DCH(SA) Practice Questions - Diploma In Child Health Of The College Of Paediatricians Of South Africa Exam

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A preterm infant born at 29 weeks gestation develops grunting, intercostal recessions, and cyanosis shortly after birth. Chest radiography reveals a diffuse ground-glass appearance with air bronchograms. What is the initial respiratory management strategy according to SA neonatal guidelines?

Immediate mechanical ventilation with high-frequency oscillatory ventilation (HFOV) Elective endotracheal intubation followed by prophylactic surfactant administration within 10 minutes High-flow nasal cannula at 1 L/min with empiric IV Dexamethasone Nasal CPAP (5-6 cmH2O) with targeted oxygen therapy, reserving exogenous surfactant for persistent FiO2 requirement >0.30

Correct Answer:

Nasal CPAP (5-6 cmH2O) with targeted oxygen therapy, reserving exogenous surfactant for persistent FiO2 requirement >0.30

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