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Fetal Lung Maturity - Antenatal corticosteroid

By AdminPosted On 05-Oct-2016


1. Surface Tension in Alveoli

Which of the following cells are responsible for producing a substance that reduces surface tension in the alveoli?


a) Clara cells

b) Macrophages

c) Smooth muscle cells

d) Type I pneumocytes

e) Type II pneumocytes

Correct Answer: e) Type II pneumocytes are responsible for the production and secretion of surfactant, that reduce the alveolar surface tension. Release of surfactant occurs from an infant’s first breath onwards. Type I pneumocyte cells line the alveolar surfaces of the lungs. They cover 97% of the alveolar surface, with type II pneumocytes covering the remainder. Their main role is to provide a barrier of minimal thickness that is readily permeable to gases such as oxygen and carbon dioxide.


2. Antenatal corticosteroid treatment can be administered upto

a) 31+6 weeks

b) 32+6 weeks

c) 33+6 weeks

d) 34+6 weeks

e) 35+6 weeks


Correct Answer: d) 34+6 weeks. For those who are at risk of preterm birth (ACOG/ RCOG/ WHO). For babies born after 36 weeks there was a trend to increase combined fetal and neonatal death (WHO).


3. Betamethasone is the steroid of choice for fetal lung maturity because

a) Decreased risk of cystic periventricular leukomalacia compared to Dexa

b) Course is completed earlier than Dexa

c) Less costly compared to Dexa

d) Betamethasone is more effective in reducing RDS

e) Betamethasone is easily available drug compared to Dexa


Correct Answer: a, b, d. Betamethasone dose is 12 mg I/M and repeat after 24 hrs. Dexa dose is 6mg I/M every 12 hrly x 4 doses (36 hrs total). Beta is more costly and is not easily available drug compared to Dexa.


4. Antenatal Corticosteroid

Antenatal corticosteroid (ACS) are known to produce hyperglycemia. A course of ACS is indicated in pregnant women with pregestational or gestational diabetes at risk of preterm delivery.


a) True

b) False


Correct Answer: a) Yes. A course of ACS is indicated in pregnant women with pregestational or gestational diabetes at risk of preterm delivery. Close monitoring and treatment by an experienced obstetrical team is essential to guarantee diabetic control and avoid the possibility of severe transient hyperglycemia. The steroid effect begins approximately 12 h after the first dose and lasts for five days.


5. Surfactant (Select False)

a) Prevents alveoli collapsing as lung volume decreases

b) Is produced by type II pneumocytes

c) Contains phosphatidyl choline

d) Is reduced in the infant respiratory distress syndrome

e) Increases surface tension


Correct Answer: e) is false. Surfactants are compounds that lower the surface tension (or interfacial tension) between two liquids or between a liquid and a solid.


6. Prophylactic Surfactant

With regard to prophylactic surfactant (given within 15 min of birth) administered to intubated infants born

a) There is a decreased incidence of PDA

b) There is an increased incidence of bronchopulmonary dysplasia or death.

c) There is a decreased incidence of pneumothorax.

d) There is an increased incidence of pulmonary interstitial emphysema.

e) There is increased mortality.


Correct Answer: c) Prophylactic intratracheal administration of natural surfactant to intubated infants


7. In lung surfactants all are true EXCEPT

a) Are produced by type I pneumocytes.

b) Production is accelerated by glucocoticid hormones.

c) Help to prevent pulmonary edema.

d) Contain up to 8% proteins.

e) May be deficient in cases of adult respiratory distress syndrome.


Correct Answer: a) Are produced by type I pneumocytes is FALSE. Type II pneumocytes are responsible for the production and secretion of surfactant, that reduce the alveolar surface tension.

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