Quiz 10: Respiratory distress and apnoea

Please choose the one, most correct answer to each question or statement.

1. Which one of the following clinical signs is used to diagnose respiratory distress?
   • Pallor
   • Decreased air entry of the chest
   • Recession
   • Pyrexia
2. Tachypnoea is defined as a respiratory rate equal or greater than:
   • 20 breaths per minute
   • 40 breaths per minute
   • 60 breaths per minute
   • 80 breaths per minute
3. Grunting is an important sign of respiratory distress and is heard during:
   • Inspiration
   • Crying
   • Apnoea
   • Expiration
4. Infants with hyaline membrane disease should be:
   • Handled frequently to prevent apnoea
   • Handled as little as possible
   • Suctioned every hour
   • Given antibiotics
5. Hyaline membrane disease is caused by:
   • Lack of surfactant
   • Too much surfactant
   • Infection
   • Too much fluid in the lungs
6. A diagnosis of hyaline membrane disease is likely with:
   • Pus cells and bacteria in the gastric aspirate at birth
   • A positive VDRL test
   • A chest X-ray showing hyperexpanded lungs
   • A chest X-ray showing a small lungs with granular lung fields
7. Hyaline membrane disease is commonly seen in:
   • Meconium-stained infants
   • Preterm infants
   • Underweight for gestational age infants
   • Postterm infants
8. Hyaline membrane disease can be expected to:
   • Improve steadily after birth
   • Steadily become worse after birth for about 6 hours then improve
   • Steadily become worse after birth for 48 to 72 hours before starting to improve
   • Only start to recover after 1 week
9. Where should an infant with hyaline membrane disease be managed?
   • In the postnatal ward with its mother
   • In a clinic
   • In a level 1 hospital
   • In a level 2 or 3 hospital
10. The commonest cause of respiratory distress is:
    • Hyaline membrane disease
    • Hypothermia
    • Wet lung syndrome
    • Meconium aspiration
11. The wet lung syndrome:
    • Improves during the first 2 to 3 days.
    • Gradually gets worse after delivery.
    • Should be treated with antibiotics.
    • Is usually fatal.
12. A hyperinflated chest in an infant with respiratory distress suggests a diagnosis of:
    • Meconium aspiration syndrome
    • Hyaline membrane disease
    • Patent ductus arteriosus
    • Pneumonia
13. Meconium aspiration syndrome can be prevented by:
    • Suctioning the airways after the infant has started to breathe
    • Suctioning the airways before the infant starts to breathe
    • Giving the infant steroids
    • Washing out the stomach
14. Which is a quick way of diagnosing pneumothorax?
    • Transilluminate the chest.
    • Take an X-ray of the abdomen.
    • Insert a chest drain.
    • Do a shake test on the gastric aspirate at birth.
15. What is a common cause of heart failure in newborn infants?
    • Dehydration
    • Patent ductus arteriosus
    • Mitral stenosis
    • Hyaline membrane disease
16. An offensive smell at birth in an infant with respiratory distress suggests a diagnosis of:
    • Meconium aspiration syndrome
    • Pneumonia
    • Syphilis
    • Tetanus
17. Periodic breathing:
    • Causes pallor.
    • Causes tachycardia.
    • Causes bradycardia and central cyanosis.
    • Causes neither central cyanosis nor bradycardia.
18. Apnoea is diagnosed when:
    • An infant stops breathing for 5 seconds.
    • An infant stops breathing for 15 seconds but remains pink.
    • An infant becomes cyanosed but does not stop breathing.
    • An infant stops breathing for 20 seconds and develops cyanosis and bradycardia.
19. Apnoea is common in:
    • Infants with septicaemia
    • Underweight for gestational age infants
    • Overweight for gestational age infants
    • Postterm infants
20. How is caffeine given to prevent apnoea?
    • Orally
    • By intramuscular injection
    • Intravenously
    • It is rubbed onto the infant’s chest