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53 Cards in this Set

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MF01 [a] The hyperventilation of pregnancy is due to:

A. Progesterone

B. Decreased resistance

C. Increased metabolic rate

D. Decreased chest wall compliance

E. V/Q mismatch
ANSWER A
MF02 [a] Normal maternal ABG at term:

A. pH 7.36, pCO2 36 mmHg

B. pH 7.42, pCO2 36 mmHg

C. pH 7.44, pCO2 30 mmHg

D. pH 7.5, pCO2 30mmHg

E. pH 7.3 pCO2 30mmHg
ANSWER C
MF03 [cl] Closure of the ductus arteriosus occurs due to:

A. Prostaglandins

B. Oxygen

C. Aortic pressure exceeds pulmonary artery pressure

D. Vascular smooth muscle contraction in the presence of oxygen

E. ?
ANSWER D

Kam says, on page 357, that the ductus arteriosus "constricts in response to the increasing PaO2 after the first breath and closure of the foramen ovale, and to decreasing concentrations of circulating and locally produces prostaglandins E1 and E2. The physiological closure occurs within 10-15 hours, and the permanent closure takes place in 2-3 weeks by thrombosis and fibrosis."
MF04 [cfkmr] With regard to the foetal circulation:

A. ? Goes into the left atrium

B. Ductus venosus drains into the IVC directly

C. Oxygen saturation is 40% in umbilical vein

D. Oxygenated blood flows from the SVC through the foramen ovale to the head

E. Ductus arteriosus directs oxygenated blood to the head
ANSWER B

The correct answer is B. Blood from the placenta flows via the umbilical vein to the left branch of the hepatic portal vein. 60% of this blood from the umbilical vein then bypasses the liver via the ductus venosus to enter the IVC directly.

This allows the oxygenated blood from the placenta to be conducted directly to the right atrium, from whence it is shunted across the foramen ovale (with the help of the crista terminalis, a ridge of muscle in the right atrium) to directly enter the left atrium and then supply the brain and heart with oxygentated blood. Therefore, option D is incorrect (blood from the SVC flows from right atrium to right ventricle and therefore does not cross the foramen ovale.

Option E is also incorrect. The ductus arteriosus does not dirct oxygentated blood to the head (this is achieved by the crista terminalis directing blood through the foramen ovale). The ductus arteriosus receives 90% of right ventricular output, allowing this blood to bypass the lungs with their high pulmonary vascular resistance. Blood from the ductus arteriosus then enters the descending aorta, and thus the less well oxygenated blood is directed to the lower limbs.

Option C is incorrect - oxygen saturation is 80% in the umbilical vein (oxygen tension is 30 mmHg), which transports oxygentated blood from the placenta to the fetus.
Apr 2001: With regard to the foetal circulation:

A. Blood from SVC goes into the left atrium via the ductus arteriosis

B. Ductus venosus drains into the IVC directly

C. Oxygen saturation is 40% in umbilical vein

D. ?
ANSWER B
Mar 02: In the foetal circulation:

A. Umbilical vein straight into IVC

B. SVC blood to LA via foramen ovale

C. Only has foetal haemoglobin

D. ?

E. ?
All of these options are incorrect. Blood from the umbilical vein must first enter the left branch of the hepatic portal vein before 60% is directed to the IVC via the ductus venosus,and 40% enters the liver. Therefore A is incorrect.

B is wrong because it is actually 60% of IVC (NOT SVC) blood which goes from right atrium to left atrium via the foramen ovale. Blood from the SVC mixes with the remaining 40% of IVC blood in the right atrium, and this blood then flows to the right ventricle.

