Phys 84 Flashcards

At 2 weeks post-implantation, which structure develops fastest relative to the fetus?
A. Fetal skeleton and muscles
B. Placenta and membranes
C. Fetal cerebral cortex
D. Fetal renal nephrons

During the first 2–3 weeks after blastocyst implantation, the fetus is best described as:
A. Rapidly gaining fat mass
B. Approaching neonatal anatomy
C. Increasing length exponentially
D. Almost microscopic

After the early microscopic period, fetal length increases almost:
A. Proportionally with age
B. Inversely with age
C. Independently of age
D. Only in third trimester

A 12-week fetus most likely measures about:
A. About 5 cm
B. About 8 cm
C. About 10 cm
D. About 25 cm

A 20-week fetus most likely measures about:
A. About 25 cm
B. About 10 cm
C. About 53 cm
D. About 5 cm

At term, the fetus most likely measures about:
A. About 25 cm
B. About 53 cm
C. About 10 cm
D. About 40 cm

An ultrasound at ~32 weeks estimates fetal weight. Average weight is closest to:
A. 1.5 lb
B. 2.0 lb
C. 4.5 lb
D. 3.0 lb

A fetus at ~36 weeks typically weighs closest to:
A. 7.0 lb
B. 3.0 lb
C. 4.5 lb
D. 11.0 lb

Which statement best matches typical birth weight patterns at term?
A. Avg 4.5 lb; 3–7
B. Avg 7 lb; 4.5–11
C. Avg 11 lb; 7–13
D. Avg 3 lb; 1–5

Beyond which point are fetal organs grossly similar to a neonate’s?
A. After month 4
B. After month 2
C. After month 1
D. After month 7

Earliest expected onset of human cardiac contractions occurs around:
A. Week 2
B. Week 8
C. Week 6
D. Week 4

When the fetal heart first begins beating, the rate is closest to:
A. 140 beats/min
B. 100 beats/min
C. 65 beats/min
D. 45 beats/min

Immediately before birth, typical fetal heart rate is closest to:
A. 140 beats/minA
B. 65 beats/min
C. 45 beats/min
D. 100 beats/min

Earliest nucleated red blood cells begin forming primarily at:
A. Week 6 liver
B. Week 4 bone marrow
C. Month 3 spleen
D. Week 3 yolk sac placenta

Initial production of non-nucleated RBCs begins around:
A. Month 3 lymphoid tissue
B. Weeks 4–5 mesenchyme endothelium
C. Week 3 yolk sac
D. Term bone marrow

The fetal liver begins forming blood cells at about:
A. Week 4
B. Month 4
C. Week 6
D. Week 12

The spleen and other lymphoid tissues begin hematopoiesis around:
A. Second trimester start
B. Week 6
C. Third month
D. At term

From the third month onward, the principal source of RBCs becomes:
A. Yolk sac endoderm
B. Bone marrow
C. Placental mesothelium
D. Alveolar epithelium

Even after bone marrow predominates, continued RBC production in lymphoid tissue especially includes:
A. Lymphocytes and plasma cells
B. Neutrophils and eosinophils
C. Platelets and reticulocytes
D. Monocytes and basophils

Why can respiration not occur during fetal life?
A. Surfactant absent until term
B. Diaphragm cannot contract
C. Airway cartilage undeveloped
D. No air in amniotic cavity

A late-gestation mechanism inhibits fetal “breathing” movements mainly to:
A. Prevent surfactant washout
B. Prevent meconium debris lung filling
C. Increase fetal oxygen demand
D. Enhance pulmonary blood flow

Up to the moment of birth, the fetal lungs are maintained with:
A. Debris-filled aspirate
B. Meconium-contaminated mucus
C. Small amounts of clean fluid
D. Completely dry alveoli

Most spinal cord and brainstem reflexes are present by:
A. First month
B. Sixth month
C. At term only
D. Third–fourth months

