Exam (elaborations)
RNC-NIC QUESTIONS AND ANSWERS
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RNC-NIC QUESTIONS AND ANSWERS
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RNC-NIC QUESTIONS AND ANSWERS"Double bubble" on xray - Answers -Duodenal atresia
4 pulmonary veins attached to the venous system, returning oxygenated blood to the
right side of the heart instead of left atrium - Answers -TAPVR
Adrenal crisis and signs of cortisol insufficiency - Answers -Complication of CAH
S/S include shock, low blood pressure, acidosis, low glucose, seizures, sodium
depletion
Albumin - Answers --Synthesized in the liver
-decreased in hepatocellular injury
Alk Phos - Answers --derived from liver, also found in bone, kidney, and small intestine
-increased an obstructed bile disease, hepatitis, bone disease
Anencephaly - Answers -A primary defect of anterior neural tube closure
Anomalies associated with esophageal atresia - Answers -SGA
VATER synd.
-vertebral
-imperf anus
-renal dysplasia
Aortic stenosis signs/symptoms - Answers -None at birth
Grade 2-6 harsh systolic murmur in upper RSB
CHF S/S delayed by weeks but progresses rapidly
Components of TOF - Answers -1) pulmonary stenosis
2) VSD
3) aorta overrides VSD
4) RV hypertrophy
Congenital adrenal hyperplasia (CAH)
Treatment - Answers -1) Restore physiological levels of cortisol
2) suppress ACTH & androgen overproduction
3) Watch fluid and electrolytes (esp low Na)
4) lifelong here, may need increased doses of cortisol with illness
Congenital adrenal hyperplasia (CAH) - Answers -A group of autosomal recessive
genetic disorders resulting from deficient activity of enzyme required to synthesize
cortisol from cholesterol in adrenal cortex
Most common cause of ambiguous genitalia
,Congenital diaphragmatic hernia
Associated with - Answers -Trisomy 13
Trisomy 18
Trisomy 21,
Trisomy 45
Trisomy X
Intestinal malrotation
Congenital diaphragmatic hernia
Care - Answers -NPO, gastric decompression
Avoid BVM, intubate
Watch for pulmonary air leaks
May need HFOV, INO, ECMO
Congenital Diaphragmatic hernia
S/s - Answers -Hallmark finding-
fluid filled stomach just below left atrium
Consistent finding that reflects RV volume overload - Answers -Hyperdynamic
precordial activity
Correct ETT placement - Answers -T1-T2
level of clavicles
Correct PICC placement - Answers -T3-5
Lower 1/3 of s. Vena cava
Correct UAC placement - Answers -Low-L3-4
Below renal arteries
High-T6-10
Correct UVC placement - Answers -T 8-9
0.5-1 cm above diaphragm
Tip in inf. vena cava
Cri du chat syndrome - Answers -
CXR heart has appearance of "egg on a string" - Answers -TGV
Dexamethasone adverse effects - Answers --increased glucose levels
-increase blood pressure
-Poor weight gain
-Increased risk of sepsis
, Di George syndrome (22q11.2 deletion syndrome) - Answers -Inherited Autosomal
dominant trait
Short stature
Hypogonadism
Hypoplasia or aplasia of thymus and parathyroid
Associated heart defects
Microcephaly
Palatial anomalies and small mouth
Hypotonia
Can have later schizophrenia & depression
Diagnosis of gastroschisis or omphalocele - Answers -Elevated AFP
DIC Labs - Answers --Low platelets
-prolonged PT and PTT
-increased FSP
-decreased fibrinogen
-increased d-dimer which is the marker DIC
Difference in PaO2 of________ or greater documents ductal shunting - Answers -15%
Digoxin works by - Answers -Increasing intracellular calcium leading to a +inotropic
effect which increases contractility
Duodenal atresia stenosis s/s - Answers -Polyhydramnios
Abdominal distention
No stools
Bilious vomiting within 24 hours
Duodenal stenosis atresia associated with - Answers -Trisomy 21
CHD
Intestinal malrotation
TE abnormalities
Anorectal defects
Eagle-Barrett Syndrome - Answers -1) absent abdominal musculature
2) GU tract abnormalities
3) undescended testicles
Oligohydramnios
Encephalocele - Answers -Failure of closure resulting in extension of brain tissue
through defect in skull
Often occipital
Erb's palsy - Answers -Brachioplexus injury involving cranial n. V & VI
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