A Neonate Born 2 Hours Ago Is Admitted to the Neonatal

question 301

Multiple Choice

A neonate born 2 hours ago is admitted to the neonatal intensive care unit due to prematurity.  He was born at 32 weeks gestation to a 30-year-old primigravida via a precipitous, forceps-assisted delivery due to a nonreassuring fetal heart rate.  Rupture of membranes occurred 5 hours before delivery and appeared clear.  The mother received betamethasone during labor.  In the delivery room, the patient was placed on continuous positive airway pressure due to tachypnea and moderate intercostal and subcostal retractions with low oxygenation saturations.  He continued to have desaturations requiring increasing levels of flow.  The patient was subsequently intubated, and umbilical lines were placed.  Temperature is 36.9 C (98.4 F) , pulse is 170/min, and respirations are 40/min.  Pulse oximetry is 90% on 40% oxygen.  Cardiac examination shows regular rate and rhythm without murmurs.  Lung examination shows equal and coarse mechanically ventilated breath sounds bilaterally.  The abdomen is protuberant but soft.  A chest radiograph is obtained.  Which of the following findings is most likely seen on imaging?

• A)Coarse lung markings with cystic changes
• B)Diffuse reticulogranular pattern with air bronchograms
• C)Interstitial infiltrates with prominent interlobar fissures
• D)Patchy bilateral infiltrates with lung hyperinflation
• E)Radiolucent zone between the lungs and chest wall

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