C is incorrect because at no stage (neither in the fetus nor after birth) is haemoglobin entirely composed of the fetal form. Before birth, HbF constitutes 90% of all Hb (this percentage declines after 35 weeks gestation such that at birth HbF is only 75-80% of the total Hb). By 6 months of age, HbF is replaced by adult Hb.
MF05 [diqr] Brown fat:

A. Produces ATP and Heat

B. Insulates the great vessels of the neck

C. Is autonomically mediated

D. Extramitochondrial uncoupling of oxidative phosphorylation
ANSWER C

Regarding Option A: Hydrolysis of triglycerides to FFA and glycerol doesn't involve ATP (either generation or consumption). The generation of heat in brown fat is by the usual Krebs cycle and generation of a proton gradient across the mitochondrial membrane, but the big difference is the presence of an "uncoupling protein" which uncouples the Kreb's cycle and other intermediary metabolism from ATP generation by providing an alternative pathway for the protons to re-enter the mitochondrial matrix, other than via ATP synthase. Normally ATP has to be consumed (eg shivering) in order for the Krebs cycle etc to progress, but this is not the case in brown fat. However brown fat does still produce ATP (mentioned in Ganong), but just less than you would expect given its consumption of nutrients. So i guess option A is technically correct, but i wouldn't consider it the single best answer

Regarding option B: Brown fat may be around the great vessels of the neck, but i don't necessarily think there role is to insulate them as such, but rather to transfer heat to them (as compared with white fat; given their different morphology, they may actually not be very good insulators?). I guess it's like comparing a heater to a blanket. So again, probably not the single best answer

Regarding Option C: CORRECT. Brown fat has a dense sympathetic innervation, so i think this IS the single best answer

Regarding Option D: INCORRECT. The uncoupling of oxidative phosphorylation occurs in the wall of the mitochondria
MF06 [d] Highest O2 saturation in the foetal circulation is in:

A. Thoracic IVC

B. Right atrium

C. Ascending aorta

D. Pulmonary vein

E. Ductus arteriosus
ANSWER A

According to diagram in Cardiovascular Physiology - Berne and Levy the oxygen saturation in the fetal circulation is as follows:

* Thoracic IVC 67%
* Right Atrium - Mixture of SVC blood (Sats 25%)and IVC blood (Sats 67%)
* Ascending Aorta 62%
* Pulmonary Vv 42%
* Ductus Arteriosus 52%

Venous return to the Right Atrium is approx 2/3's IVC and 1/3 SVC. Therefore sats approx 52%.
MF06b [o] With regard to fetal circulation:

A. Fetal umbilical vein has higher PO2 than maternal vein

B. Fetal umbilical vein has higher PO2 than fetal umbilical artery

C. Foetal haemoglobin has a lower affinity for O2 than which increases delivery to foetal tissues.

D. The stroke volume of the left ventricle is the same as the stroke volume of the right ventricle.

E. Only 12% of the right ventricular output enters the pulmonary circulation.
ANSWER B

A. Incorrect. Uterine vein Po2 40mmHg > Umbilical Vein Po2 30mmHg

B. Correct. Umbilical Vein PO2 30mmHg > Umbilical Artery PO2 20mmHg

C. Incorrect - Foetal Haemoglobin has an increased affinity for O2 (compared with HbA) which assists with the loading of O2 at a reduced pO2 - L shift of ODC.

D. Incorrect - In the adult circulation, where the circulatory system is in series and there are no shunts, the stroke volume of the RV should equal that of the LV and cardiac output can be defined in terms of the volume of blood ejected by one ventricle in 1 min. In the fetus, as a result of intracardiac and extracardiac shunting, the stroke volume of the fetal LV is not equal to the stroke volume of the RV. The RV receives about 65% of the venous return and the LV about 35%. Thus, in the shunt dependent circulation of the fetus, the situation is much more complex and cardiac output must be defined in different terms.

The cardiac output of the fetus can only be spoken of in terms of the total output of both ventricles—the combined ventricular output (CVO).2 About 45% of the CVO is directed to the placental circulation with only 8% of CVO entering the pulmonary circulation.

E. Incorrect - About 45% of the CVO is directed to the placental circulation with only 8% of CVO entering the pulmonary circulation.
Alt version Jul03: Foetal circulation:

A. O2 tension (not saturation) of umbilical artery is lower than in maternal uterine vein.

B. Foetal haemoglobin has a lower affinity for O2 than which increases delivery to foetal tissues.

C. ?
A. Correct - The pO2 of the umbilical artery 20mmHg, pO2 maternal uterine vein 40mmHg

B. Incorrect - Foetal Haemoglobin has an increased affinity for O2 (compared with HbA) which assists with the loading of O2 at a reduced pO2 - L shift of ODC.
MF07 [e] Which of the following is immediately due to onset of ventilation in the newly born?

