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OS 213 Respiratory EXAM 1 > Approach to Neonate with Respiratory Distress > Flashcards

Approach to Neonate with Respiratory Distress Flashcards

1
Q

Manifestation of neonatal respiratory distress

A

Tachypnea

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2
Q

Neonatal tachypnea

A

> 60 breaths/min

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3
Q

T of F the presence of cyanosis necessarily means the newborn is respiratory distress

A

F

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4
Q

Cessation of breathing for 20 seconds

A

Apnea

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5
Q

Motor responses can be monitored and evaluated by measuring

A

EMG activity, intrathoracic pressure and lung function parameter

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6
Q

Sensors of thoracic expansion and alveolar respiration

A

J-receptors, irritant receptors and stretch reeptors

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7
Q

How can the baby conserve oxygen and energy

A

by not moving and not breathing

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8
Q

Best strategy to control hypoxemia in utero

A

APNEA

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9
Q

volume inspired above the tidal volume

A

Inspiratory reserve volume

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10
Q

Volume of a normal breath

A

TIDAL volume

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11
Q

Volume expired after expiration of tidal volume

A

ERV

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12
Q

volume that remains after the maximal expiration

A

Residual volume

FRC-ERV

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13
Q

volume expired after maximal inspiration

A

Vital capacity

TLC-RV

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14
Q

volume that lung can maximally hold

A

TLC
TLC= TV+ERV +RV

200ml in newborn

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15
Q

The tidal volume only uses __% or less of our TLC

A

10%

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16
Q

Tidal volume can increase by?

A

modifying insoiratory and expiratory

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17
Q

Ventilatory strategy of transient tachypnea

A

Increase frequency of breathing

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18
Q

Suprasternal retractions and head bobbing

A

Recruit more alveoli by increasing the use of accessory muscles

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19
Q

STrategy to recruit more functional respiratory units from ERV

A

Using inspiratory musles of laryngeal narrowing during expiration

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20
Q

Due to poor compliance and attempt to improve oxygenation

A

Grunting

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21
Q

only age group that exhibits grunting

A

Newborns

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22
Q

Involves closing glottis to keep the lungs a little inflated

A

Grunting

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23
Q

Observe in conditions with obstruction of airways and in most aspiration syndromes

A

Changing the size of alveolar gas reserve

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24
Q

Cardiac causes of respiratory distress

A

Left to right shunt
Congestive cardiac faiure
Obstruction to pulmonary Venous Flow

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25
Q

Neurologic causes of respiratory distress

A

Post asphyxia state
Subarachnoid hemorrhage
Infections

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26
Q

Metabolic causes of respiratory distress

A 
Metabolic acidosis
Sepsis
Hyperthermia/hypothermia
Narcotic withdrawal
Drugs
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27
Q

Fastest way to correct acidosis

A

blowing off CO2 rapidly

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28
Q

Pulmonary (Mechanical) causes

A 
Ribcage anomalies
Pneumothorax
Pneumomediastinum
Pleural effusion
Chylothorax
severe abdmonal distension
29
Q

Pulmonary (Developmental) causes

A 
TEF
CCAM
CDH
sequestration 
Pulmonary hypoplasia
lobar emphysema
congenital lung cyst
30
Q

Pulmonary (Airway abonarmalities)

A 
Chonal stenosis, atresia
Laryngeal web
Laryngotracheomalacia
Bronchomalacia
Subglottic stenosis
31
Q

Pulmonary (Parenchymal) causes

A 
Transient tachypnea of the newborn
Hyaline membrane disease
Pulmonary edema
Aspiration syndromes
Pneumonia
pulmonary hemorrhage
32
Q

Persistent Pulmonary Hypertension of the newborn

A

Vascular disease - not parenchymal

pulmonary vascular disease -> increased pulmonary vascular resistance

33
Q

Also known as Respiratory distress syndrome Type I

A

Hyaline Membrane disease (developmental disorder)

34
Q

conditions than can cause an even lower production of surfactant in an effort to decrease metabolic demand

A

Hypoxemia and hypercarbia

35
Q

Deficiency of surfactant

A 
Decrease FRC
Atelectasis
Increased R to L shunt
Increased work of breathing
V/Q mismatch`
36
Q

collapse of an expanded lung especially in infants which is also a failure ofpulmonary alveolu to expand at birth

A

Atelectasis

37
Q

Increases R toL shunt because of pulmonary hypoperfusion

A

Atelectasis

38
Q

Potent vasodilators

A

high pH and low Co2 conditions

39
Q

Increased pressure due to vasoconstriction and may lead to capillary endothelial damage

A

Pulmonary hypertension

40
Q

composed of a high molecular weight proteinaceous substance

A

Hyaline membranes

41
Q

May cause the development of bronchopulmonary dysplasia

A

hyaline membrane

42
Q

Progressive atelectasis leads to worsening in the first ____hours

A

24 -28 hours

43
Q

End result of HMD

A

Capillary damage

Alveolar necrosis

44
Q

Radiologic findings of HMD

A

Reticulo-granular pattern
Severe white lungs - semisolid
Steepled appearance - some alveoli have air in it

45
Q

bronchi visible as black lines

A

Air bronchogram sign

46
Q

manangement of HMD

A

Continuous positive airway pressure

Surfactant replacement therapy

47
Q

How do you give surfactant to a baby who is not intubated>

A

INSURE PROCEDURE

48
Q

Dosage for surfactant administration intrathecally

A

4 cc/kg (1cc/kg/quadrant)

49
Q

How do the surfactant enter the 4lung quadrants

A

Use gravity

50
Q

Also called respiratory distress syndrome type II

A

Transient tachypne of the newborn TTN

51
Q

Most common cause of respiratory distress in newborns

A

Transient tachypnea of the newborn

52
Q

Main pathology of the TTN

A

Delay in the resorption of fetal lung field

53
Q

Rate of production of fetal lung fluid

A

20 ml/kg of fluid in the fetal lungs

54
Q

What happens during labor?

A

there is plenty of beta adrenergic stimulation -> there is cessation of fetal lung fluid production

55
Q

How many fluid is removed during labor

A

2/3

56
Q

How many fluid is removed during baby’s first breath

A

1/3

57
Q

Fluid resorption begins with

A

child’s first breath

58
Q

Radiographic findings of TTN

A

Streaky linear hilar densities

59
Q

Management of TTN

A

self limiting disease and is managed conservatively with supportive care

Fluid electrolytes thermoregulati
Oxygen if needed

60
Q

Representative of all aspiration syndromes

A

Meconium Aspiration Syndrome

61
Q

MAS is non existent among

A

Preterm neonates

62
Q

MAS may result in

A

severe hypoxemia, acidosis, and respiratory failure

63
Q

Air leak syndromesL Allows air to enter but not exit

A

Ball Valve Effect

64
Q

Radiographic findings of MAS

A

cotton wool-like fluffy infiltrates or densities

65
Q

Classification of PPHN

A

PPHN associated with pulmonary parenchymal disease

PPHN with radiographically normal lungs and no evidence of parenchymal disease

PPHN associated with hypoplasia of the lungs

66
Q

Radiographic findings of PPHN

A

No vascular markings are observed because the vessels are constricted(oligemic x-ray)

67
Q

Manangement of PPHN

A

Vasodilators

68
Q

How to rule out pulmonary atresia

A

Passage of catheter through the nares

OS 213 Respiratory EXAM 1 (19 decks)

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