A 3-Hour-Old Girl Is Evaluated in the Neonatal Intensive Care

question 626

Multiple Choice

A 3-hour-old girl is evaluated in the neonatal intensive care unit for cyanosis.  She was born at 38 weeks gestation by cesarean delivery for nonreassuring fetal heart tones.  The mother is a 28-year-old primigravida who had an uncomplicated pregnancy.  Apgar scores were 8 at both 1 and 5 minutes.  The infant was initially rooming-in with her mother but was moved to the nursery shortly after delivery due to a dusky appearance.  Pulse oximetry of the right hand and leg shows 72% on room air.  The patient remains hypoxic after 10 minutes of breathing 100% oxygen delivered by hood.  On examination, she is cyanotic and tremulous.  She has low-set ears, micrognathia, and a cleft palate.  Chest x-ray reveals an absent thymus.  Echocardiography shows truncus arteriosus.  Given the presumed diagnosis, this patient most likely has which of the following conditions?

• A)Anemia
• B)Duodenal atresia
• C)Horseshoe kidney
• D)Hypocalcemia
• E)Hypoglycemia
• F)Myelomeningocele
• G)Neutropenia

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Definitions:

Listening

The act of actively paying attention to sound, with the intent of understanding and often responding to it.

Information Overload

A state where an individual or system is overwhelmed by the amount of information to process, leading to indecision or inability to act effectively.

Proxemics

The examination of how humans utilize space and the impact that the concentration of individuals in an area has on their behavior, communication, and interactions with each other.

First Bubble

The initial phase or occurrence of inflated expectations and speculative investments in a particular industry or market, often leading to a collapse.