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Old 09-10-2011
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Default Best next step in PDA newborn

A 2 day old full term male infant is noted to have a systolic and diastolic continuous murmur at the right upper sternal border. His vital signs are normal and he is overall doing well. Which of the following interventions should be done at this time?

A) Administration of a diuretic
B) Administration of indomethacin
C) Surgical ligation
D) Observation
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I would go with B.
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Old 09-11-2011
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B) Administration of Indomethacin
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its C surgical ligation
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B.
indomethacin helps closure of pda....
it is left patent in case of transposition of great vessels
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Old 09-11-2011
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B.adm indomethacin
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B) Administration of indomethacin
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Old 09-11-2011
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Correct Answer Correct answer

Answer: D - observation
This infant has a patent ductus arteriosus (PDA) which is a communication between the pulmonary artery and the aorta. Since the blood pressure in the aorta is always higher than that in the pulmonary artery (in both systole and diastole), blood is continuously flowing from left (aorta) to right (pulmonary artery) causing a continuous murmur. Most PDAs will close spontaneously within weeks to months and no intervention is needed. If symptoms are present, a diuretic (A) or indomethacin (B) can be given to close the PDA. Indomethacin, a nonsteroidal anti-inflammatory drug, blocks the production of prostaglandins which are needed to keep the PDA open.*
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Old 09-11-2011
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Quote:
Originally Posted by alaahoda2001 View Post
Answer: D - observation
This infant has a patent ductus arteriosus (PDA) which is a communication between the pulmonary artery and the aorta. Since the blood pressure in the aorta is always higher than that in the pulmonary artery (in both systole and diastole), blood is continuously flowing from left (aorta) to right (pulmonary artery) causing a continuous murmur. Most PDAs will close spontaneously within weeks to months and no intervention is needed. If symptoms are present, a diuretic (A) or indomethacin (B) can be given to close the PDA. Indomethacin, a nonsteroidal anti-inflammatory drug, blocks the production of prostaglandins which are needed to keep the PDA open.*
The physiological closure occurs within 24 hours and anatomical within 2 -3 weeks in PRETERM.
But its A full term baby so shouldnt we consider surgical intervention.
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