatic hernia depends on which of the following factors? 1) Spontaneous closure without the need for surgery 2) Size of the diaphragmatic defect 3) Condition of the lung on the unaffected side 4) Degree of hypoplasia

Which of the following chest radiograph findings is typically not associated with a CDH?

In the delivery room, which of the following are recommended to manage a newborn with a CDH? 1) Administer oxygen. 2) Begin bag and mask manual ventilation. 3) Intubate and ventilate the neonate. 4) Place the newborn in the Trendelenburg position.