By midpregnancy, the fetus typically begins to:
A. Ingest and absorb amniotic fluid
B. Synthesize mature antibodies
C. Complete renal acid-base control
D. Replace placenta with lungs

During the last 2–3 months, which function approaches that of a normal neonate?
A. Cardiac conduction system
B. Bone marrow stem-cell niche
C. Gastrointestinal function
D. Placental gas exchange

Meconium is best described as:
A. Mucus epithelial cells swallowed residue
B. Pure fetal urine concentrate
C. Surfactant mixed with plasma
D. Placental trophoblast fragments

Second-trimester fetal urine contributes approximately what fraction of amniotic fluid?
A. 10–20%
B. 30–40%
C. 50–60%
D. 70–80%

Severe fetal kidney dysfunction most directly increases risk of:
A. Polyhydramnios with macrosomia
B. Oligohydramnios and fetal death
C. Meconium ileus with obstruction
D. Neonatal hypocalcemia only

Fetal renal regulation of ECF volume, electrolytes, and acid-base is:
A. Fully mature by midpregnancy
B. Mature by birth
C. Nearly absent until late fetal life
D. Hyperactive in second trimester

The fetus primarily uses which fuel for energy?
A. Glucose
B. Ketone bodies
C. Free fatty acids
D. Amino acids

Fetal calcium + phosphate needs are about what fraction of maternal bone stores?
A. About 20%
B. About 10%
C. About 2%
D. About 50%

Which nutrient accumulates faster than calcium/phosphate in the fetus?
A. Iron
B. Vitamin D
C. Vitamin C
D. Vitamin K

Early embryonic iron uptake occurs primarily via:
A. Maternal hepatocytes
B. Amniotic epithelium
C. Fetal renal tubules
D. Trophoblastic cells

Hemolysis in erythroblastosis fetalis severe cases can cause fetal death mainly from:
A. Hypoglycemia
B. Hyperkalemia
C. Coagulopathy
D. Lack of adequate RBCs

Term fetal liver iron is most important after birth for:
A. Hemoglobin synthesis months
B. Surfactant production
C. Bone matrix formation
D. Coagulation factor activation

Which combination is required for RBCs and nervous tissue growth?
A. Vitamin C and D
B. Vitamin K and C
C. Vitamin B12 and folate
D. Vitamin D and K

A deficiency impairing connective tissue matrix suggests low:
A. Vitamin K
B. Vitamin D
C. Vitamin B12
D. Vitamin C

Maternal vitamin most critical for GI calcium absorption is:
A. Vitamin C
B. Vitamin D
C. Vitamin K
D. Vitamin B12

Fetal vitamin K is used to form which coagulation factor?
A. Factor VII
B. Factor VIII
C. Factor XIII
D. Factor I

Maternal vitamin K insufficiency most directly causes deficiency of:
A. Factor VIII and fibrinogen
B. Factor IX and XII
C. Factor V and VIII
D. Factor VII and prothrombin

Most vitamin K is normally produced by bacteria in the:
A. Maternal ileum
B. Neonatal colon
C. Mother’s colon
D. Placental villi

Newborn vitamin K deficiency risk is highest initially because:
A. Placental transfer stops
B. No colonic flora
C. Liver cannot store
D. Kidneys excrete vitamins

After an undepressed delivery, breathing begins:
A. Within one hour
B. After five minutes
C. After 40 minutes
D. Within seconds

Normal respiratory rhythm usually occurs within:
A. Less than 1 minute
B. Less than 10 minutes
C. About 40 minutes
D. About 5 minutes

Maternal general anesthesia most commonly causes neonatal respiration to be:
A. Immediate vigorous breathing
B. Delayed several minutes
C. Apnea for hours
D. Tachypnea at birth

Head trauma during delivery can impair breathing via:
A. Cord compression
B. Surfactant deficiency
C. Depressed respiratory center
D. Low vitamin K

Prolonged fetal hypoxia during delivery can cause:
A. Respiratory center depression
B. Increased respiratory drive
C. Increased surfactant secretion
D. Immediate rhythmic breathing