A. Increased left atrial pressure

B. Closure of ductus venosus

C. Decreased RV pressure

D. ?
ANSWER C

* Onset of ventilation in the neonate leads to increased blood flow through the lungs due to

1. A direct effect of outwards traction on the pulmonary vessels due to lung expansion, (decreased PVR related to lung vol, remember diagram in West) and
2. A(slightly later) effect of increased oxygenation causing pulmonary vascular dilation (loss of Hypoxic Pulmonary Vasoconstriction),

* Both these factors will cause a decrease in pulmonary vascular resistance and increased blood flow through the lungs. This will have the effect of

1. Decreasing right ventricular pressure due to decreased right ventricular afterload (option C), and
2. Increasing left atrial pressure due to increased blood flow from the pulmonary vasculature to the left atrium (option A)
MF07b [f] Which effect is due to spontaneous ventilation in neonate? (Or: The first breath in a neonate has a predominant role in:)

A. Decreasing RV outflow pressure

B. Closure of ductus venosus

C. Closure of foramen ovale

D. Increased systemic vascular resistance

E. Increased LV pressure
BEST ANSWER (MF07b) = A. The other things do happen, but C/D/E are more correctly attributed to the increased SVR. Ventilation directly causes decreased PVR and therefore lower RV pressure.
MF08 [gi] FRC in the neonate:

A. 1 ml/kg

B. 15 ml/kg

C. 30 ml/kg

D. 70 ml/kg
ANSWER C

At term, foetal lung contains ~20ml/kg of fluid

FRC rises rapidly at birth - 17ml/kg at 10 min

FRC increases to almost 30 ml/kg by 30-60 min
MF09 [g] Foetal circulation:

A. Inferior vena cava blood has high pO2 because of ductus venosus

B. Inferior vena cava blood enters the head via ductus arteriosus

C. ?
A. correct (ductus venosus PO2 is at foetal maximum of 30mmHg)

B. Incorrect. Ductus arteriosus connects pulmonary artery to aorta, therefore bypass lungs. It is irrelevant to brain circulation.
MF10 [hq] The reason for increased aortic pressure after birth:

A. Removal of placental circulation

B. Duct closure

C. Increased pulmonary flow

D. ?
ANSWER A

At birth, circulation changes from parallel system to a system in series. Consequence of resistance changes throughout neonate circulation Placenta provides low-resistance and is eliminated when cord is clamped. Results in

* increased systemic vascular resistance (->increased BP)
* increased LVEDP
* decreased RAP due reduced vena cavae flow

Lung expansion decreases PVR (removal of hypoxic vasoconstriction) along with increasing PaO2 , pH and decreasing PaCO2. The closure of the ductus arteriosus and the decreased PVR mean that the output of the right ventricle all passes through the lung. LAP increases due to increased pulmonary blood flow and increased LVEDP

Foramen ovale closes (functional) when LAP exceeds RAP. Permanent closure at 4-6/52 post birth

Ductus arteriosus constricts with increasing PaO2, closure of foramen ovale and decreasing concentrations of PGE1 and PGE2. Physiological closure: 10-15hours & Permanent closure: 2-3 weeks

Persisting foetal circulation may occur with hypoxia or acidosis.

Ductus venosus closes several hours post birth.
MF11 [i] Tidal volume of a neonate:

A. 1 ml/kg

B. 3 mls/kg

C. 7 mls/kg

D. 15 mls/kg

E. 30 mls/kg
ANSWER C

Tidal volume of neonates is 7mls/kg.
MF11b [j] Tidal volume in a 2.3kg neonate:

A. 4.6ml

B. 10ml

C. 15ml

D. 30ml

E. 45ml
ANSWER C

So TV in 2.3kg neonate = 7 x 2.3 = 16.1ml
MF11c [j] The FVC of a neonate weighing 2.3 kg is:

A. 100 ml

B. 150 ml

C. 200 ml

D. 250 ml

E. 300 ml
ANSWER B
MF12 The neonate has

A. Less plasma cholinesterase

B. Higher volume of distribution for neuromuscular blockers

C. Higher levels of alpha-1 acid glycoprotein

D. High levels of cytochrome P450 enzymes
A. Correct. The infant has half the cholinesterase activity of the older child or adult (however there is still adequate enzyme to metabolise the drug)

* (from Brandis course notes 2006, p 26)

B. Correct. Muscle relaxants are highly ionised, hence penetrate cell membranes poorly. They are virtually trapped in the ECF, so Vd correllates with ECF. ECF decreases with age.

