08b: Pediatric Pathology, Risk/Benefit Flashcards
“Prematurity” is gestational age under (X) weeks and weight under (Y) grams/lb.
X = 37 Y = 2500 grams (5.5 lbs)
T/F: Prematurity is the most common cause of neonatal mortality.
False - congenital anomalies are most common (prematurity is second)
Which organ systems are most affected by prematurity?
Neuro, GI, Resp
T/F: Twin pregnancy (multiple gestation) is risk factor for prematurity.
True
Vaginal delivery provides compression on baby’s chest. Why would this be a good thing, especially to prevent (X)?
X = neonatal respiratory distress syndrome
Physical stress increases glucocorticoids (to allow surfactant development)
Maternal medical history of (X) increases risk of neonatal RDS due to (high/low) levels of fetal (Y).
X = diabetes
High
Y = insulin
List treatment options for neonatal RDS.
- (Before birth) Maternal steroids
- Artificial surfactant
- Mechanical ventilation
- O2 supplementation
List some complications of oxygen therapy.
(RIB acronym)
- Retrolental Fibroplasia
- Intraventricular hemorrhage
- Bronchopulmonary Dysplasia (BPD)***
Clinical presentation of necrotizing enterocolitis:
- Abdominal distension
- Absent bowel sounds
- Bloody stools
- Possible perforation (air in abdomen)
Predisposing factors for intraventricular hemorrhage in infant.
- Prematurity
- Hypoxia
- Breech (butt first) delivery
Clinical symptoms of intraventricular hemorrhage in infant.
- Apnea
- Lethargy
- Poor muscle tone
- Seizures
T/F: Autopsy usually provides clear cause of death in SIDS.
False
T/F: CF is the most common lethal genetic disease that affects Caucasians.
True
CF primary defect is abnormal function of (X) channel on (Y) chromosome. What’s the most common mutation among Caucasians?
X = epithelial Cl (CFTR) Y = 7
DeltaF(508)
Meconium Ileus is a condition common in (X) disease. Briefly describe this condition.
X = CF
Thick, sticky meconium blocks ileus
CF patients likely have which vitamin/mineral deficiencies?
Fat-soluble vitamins (ADEK)
Microscopically, Bronchopulmonary Dysplasia (BPD) shows (collapsed/dilated) alveoli, airway (hypo/hyper)-plasia, alveolar wall (thinning/thickening) and (presence/absence) of fibrosis.
Dilated;
Hyperplasia (and squamous metaplasia)
Thickening;
Presence
The major abnormality in Bronchopulmonary Dysplasia (BPD) is:
Alveolar hypoplasia (decrease number of alveoli)
Microscopically, Neonatal RDS shows (collapsed/dilated) alveoli and (X)-rich (Y) in the alveolar spaces.
Collapsed;
X = protein/fibrin
Y = exudate
Among environmental factors, which are the most important modifiable risk factors for
SIDS?
- Sleeping prone and on soft surfaces
2. Thermal stress
List the two most common causes of infant sudden “unexpected” death.
- Infection
2. Unsuspected congenital anomalies
List two advantages of RCTs.
- Estimate absolute and relative risk
2. Determine causality
List two disadvantages of RCTs.
- Expensive
2. Not feasible for low-incidence outcomes
T/F: Generalizability of findings is not a limitation of RCTs.
False
Relative risk equation for groups p1 v p2. And absolute risk reduction?
RR: p1/p2
Absolute risk reduction equation for groups p1 v p2. And NNT (number needed to treat) equation?
ARR: p1-p2
NNT: 1/ARR
T/F: In case-control studies, it isn’t possible to determine absolute risk.
True
Drug is given to those at higher risk of outcome, so it appears that drug causes that outcome. What kind of bias?
Indication bias
Case-control study: if (X) group much larger than (Y) group, the odds ratio can be an approximation of (Z).
X = control (no effect) Y = case (effect) Z = RR
Which cytokine do (X) leukocytes produce to kill multicellular parasites?
X = eosinophils
Major Basic Protein
Eosinophilia can result from which condition(s)?
(NAAACP acronym)
- Neoplasm
- Allergic diseases
- Asthma
- Addison’s
- Collagen Vascular Disease
- Parasites
Eosinophilic Granulomatosis with Polyangiitis: 95% of the time starts with (X) condition. The disease is essentially inflammation of (Y).
X = asthma Y = small and medium-sized arteries (vasculitis)
Eosinophilic Granulomatosis with Polyangiitis: positive lab results for (X) Ab.
X = P-ANCA (anti-neutrophil cytoplasmic Ab)
Eosinophilic Granulomatosis with Polyangiitis: treatment options include…
- Corticosteroids (low-dose for life)
2. Cyclophosphamide
Cyclophosphamide is primarily a(n) (X) agent with (Y) properties that allow its use for Eosinophilic Granulomatosis with Polyangiitis.
X = anti-neoplastic Y = immunosuppressive
Cyclophosphamide must be activated to (X) by (Y) enzyme.
X = 4-hydroxy-cyclophosphamide Y = liver cytochrome p450
T/F: Cyclophosphamide has wide utility (multiple cancers and for immunosuppressive effects).
True