Which delivery complication commonly causes fetal hypoxia?
A. Neonatal meconium passage
B. Maternal hyperventilation
C. Increased amniotic fluid
D. Umbilical cord compression

A sudden loss of placental exchange during labor suggests:
A. Umbilical vein dilation
B. Placental premature separation
C. Excess fetal swallowing
D. Early neonatal feeding

Classic erythroblastosis fetalis risk pairing is:
A. Fetus Rh−, mother Rh+
B. Fetus Rh+, mother Rh−
C. Fetus Rh−, mother Rh−
D. Fetus Rh+, mother Rh+

Excessive maternal anesthesia can worsen fetal hypoxia by:
A. Depresses maternal oxygenation
B. Increases uterine perfusion
C. Enhances fetal breathing
D. Increases placental exchange

Some neonates may survive without breathing for up to:
A. Two minutes
B. Ten minutes
C. Thirty minutes
D. One hour

At birth, alveoli are initially collapsed mainly because of:
A. Thick alveolar cartilage
B. No pulmonary capillaries
C. Surface tension of fluid
D. Excess surfactant

First opening of alveoli usually requires more than:
A. Greater than 5 mmHg
B. Greater than 10 mmHg
C. Greater than 15 mmHg
D. Greater than 25 mmHg

Breathing becomes completely normal approximately:
A. About 40 minutes
B. About 5 minutes
C. About 1 minute
D. About 10 minutes

Severe neonatal respiratory distress is most associated with:
A. Post-term infants
B. Maternal folate deficiency
C. Maternal vitamin C excess
D. Prematurity or maternal diabetes

A hallmark of respiratory distress syndrome is failure to secrete:
A. Excess lung fluid
B. Inadequate surfactant
C. Excess prothrombin
D. High fetal urine

Surfactant primarily helps alveoli by:
A. Increases fluid surface tension
B. Thickens alveolar mucus
C. Decreases alveolar surface tension
D. Dries alveolar lining

Surfactant is produced by which cells?
A. Type II pneumocytes
B. Type I pneumocytes
C. Alveolar macrophages
D. Pulmonary fibroblasts

Meaningful surfactant secretion begins mainly during the last:
A. Last 1 week
B. Last 1 to 3 months
C. First 1 to 3 months
D. Midgestation only

During fetal life, minimal cardiac output is directed through which organs?
A. Kidneys and skin
B. Brain and myocardium
C. Lungs and liver
D. Gut and spleen

The fetal heart must pump large quantities of blood through the:
A. Placenta
B. Coronary arteries
C. Cerebral arteries
D. Renal arteries

Placental blood in the umbilical vein mainly bypasses the liver via the:
A. Ductus arteriosus
B. Foramen ovale
C. Portal vein
D. Ductus venosus

Well-oxygenated placental blood enters mainly the ______ side of the heart.
A. Right
B. Left
C. Posterior
D. Inferior

The left ventricle preferentially supplies the:
A. Head and forelimbs
B. Placenta and kidneys
C. Liver and gut
D. Lungs and diaphragm

Blood from the SVC is directed through which valve into the right ventricle?
A. Mitral valve
B. Pulmonic valve
C. Aortic valve
D. Tricuspid valve

Most right-ventricular output reaches the descending aorta via the:
A. Foramen ovale
B. Ductus venosus
C. Ductus arteriosus
D. Coronary sinus

Deoxygenated fetal blood returns to the placenta primarily via the:
A. Pulmonary arteries
B. Umbilical arteries
C. Umbilical vein
D. Hepatic veins

Approximately what fraction of fetal blood flow goes through the lungs?
A. About 12%
B. About 25%
C. About 45%
D. About 55%

At birth, loss of placental flow causes systemic vascular resistance to:
A. Decrease slightly
B. Approximately double
C. Remain unchanged
D. Fall fivefold

After birth, pulmonary vascular resistance primarily:
A. Increases markedly
B. Remains high
C. Decreases greatly
D. Becomes zero