* (from Brandis course notes 2006, p 25)

C. Incorrect. Less alpha 1 acid glycoprotein in the noenate

* (from Brandis course notes 2006, p 3)

D. Incorrect. Less CP450 in the newborn, rapid increase in first few weeks of life

* (from Brandis course notes 2006, p 6)
MF13 [j] Maternal-fetal ABO incompatibility is less common than Rhesus incompatibility because:

A. Fetal antibodies to ABO are less developed

B. Maternal ABO antibodies do not cross the placenta

C. Maternal ABO antigens do not cross the placenta

D. Fetal ABO antigens are less immunogenic
ANSWER B

ABO antibodies are IgG, therefore do not cross placenta
MF13 [j] Maternal-fetal ABO incompatibility is less common than Rhesus incompatibility because:

B: Maternal Ab’s rarely cross placenta

C: Foetal RBC’s rarely enter circulation

D: Foetus have immature ? Ab’s/Ag’s

E: Foetus have absent ?Ab’s/Ag’s
ANSWER B
MF14 [kq] With regard to the neonate

A. Static compliance is greater than adult values

B. Dynamic compliance is greater than adult values

C. Specific compliance is the same as adult values

D. Dynamic compliance is the same as adult values

E. Static compliance is the same as adult values.
Answer is C

* Static compliance is less than adult
* Dynamic compliance is less than adult

* Specific compliance =Compliance/FRC = 0.05 cmH2O-1 in both adult and neonatal lung.
Alt version: Comparing the neonate to adult lung

A. Dynamic compliance of the lung is more in the neonate

B. Dynamic compliance of the lung is the same in the neonate

C. Static compliance of the chest wall is more in the neonate

D. Static compliance of the of the lung is the same in the neonate

E. Specific static compliance is more in the neonate
ANSWER A
MF15 [l] (. .??. . paO2 in maternal uterine blood. . .) but foetus can maintain adequate O2 because:

A. Large placental surface area

B. Double Haldane effect

C. Foetal haemoglobin

D. ?

E. ?
ANSWER C
MF17 [mpq] Foetal haemoglobin:

A. All is in the form of HbF

B. HbO2 dissociation curve is shifted to the left

C. ?

D. ?

E. ?
ANSWER B
MF18 [op] The Thermoneutral Zone is best correlated with:

A. Core temp with no energy consumption

B. Ambient temp in which core temp can be maintained without sweating.

C. Peripheral temperature at which.. ? . . . .

D. Core temperature at which... ? . . . .

E. ?
ANSWER B

The Thermoneutral Zone is the range of ENVIRONMENTAL temperatures over which metabolic heat production is minimal (minimal O2 consumption) and thermoregulation is maintained by vasomotor activity. (Power & Kam, p376)

* Term neonates: 32-34 deg celsius.
* Adults 25-30 deg celsius.
* Preterm babies need higher range due to higher evaporative heat losses.
NZ01 [1987]
In the foetus:
A. The umbilical arteries come off the aorta
B. The ductus venosus passes from the portal vein to the IVC
C. The ductus arteriosus bypasses the liver
D. The cord contains two veins and one artery
All wrong

A : umbilical arteries come off internal ilaic artery x2

B: Umbilical vein drain into left hepatic artery and DV (straight to IVC)

C: DA shunt from pulmonary artery to descending aorta

D : 2 arteries and 1 vein
PH05 [1986] [1987]
Normal maternal blood gases:
A. pH 7.4
B. Bicarbonate 31mmol/l
C. pCO2 50mmHg
D. Metabolic alkalosis
E. None of the above
Answer A

