Shilpa Gulati
to progress. Use ← and → to navigate pages. Press A newborn boy is born on your service at 37-weeks-gestation to a G1P1 mom via normal spontaneous vaginal delivery. The pregnancy was without concern but mom missed most of the visits scheduled in the second half of her pregnancy. However, the baby’s APGARS at 1 and 5 minutes are 6 and 6; he cries immediately but appears cyanotic at 1 min. The neonatal resuscitation team starts bag-mask positive pressure ventilation, and at 5 min he remains blue with tachypnea and dyspnea despite 100% oxygen via mask. The patient becomes bradycardic and bag-mask ventilation is started, but his HR remains around 45 bpm.
On exam you notice that his heart sounds are diminished on the left and he lacks lung sounds on the same side. His abdomen appears scaphoid.
What is the most likely diagnosis?
Expand all answers
Meconium aspiration | |
Pneumothorax | |
Congenital diaphragmatic hernia | |
Choanal atresia |
What is your best next step?
Expand all answers
Administer IV atropine | |
Administer IV epinephrine | |
Begin chest compressions | |
Intubate with endotracheal tube | |
What additional tasks are important in resuscitation?
Expand all answers
Supportive care | |
Insertion of an NG tube | |
Administer IV glucose | |
Administer IV bicarbonate |
Which of the following is true:
Expand all answers
Surgical repair should occur in the delivery room | |
Patients suffer no long term pulmonary complications following repair | |
CDH cannot be diagnosed by prenatal ultrasound | |
CDH often presents similar to a tension pneumothorax |
A newborn boy is born on your service at 37-weeks-gestation to a G1P1 mom via normal spontaneous vaginal delivery. The pregnancy was without concern but mom missed most of the visits scheduled in the second half of her pregnancy. However, the baby’s APGARS at 1 and 5 minutes are 6 and 6; he cries immediately but appears cyanotic at 1 min. The neonatal resuscitation team starts bag-mask positive pressure ventilation, and at 5 min he remains blue with tachypnea and dyspnea despite 100% oxygen via mask. The patient becomes bradycardic and bag-mask ventilation is started, but his HR remains around 45 bpm.
On exam you notice that his heart sounds are diminished on the left and he lacks lung sounds on the same side. His abdomen appears scaphoid.
What is the most likely diagnosis?
Expand all answers
Meconium aspiration | |
Pneumothorax | |
Congenital diaphragmatic hernia | |
Choanal atresia |
What is your best next step?
Expand all answers
Administer IV atropine | |
Administer IV epinephrine | |
Begin chest compressions | |
Intubate with endotracheal tube | |
What additional tasks are important in resuscitation?
Expand all answers
Supportive care | |
Insertion of an NG tube | |
Administer IV glucose | |
Administer IV bicarbonate |
Which of the following is true:
Expand all answers
Surgical repair should occur in the delivery room | |
Patients suffer no long term pulmonary complications following repair | |
CDH cannot be diagnosed by prenatal ultrasound | |
CDH often presents similar to a tension pneumothorax |