A fivefold fall in lung resistance most directly lowers:
A. Pulmonary arterial pressure
B. Aortic systolic pressure
C. Portal venous pressure
D. Umbilical arterial pressure

Immediately after birth, which atrial pressure pattern promotes foramen ovale closure?
A. High RA, low LA
B. Low RA, low LA
C. High RA, high LA
D. Low RA, high LA

The flap valve over the foramen ovale closes because blood now attempts to flow:
A. RA → LA
B. LA → RA
C. RV → LV
D. LV → RV

Failure of permanent foramen ovale closure is called:
A. Tetralogy of Fallot
B. Patent ductus arteriosus
C. Patent foramen ovale
D. Atrial septal aneurysm

In a patent foramen ovale, the valve stays shut mainly because:
A. RA exceeds LA pressure
B. RA equals LA pressure
C. LA equals RA pressure
D. LA exceeds RA by 2–4

After birth, blood begins to flow through the ductus arteriosus primarily:
A. Aorta → pulmonary artery
B. Pulmonary artery → aorta
C. Vena cava → aorta
D. Aorta → umbilical arteries

“Functional closure” of the ductus arteriosus usually occurs within:
A. 1 hour
B. 1 to 3 hours
C. 1 to 8 days
D. 2 to 3 weeks

Within hours after birth, the ductus arteriosus first:
A. Dilates widely
B. Constricts markedly
C. Becomes fibrotic
D. Shunts LA → RA

Ductus arteriosus closure is promoted by:
A. ↑O2, ↓PGE2 effects
B. ↓O2, ↑PGE2 effects
C. ↑PGE2, ↓SVR
D. ↓O2, ↑SVR

A medication often used to close a PDA is:
A. Alprostadil
B. Furosemide
C. Propranolol
D. Indomethacin

The ductus venosus typically closes within:
A. 1 to 8 days
B. 1 to 3 hours
C. 2 to 3 days
D. 1 to 3 months

After ductus venosus closure, portal venous pressure rises to about:
A. 2 to 4 mm Hg
B. 25 mm Hg
C. 6 to 10 mm Hg
D. 30 to 40 mm Hg

The rise in portal pressure after birth mainly forces blood to flow through:
A. Ductus arteriosus lumen
B. Foramen ovale
C. Umbilical arteries
D. Liver sinuses

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Typical neonatal weight change in the first 2–3 days is:
A. 5 to 10% loss
B. 5 to 10% gain
C. 20% gain
D. No measurable change

Normal neonatal respiratory rate is closest to:
A. 12 breaths/min
B. 20 breaths/min
C. 60 breaths/min
D. 40 breaths/min

If ~55% of blood goes through placenta, about how much goes through fetal tissues?
A. About 12%
B. About 25%
C. About 45%
D. About 80%

Average neonatal cardiac output is closest to:
A. 500 mL/min
B. 250 mL/min
C. 1000 mL/min
D. 150 mL/min

Relative to body weight, neonatal output is:
A. One-third adult per kg
B. Same as adult per kg
C. Half adult per kg
D. Twice adult per kg

First-day neonatal arterial pressure averages:
A. 60/40 mm Hg
B. 70/50 mm Hg
C. 90/60 mm Hg
D. 110/70 mm Hg

Immediately after birth, neonatal WBC count is about:
A. 9,000 per mm³
B. 15,000 per mm³
C. 25,000 per mm³
D. 45,000 per mm³

Physiologic anemia of infancy is typical at:
A. 6 to 12 weeks
B. 6 to 12 months
C. 1 to 2 weeks
D. First 72 hours

Physiologic hyperbilirubinemia is most typical during:
A. 6 to 12 weeks
B. 3 to 6 months
C. First 2 weeks
D. After 1 year

The neonate rids bilirubin primarily through the:
A. Placenta
B. Neonate’s liver
C. Neonate’s kidneys
D. Neonate’s lungs