* A. True: as stated in the Physiology Viva Book the arterial pH is normal at term. This is the one example of complete compensation in normal physiology.
* B. False: the HCO3 is lowered
* C: False: pCO2 is ~32mmHg due to maternal hyperventilation
* D: False: respiratory alkalosis with (complete) metabolic compensation
PH06 [1988] [Mar92]
What is the main lung function derangement in pregnancy?
A. Decreased tidal volume
B. Decreased VC
C. Decreased FRC
D. Decreased airway resistance
E. ?
ANSWER C and D

The respiratory changes in pregnancy include:

* Increased Respiratory Rate 15%
* Decreased FRC 20% (decreased ERV & RV)
* Increased Tidal Volume 30-40%
* Increased Minute Volume 50%
* Increased Alveolar Ventilation 70%
* decreased ariway resistance
PH06b [Mar93]

Typical physiological changes in pregnancy at term, compared to the non-pregnant
state include a twenty percent
A. Increase in alveolar ventilation
B. Increase in tidal volume
C. Increase in vital capacity
D. Reduction in arterial pH
E. Reduction in functional residual capacity
ANSWER E

The respiratory changes in pregnancy include:

* Increased Respiratory Rate 15%
* Decreased FRC 20% (decreased ERV & RV)
* Increased Tidal Volume 30-40%
* Increased Minute Volume 50%
* Increased Alveolar Ventilation 70%
* decreased ariway resistance
PH11 [1988] [Aug91]

With which of the following vessels are the following results compatible?
pO2 15, SO2 26%, O2 5 vols%
A. Umbilical artery
B. Umbilical vein
C. Uterine vein
D. ?
Answer: A

* Umbilical artery: pH 7.21, p02 = 18, pCO2 = 55, Sa02 = 45%, Ca02 = lOmlldl
* Umbilical vein: pH 7.32, pO2 28, pC02 = 40, Sa02 = 70%, CaO2 = 16 mlldl
PH12 [1988] [Mar91] [Mar92]
In non-shivering thermogenesis:
A. Vessels and muscles of neck are involved
B. Perinephric & periadrenal fat
C. Interscapular mass
D. Gluteal muscles
ANSWER A
With respect to respiration in neonates (as compared to young adult): Which is true:
A. Diaphragmatic respiration
B. O2 consumption (mls/kg) x 3 times that of an adult
C Specific compliance much the same
D pO2 is 20 mmHg less than adult (on room air)
E Larger VD/VT ratio
F Lack of type I fibers
G Alveolar ventilation (mls/kg) roughly the same
H. Increased alveolar ventilation to FRC ration
ANSWER C and H

Lung Volumes/Capacities Neonate vs Adult in (mL/kg or mL/kg/min as appropriate)

* Lower
o TLC 60 vs 80

* "Low end of normal"
o FRC 30-35 vs 32-50

* Same
o Vt = 6.5
o Vd = 2.2

* Higher
o Vm = 220 vs 100
o Va = 140 vs 60
o Va/FRC ratio = 5:1 vs 1.5:1


O2 Consumption (mL/kg/min)

* around doubled
o 7-10 vs 3-4


Blood Gases on room air (mmHg)

* PO2 68 vs 98
* PCO2 34 vs 40
* pH "in normal range"

PO2 increases to adult levels over childhood, "much of it in the 1st year"

F :???
PH13b ANZCA version [2001-Apr] Q105

Pulmonary function values which are significantly different
between normal infants and normal adults include
1. tidal volume as ml.kg-1
2. tidal volume to FRC ratio
3. physiologic dead space to tidal volume ratio
4. O2 consumption as ml.kg-1.min-1
ANSWER 2 and 4

Lung Volumes/Capacities Neonate vs Adult in (mL/kg or mL/kg/min as appropriate)

* Lower
o TLC 60 vs 80

* "Low end of normal"
o FRC 30-35 vs 32-50

* Same
o Vt = 6.5
o Vd = 2.2

* Higher
o Vm = 220 vs 100
o Va = 140 vs 60
o Va/FRC ratio = 5:1 vs 1.5:1


O2 Consumption (mL/kg/min)

