Approach to complications of prematurity (late) Quiz: Ace Your Exams
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A 6-week-old boy is evaluated in the Neonatal Intensive Care Unit (NICU) for arm swelling noted by nursing staff. The infant was delivered at 27 weeks’ gestation due to preterm labor and was stabilized after immediate resuscitation. Birth weight was 970 grams. The hospital course is complicated by respiratory distress syndrome and a patent ductus arteriosus (PDA) that was treated surgically. Temperature is 37°C (98.6°F), pulse is 135/min, respirations are 40/min, blood pressure is 50/32 mm Hg, and oxygen saturation is 98% on nasal cannula with 25% FiO2. On physical examination, the left upper arm is swollen and tender to touch. Cardiopulmonary and abdominal exams are unremarkable. Alkaline phosphatase is 1057 U/L, and phosphorus is 1.8 mg/dL. A radiograph of the arm reveals an oblique fracture of the shaft of the left humerus. Which of the following is the most probable cause of this patient’s fracture?
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