Early neonatal bilirubin excretion is limited by poor:
A. Renal bilirubin filtration
B. Hepatic bile acid synthesis
C. Albumin bilirubin binding
D. Glucuronic acid conjugation

Mild jaundice from physiologic hyperbilirubinemia lasts:
A. 12 to 24 hours
B. 6 to 12 weeks
C. 6 months
D. 1 to 2 weeks

Most important abnormal cause of severe neonatal jaundice:
A. Breast milk jaundice
B. Erythroblastosis fetalis
C. Gilbert syndrome
D. Crigler-Najjar syndrome

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In erythroblastosis fetalis, the mother becomes:
A. Immunized against Rh factor
B. Tolerant to Rh factor
C. Unable to make antibodies
D. Immunized against ABO antigens

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Hemolysis in erythroblastosis fetalis releases excess:
A. Glucose
B. Bilirubin
C. Calcium
D. Prothrombin

Severe cases can cause fetal death mainly from:
A. Hypoglycemia
B. Hyperkalemia
C. Coagulopathy
D. Lack of adequate RBCs

Bilirubin is conjugated in the liver with:
A. Glycine
B. Sulfate
C. Glucuronic acid
D. Glutathione

Neonatal hepatic production of coagulation factors is:
A. Excessive
B. Too little
C. Fully normal
D. Platelet-limited only

A neonate struggles with starch digestion due to low:
A. Lactase
B. Trypsin
C. Pancreatic lipase
D. Pancreatic amylase

Compared with older children, neonatal fat absorption is:
A. Much higher
B. Somewhat less
C. Complete at birth
D. Absent until weaning

Early neonatal liver function makes ____ unstable and low:
A. Chloride
B. Creatinine
C. Glucose
D. Urea

Neonates lose heat readily mainly because of:
A. Low respiratory rate
B. High subcutaneous fat
C. Low cardiac output
D. Large surface area ratio

Rapid bone ossification increases need for:
A. Iron
B. Calcium
C. Iodine
D. Sodium

Breast milk vitamin supply is adequate unless mother has severe:
A. Vitamin D deficiency
B. Vitamin K deficiency
C. Vitamin C deficiency
D. Folate deficiency

Maternal antibodies reach the fetus mainly via the:
A. Placenta
B. Umbilical arteries
C. Neonatal colon
D. Amniotic fluid

The neonate forms antibodies to a significant extent:
A. By the first day
B. By the first week
C. By the first month
D. Not significantly early on

Maternal antibodies protect the infant for about:
A. 2 weeks
B. 2 years
C. 6 months
D. 6 years

Inherited antibodies are typically insufficient against:
A. Whooping cough
B. Measles
C. Diphtheria
D. Polio

For full safety, pertussis immunization is needed within:
A. First 24 hours
B. First month
C. First year
D. First 6 months

Excess fetal androgen exposure in a female fetus can cause:
A. Turner syndrome
B. Müllerian agenesis
C. Hermaphroditism
D. Androgen insensitivity

Maternal antibodies protect against major infections including:
A. Pertussis influenza varicella
B. Diphtheria measles polio
C. RSV rotavirus norovirus
D. Candida HSV toxoplasma

A 2-day-old has breast enlargement with milky discharge; a small subset develop inflammatory mastitis. Most likely cause of the milk secretion is:
A. High neonatal prolactin surge
B. Placental maternal sex hormones
C. Congenital duct obstruction
D. Neonatal hypothyroidism

A newborn of an untreated diabetic mother is at highest risk for which change?
A. Adrenal cortex hypofunction
B. Thyroid hyposecretion
C. Pancreatic acinar atrophy
D. Islet hypertrophy hyperfunction

In this infant (untreated diabetic mother), blood glucose can fall shortly after birth to:
A. Below 20 mg/dL
B. Below 40 mg/dL
C. Below 60 mg/dL
D. Below 100 mg/dL

