A 4-Hour-Old Girl Is Evaluated in the Neonatal Intensive Care

question 189

Multiple Choice

A 4-hour-old girl is evaluated in the neonatal intensive care unit.  The patient was born at 30 weeks gestation via spontaneous vaginal delivery after 3 hours of labor.  Membranes ruptured at the onset of labor and amniotic fluid appeared clear.  Immediately after birth, the child was placed on continuous positive airway pressure by nasal prongs due to signs of breathing difficulty.  Temperature is 36.7 C (98 F) , pulse is 158/min, and respirations are 54/min.  Pulse oximetry is 92% on 60% oxygen.  Examination shows audible grunting and subcostal chest wall retractions.  Cardiac examination shows no murmurs.  A chest x-ray is obtained: The radiographic findings in this patient most likely represent which of the following?

• A)Air leakage into pleural space
• B)Alveolar and capillary dysplasia
• C)Diffuse atelectasis
• D)Occlusion of the bronchioles
• E)Retained extracellular fluid

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