Thu7October1249PM 2

A patent ductus arteriosus (PDA) in a newborn infant:

True / False

Should be suspected when the femoral pulses are weak or impalpable Correct

Closure of the duct may be achieved using an prostaglandin infusion Correct

Causes a wide pulse pressure Incorrect answer selected

Cyanosis is an early presentation Correct

Is commonly encountered in very low birthweight infants Correct

Explanation

The ductus arteriosus (PDA) is normally functionally closed by 12 to 24 hours of age in healthy, full-term newborns. However, permanent (anatomic) closure is usually complete within 2 to 3 weeks. The murmur of a PDA is typically a continuous, "machinery" murmur below the clavicle, radiating to the back.

Patent ductus arteriosus (PDA) is frequent in very low birthweight and premature babies and causes a wide pulse pressure (>30mmHg) due to a combination of a mild increase in systolic blood pressure to overcome the decrease in distal blood flow due to run-off through the PDA during diastole and a lower diastolic blood pressure from the run-off. .

Initially a left-to right shunt exists but longstanding effects on the pulmonary circulation may lead to Eisenmengers syndrome.

Weak femoral pulses suggest aortic coarctation.

An infusion of a prostaglandin is used to maintain ductal patency, whereas drugs that inhibit cyclo-oxygenase will cause closure of the duct. Pharmacological treatments to encourage closure include, paracetamol or indomethacin and ibuprofen.

Answer Statistics

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Average score: 70.00%

Times answered: 276