* around doubled
o 7-10 vs 3-4


Blood Gases on room air (mmHg)

* PO2 68 vs 98
* PCO2 34 vs 40
* pH "in normal range"

PO2 increases to adult levels over childhood, "much of it in the 1st year"
PH13c ANZCA version [2002-Aug] Q100, [2003-Apr] Q17

Compared to an adult, in the neonate:
A. FRC is a more efficient buffer to changes in partial pressures of inspired gases
B. closing volume in ml/kg is lower
C. oxygen consumption in ml/kg is similar
D. FRC in ml/kg is higher
E. the ratio of alveolar ventilation to FRC is higher
ANSWER E
PH14b ANZCA version [2001-Apr] Q134
In an infant
1. the chest wall is more compliant than in an adult
2. the diaphragm lacks type 1 muscle fibres
3. oxygen consumption (in ml.kg-1.min-1) is twice that of an adult
4. anatomical deadspace volume (in ml.kg-1) is larger than in an adult
ANSWER 1 and 3

1. True

2. False - There are fewer type I fibres, not a lack.

From Kam p359 "There are (also) fewer Type I muscle fibres in the diaphragm and intercostal muscles, hence these respiratory muscles fatigue easily."
From Miller p2369 "These muscles do not achieve the adult configuration of type I muscle fibers until the child is approximately 2 years old"

3. True - two to three times

4. False - relatively smaller
PH14a [1988] [Aug93] [Apr97] [Jul97] [Apr98] [Jul98] (type K)

Neonatal respiratory system different as:
1. Diaphragmatic breathing
2. Decreased type I fibres in diaphragm
3. Increased sensitivity to opioids
4. Sinusoidal breathing with no expiratory pause
5. Increased chest compliance
* 1. A - True. "The respiration is irregular and mainly diaphragmatic." Power & Kam. p 360.
* 2. B - True. "There are also fewer Type I muscle fibres (slow contracting and highly oxidative fibres used for sustained contractions) in the diaphragm and intercostal muscles and hence these respiratory muscles fatigue easily." Power & Kam. p 359-360.
* 3. C - True. "Yet, the fact that apparent toxicity occurred with a maternal dose as low as 0.63 mg/kg/day of codeine should serve as a reminder that the higher sensitivity of neonates to the CNS-depressing effects of opioids may put some infants at risk even with an apparently small maternal dose." Pharmacogenetics of Neonatal Opioid Toxicity Following Maternal Use of Codeine During Breastfeeding: A Case–Control Study. Clinical Pharmacology & Therapeutics (2008); 85, 1, 31–35 doi:10.1038/clpt.2008.157.
* 4. D - True. "The respiratory pattern is sinusoidal with no expiratory pause seen." Asian Intensive Care: problems & solutions.
* 5. E - ? True "Lung compliance increases during the first few hours after birth. Specific compliance is similar in the neonate, infant and adult. The chest wall is very compliant because of the soft rib cage of the infant." Power & Kam. p 360.
PH15 [1988] [Mar91] [Aug91] [Aug93]
Neonates:
A. Oxygen stored in brown fat
B. Baroreceptors are more sensitive than in an adult
C. Cardiac output same as adult on a weight basis
D. Heart has less compliance than adult
ANSWER D

Baroreceptors In infants: Baroreceptor responsiveness increase with post menstrual age in neonates and pre-term infants.
PH21a Pregnancy:

A. Decreased FRC

B. Increased alveolar ventilation

C. Increased AP and transverse diameters of chest expansion on inspiration

D. Diaphragm up 4 cms

E. All of the above
ANSWER E
PH21b ANZCA version [2004-Aug] Q48

Typical physiological changes in pregnancy at term, compared to the non-pregnant state include a twenty percent
A. increase in alveolar ventilation
B. increase in tidal volume
C. increase in vital capacity
D. reduction in arterial pH
E. reduction in functional residual capacity
ANSWER E