The most common maternal diabetes type associated with “large babies” is:
A. Maternal type 1 diabetes
B. Maternal type 2 diabetes
C. Maternal hyperthyroidism
D. Maternal adrenal insufficiency

The key maternal metabolic feature driving this macrosomia is:
A. Absolute insulin deficiency
B. Autoimmune beta destruction
C. Low placental glucose transfer
D. Insulin resistance hyperinsulinemia

Which best explains how type 2 diabetes increases fetal growth?
A. Fetal hyperinsulinemia plus nutrients
B. Low fetal insulin levels
C. Reduced placental nutrient delivery
D. Low maternal glucose levels

Uncontrolled maternal type 1 diabetes most likely leads to:
A. Macrosomia with low mortality
B. Normal growth normal maturation
C. Stunted growth, impaired maturity, mortality
D. Islet hypertrophy only

A neonate is born with hypofunctional adrenal cortices. A likely cause is:
A. Maternal hyperthyroidism exposure
B. Fetal pancreatic hypoplasia
C. Vitamin D excess
D. Agenesis or exhaustion atrophy

Maternal hyperthyroidism or excess thyroid hormone therapy most likely causes the infant’s thyroid to be:
A. Temporary thyroid hyposecretion
B. Permanent thyroid absence
C. Cortisol excess state
D. Neonatal hyperthyroidism

A mother had her thyroid removed before pregnancy; very high gestational thyrotropin occurs. The infant may be born with:
A. Temporary neonatal hypothyroidism
B. Temporary neonatal hyperthyroidism
C. Permanent cretin dwarfism
D. Neonatal adrenal failure

An infant is >2 months premature. Diet should be:
A. Low fat diet
B. High fat cow milk
C. High starch formula
D. Ketogenic diet

In premature infants, immature liver function commonly leads to low plasma proteins causing:
A. Hyperproteinemia hypertension
B. Polycythemia jaundice
C. Metabolic alkalosis
D. Hypoproteinemic edema

A very premature infant receives high supplemental oxygen and later develops blindness (retrolental fibroplasia). The mechanism is:
A. Retinal ischemia from anemia
B. Lens proteins denature
C. Retinal vessel growth stops
D. Bilirubin stains retina

Brain mass growth is best described by which pairing (with near-adult size by end year 2)?
A. 55% birth 26% one-year
B. 80% birth 90% one-year
C. 10% birth 30% one-year
D. 26% birth 55% one-year

True respiration cannot occur in fetal life (no air), but respiratory attempts begin around:
A. Week 4
B. Month 4
C. Month 6
D. End first trimester

Most reflexes involving spinal cord and brainstem are present by the 3rd–4th month; meanwhile the:
A. Cerebral cortex fully mature
B. Brainstem reflexes; cortex immature
C. Cortex dominates respiration
D. Cortex fully myelinated

Myelination of major tracts becomes complete at about:
A. At birth
B. End second year
C. About one year
D. At puberty

Meconium late in pregnancy is best described as:
A. Pure fetal urine concentrate
B. Only maternal blood pigments
C. Surfactant with lung proteins
D. Residue mucus; excreted amniotic

Fetal kidneys begin urine excretion when, and urine makes what fraction of amniotic fluid?
A. First trimester; 10–20%
B. Third trimester; 30–40%
C. Second trimester; 70–80%
D. After birth; 70–80%

Abnormal fetal kidney development reducing amniotic fluid (and risking fetal death) is called:
A. Polyhydramnios
B. Oligohydramnios
C. Hydronephrosis
D. Ascites

Half of the 22.5 g fetal calcium accumulation occurs mainly during the:
A. Last four weeks
B. First four weeks
C. Second trimester
D. First trimester

Which vitamin mapping is correct for fetal needs?
A. D for RBC; C for nerves
B. K for bones; A for RBC
C. C for RBC; B12 for bones
D. B12, folate, RBC nerves; D bones

The “slightly asphyxiated” state of birth primarily stimulates breathing via:
A. Hyperoxia and alkalosis
B. Hypoglycemia and ketosis
C. Hypocapnia and alkalosis
D. Hypoxia and hypercapnia

