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Neonatal Respiratory Distress Syndrome (RDS) / Hyaline Membrane Disease
Classic features in a preterm neonate (34 weeks):
- Grunting (auto-PEEP to prevent alveolar collapse)
- Subcostal/intercostal retractions
- Central cyanosis
- Ground glass appearance + air bronchograms on CXR
Pathophysiology:
\[\downarrow \text{Surfactant} \Rightarrow \uparrow \text{Alveolar surface tension} \Rightarrow \text{Alveolar collapse (atelectasis)} \Rightarrow \text{V/Q mismatch} \Rightarrow \text{Hypoxia}\]
Treatment:
- Surfactant replacement therapy (Poractant alfa / Beractant) via ETT β single or multiple doses
- Respiratory support: nCPAP (preferred if breathing spontaneously) or mechanical ventilation
- Oxygen to maintain SpOβ \(91{-}95\%\) (avoid hyperoxia β risk of ROP)
- Caffeine citrate (reduces apnea of prematurity)
Prevention (antenatal): Betamethasone \(12\,\text{mg}\) IM Γ 2 doses (24 hr apart) given to mother before 34 weeks delivery β accelerates fetal surfactant production.
A suspense account was opened after a trial balance failed to agree. Errors found:
- Sales invoice for $1,240 completely omitted.
- Purchases entered as $85,600 instead of $87,580.
- Rent paid $2,600 posted as $6,200 in rent account.
What was the original balance on the suspense account?
Option A ($1,620 credit) is correct.
Only one-sided errors affect the suspense account:
- Error 1 (complete omission): Does NOT affect suspense.
- Error 2: Purchases understated by $1,980 → Debit Purchases, Credit Suspense $1,980.
- Error 3: Rent overposted by $3,600 → Debit Suspense, Credit Rent $3,600.
Net: Dr $3,600 − Cr $1,980 = Dr $1,620 needed → original balance was $1,620 credit.
This two-blank sentence requires logical consistency between both answers.
Blank (i): The second clause tells us that “high” artists ceded (gave up) the depiction of everyday objects to commercial artists. This implies that depicting ordinary things was not part of serious American art. So Blank (i) = missing from.
- “Valued in” or “crucial to” would directly contradict the idea that high artists abandoned this type of depiction.
Blank (ii): The artists surrendered the depiction of objects from everyday life — these are ordinary and unremarkable objects, i.e., commonplace.
- “Beautiful” or “complex” do not match the subject of “everyday objects.”
Correct Answers: Blank (i) = A (missing from), Blank (ii) = E (commonplace).
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