A-increase by 70% B-increase by 40% C-unchanged D-unchanged
PH21c [Mar91]
Physiological changes of pregnancy include:
A. Increased O2 consumption by 40% ( ? 20% )
B. Increased alveolar ventilation by 40%
C. Increased circumference of thorax
D. Increased fibrinogen by 20%
E. Decreased expiratory reserve volume
ANSWER C

A-increase by 60%
B-increase by 70%
C-true
D-
E-increase by 20%
PH21d [Mar92]

Pregnancy, which is FALSE
A. Oxygen dissociation curve shifted to right
B. Decreased red cell mass
C. C.O. max in third stage
D. Decreased SVR
E. Increased 2,3 DPG in maternal red cells
ANSWER B
PH21e ANZCA version [2001-Aug] Q135

Respiratory changes associated with full-term pregnancy include
1. reduction in functional residual capacity
2. reduction in arterial carbon dioxide
3. increased alveolar-arterial oxygen gradient
4. rightward shift of the P50 of the oxygen-haemoglobin dissociation curve
ALL CORRECT
PH24

Neonates have higher respiratory rates than adults because of:

A. Increased airway resistance

B. Decreased thoracic compliance

C. Immature chemoreceptors

D. Non-respiratory acidosis
ANSWER A

Nunn figure 6.11
PH30 [Mar92]
Brown fat stores involve all of these EXCEPT:
A. Between scapula
B. Peri-nephric & around adrenals
C. Gluteal region
D. Involves muscles & blood vessels of neck
E. Around great vessels in root of neck / thoracic inlet
ANSWER C
PH32 [Mar93]
The lower limit of normal blood glucose concentration (mmol/l) in an infant more than 3 days old is:
A. 4.3 mmol/l
B. 3.2
C. 2.2
D. 1.1
ANSWER D

Premature 20–60 1.1–3.3

Neonate 30–60 1.7–3.3
PH33 [Mar93] [Aug99]

The normal Hb (gm/dl) for age during infancy is:

A. 16 at 3 months

B. 12 at 3 months

C. 11 at 12 months

D. 10 at 8 months

E. 9 at 4 months
ANSWER B

Infant

* Term (cord blood) 135-195 g/L
* 3-6 months 95-135 g/L

Child

* 1 year 105-135 g/L
* 3-6 years 105-140 g/L
* 10-12 years 115-145 g/L
PH54 ANZCA version [2003-Apr] Q147
The partial pressure of oxygen in the blood of the fetal umbilical vein is
A. 27 mmHg
B. 33 mmHg
C. 40 mmHg
D. 45 mmHg
E. 70 mmHg
ANSWER B
PH55 ANZCA version [2003-Aug] Q122
The oxygen saturation of fetal haemoglobin in the fetal umbilical vein is
A. 50%
B. 60%
C. 70%
D. 80%
E. 90%
ANSWER D
PH59 [Jul06]
Normal values for pregnant woman:
A. Base excess +5mmol/L
B. pH = 7.4
C. Increased FRC
D. pCO2 = 45mmHg
E.
ANSWER B
Can04-4 Gastric motility and risk of regurgitation returns to normal in the pregnant female

A. 1-3 days postpartum

B. 10-14 days post partum

C. 3-6 weeks post partum

D. greater than 6 weeks

E. with involution of the uterus
ANSWER A

Within 18hours post partum
Can04-28 Which coagulation factor decreases during pregnancy?

A. Factor I

B. Factor VII

C. Factor VIII

D. Factor IX

E. Factor XIII
ANSWER E by exclusion

Factor I, VII, VIII, IX, X and fibrinogen increase

ATIII, protein C and S stay the same

Factor XI falls
Concerning the foetal circulation

a) It is possible for vena caval blood to each the aorta without going through the left ventricle or left atrium

b) The pO2 in the descending aorta is less than in the ductus arteriosus

c) The foramen ovale closes at birth because of increased left atrial pressure

d) At birth flow in the ductus arteriosus reverses because of decreased pulmonary resistance

e) Umbilical arterial blood has a higher PO2 than umbilical venous blood
ANSWER A

B : false well oxygenated blood from LV which perfuses the head and upper body continues and mixes with deoxygenated shunt blood through DA

C: partially true

D: false

E : false