The key sensory trigger that supports breathing onset is:
A. Sudden cooling of skin
B. Umbilical venous stretch
C. Fetal swallowing reflex
D. Pupillary light response

During delivery, which event can directly cause fetal hypoxia?
A. Early colonic colonization
B. Increased fetal urine output
C. Umbilical cord compression
D. Maternal vitamin C deficiency

Another intrapartum cause of fetal hypoxia is:
A. Premature placental separation
B. Neonatal pancreatic amylase deficiency
C. Excess neonatal surfactant secretion
D. Early ductus venosus closure

Which pair contains only causes of fetal hypoxia during delivery?
A. Maternal fever, uterine relaxation
B. Meconium passage, tachycardia
C. Hyperventilation, cord dilation
D. Uterine contracture, maternal anesthesia

Adults often survive ~4 minutes apneic; neonates may survive apneic for about:
A. 2 minutes
B. 10 minutes
C. 6 minutes
D. 20 minutes

Fluid-filled, collapsed alveoli usually require more than what negative pressure to open initially?
A. 5 mmHg
B. 10 mmHg
C. 25 mmHg
D. 60 mmHg

The first breath is typically strongest, reaching approximately:
A. −25 mmHg
B. −10 mmHg
C. −5 mmHg
D. −60 mmHg

After the initial breaths (with the second breath easier), breathing becomes completely normal by about:
A. 40 minutes
B. 5 minutes
C. 3 hours
D. 1 day

A neonate develops respiratory distress syndrome (RDS). Highest-risk groups include premature infants and infants of:
A. Maternal hypothyroidism
B. Diabetic mothers
C. Maternal iron deficiency
D. Maternal hypertension only

Premature infants tend toward which acid–base status, given high metabolism and kidney immaturity?
A. Acidotic tendency
B. Alkalotic tendency
C. Always normal pH
D. Respiratory alkalosis only

In neonatal RDS, alveoli may fill with proteinaceous fluid and desquamated cells, termed:
A. Meconium aspiration syndrome
B. Bronchopulmonary dysplasia
C. Neonatal pneumonia
D. Hyaline membrane disease

Meaningful surfactant secretion begins mainly during the last:
A. 1 week
B. 6 months
C. First trimester
D. 1 to 3 months

A key consequence of inadequate surfactant is:
A. Alveolar collapse, pulmonary edema
B. Increased lung compliance
C. Decreased surface tension forces
D. Permanent alveolar hyperinflation

Oxygenated blood entering the right atrium from the IVC is directed mainly through the:
A. Tricuspid valve
B. Pulmonary valve
C. Foramen ovale
D. Coronary sinus

Deoxygenated SVC blood reaches the descending aorta mainly through the:
A. Ductus arteriosus
B. Ductus venosus
C. Foramen ovale
D. Mitral valve

In fetal life, pulmonary vessels are relatively constricted mainly because:
A. Aeration induces vasodilation
B. Hypoxia induces vasoconstriction
C. Surfactant causes vasospasm
D. Hypercapnia causes vasodilation

After birth, lung aeration/expansion causes pulmonary vessels to:
A. Remain constricted
B. Constrict further
C. Become unresponsive
D. Vasodilate

A large fall in pulmonary resistance after birth most directly lowers:
A. Pulmonary arterial, RV, RA pressures
B. Aortic, LV, LA pressures
C. Portal venous pressure only
D. Umbilical arterial pressure only

A patent foramen ovale is often clinically minor because:
A. RA pressure keeps it closed
B. LA pressure keeps it closed
C. Aortic pressure seals it shut
D. Pulmonary pressure seals it shut

A premature infant receives high oxygen and later develops blindness from abnormal retinal vessel changes. This condition is called:
A. Hyaline membrane disease
B. Kernicterus
C. Retrolental fibroplasia
D. Meconium aspiration syndrome