Arab Board Pediatrics Final Written

Practice session

A preterm male infant born at 29 weeks of gestation develops expiratory grunting, nasal flaring, and prominent intercostal retractions within 30 minutes of birth. Arterial blood gas shows pH 7.22, PaCO2 58 mmHg, PaO2 48 mmHg, and HCO3 22 mmol/L on continuous positive airway pressure (CPAP) of 6 cmH2O and FiO2 0.45. Chest radiography reveals diffuse reticulogranular ground-glass opacities with air bronchograms and low lung volumes. What is the definitive initial therapy?

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