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Old 09-09-2012
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Arrow Gyrus Daily Questions; Pediatrics #32

A full-term newborn infant is having episodes of cyanosis and apnea, which are worse when he is attempting to feed, but he seems better when he is crying. The most important next step to quickly establish the diagnosis is

a. Echocardiogram
b. Ventilation perfusion scan
c. Passage of catheter into nose
d. Hemoglobin electrophoresis
e. Bronchoscopic evaluation of palate and larynx
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Old 09-09-2012
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I say C...
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choanal atresia......C
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Old 09-09-2012
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Yes correct..

The answer is c. It is important to make the diagnosis of choanal atresia quickly because it responds to treatment but can be lethal if unrecognized and untreated. Most neonates are obligate nose breathers because they cannot breathe adequately through their mouths. Infants with choanal atresia have increased breathing difficulty during feeding and sleeping and improved respirations when crying. A variety of temporizing measures to maintain an open airway have been used, including oropharyngeal airways, positioning, tongue fixation, and endotracheal intubation, but surgical correction with placement of nasal tubes is most effective. The diagnosis can be made by failure to pass a catheter through the nose to the pharynx
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