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Egans 11th > Chapter 34 Neo/ped Disorders > Flashcards

Chapter 34 Neo/ped Disorders Flashcards

1
Q

How to differentiate ttnb and rds

A

Rds is in preemies, ttnb is in term

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2
Q

Patho of rds

A

Decreased surfactant causes atelectasis, v/q mismatch and increased work of breathing.

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3
Q

What happens to ABGs during rds

A

Acidosis

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4
Q

Hypoxemia and acidosis cause increased or decreased pvr?

A

Increased

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5
Q

Signs of rds

A 
Tachypnea
Retractions 
Paradoxical breathing
Grunting
Nasal flaring
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6
Q

Breath sounds with rds are

A

Fine inspiratory crackles

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7
Q

How is rds diagnosed

A

Cxr with diffuse infiltrates, air bronchograms and low lung volumes

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8
Q

Treatment for rds

A

Cpap
Surfactant
Hfo

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9
Q

What causes ttnb

A

Delayed absorption of fetal lung fluid

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10
Q

Pathophysiology of ttnb

A

Increased lung fluid causes decreased compliance. This can cause air trapping in some areas and hyperinflation in others

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11
Q

Increased risk for ttnb

A

Cold c sections and prolonged labour

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12
Q

Chest X-ray with ttnb

A

Perihilar streaking

Pleural effusions in costophrenic angles and fissures

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13
Q

Treatment for ttnb

A

Cpap and frequent position changes

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14
Q

Amniotic fluid consists of?

A

Fetal lung fluid, urine and transudate from uterine wall

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15
Q

What is meconium

A

Thick, sticky substance contained in the fetal bowel

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16
Q

What increases risk of mas?

A

Post term delivery

Lack of oxygen in utero

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17
Q

What are the three primary problems with mas

A

Pulmonary obstruction
Lung tissue damage
Pulmonary hypertension

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18
Q

Ball valve obstruction means

A

Gas can enter but not exit

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19
Q

Type of obstruction that occurs with mas is

A

Ball valve obstruction

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20
Q

What are common complications with mas

A

Pphn and right to left shunting

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21
Q

Signs of mas

A

Fetal tachycardia
Presence of meconium in amniotic fluid
Gasping respirations

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22
Q

Cxr with mas

A

Irregular densities with atelectasis and hyperinflation

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23
Q

ABG with mas will show

A

Hypoxemia and metabolic acidosis

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24
Q

Treatment for meconium

A

If vigorous. Warm dry and stim and suction

If not vigorous, intubate and suction ASAP

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25
Q

Bpd pathophysiology

A

Caused atelectrauma and volutrauma and exposure to high levels of oxygen

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26
Q

Chest X-ray with bpd shows

A

Atelectasis emphysema and fibrosis

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27
Q

Treatment of bpd

A

Preventing vili
Surfactant if needed
Lowest o2 levels required

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28
Q

What is apnea of prematurity

A

Periods of apnea that last longer than 15 seconds or occur with bradycardia or cyanosis

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29
Q

Cause of apnea of prematurity

A

Immature control of resp drive

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30
Q

Treatment of apnea of prematurity

A

Caffeine
Theophylline
Flow

31
Q

Causes of pphn

A

Oligohydraminos
Cdh
Lung Hypoplasia
Total anomalous venous return

32
Q

Treatmentfor pphn

A 
Treat cause 
Oxygen if caused by hypoxia 
Surfactant for rds 
Intubation and mv if needed 
Can consider ino and ecmo if severe
33
Q

What is laryngomalacia

A

Floppy larynx tissues that can cause partial obstruction of the airway

34
Q

What is tracheal malacia

A

Soft, floppy larynx tissues that can collapse and block the airway

35
Q

What is tracheal stenosis

A

Narrowing of the trachea

36
Q

How does tef present

A

Difficulty swallowing
Bubbling and frothing at the mouth
Choking during feeding

37
Q

What is the most common type of tef

A

Esophageal atresia with a distal fistula

38
Q

What is cdh

A

A hole in the diaphragm

39
Q

What does cdh frequently cause later in life

A

Scoliosis to side of cdh and severe gerd

40
Q

What are other neonatal problems with cdh

A 
Lung hypoplasia
decreased alveoli, 
decreased pulmonary vasculature 
Pulmonary hypertension 
Unusual anatomy of the inferior vena cava
41
Q

Signs and symptoms with cdh

A

Cyanosis
Scaphoid abdomen
Decreased breath sounds
Muffled heart sounds

42
Q

Treatment of cdh

A

Intubation
Attaching stomach to suction to allow adequate ventilation
Surgery at 7-10 days of life

43
Q

What is omphalocele

A

When the infants intestine is outside of the body surrounded in tissue similar to umbilical cord

44
Q

What is gastroschesis

A

When the bowel of an infant is outside the abdomen

45
Q

4 defects with tetralogy of fallout

A

pulmonary stenosis
Ventricular septal defect
Right ventricular hypertrophy
Overriding aorta

46
Q

Symptoms of tof

A

Heart murmur

Intermittent severe cyanotic spells

47
Q

What are cyanotic heart diseases

A

Transposition of the great arteries

Tetralogy of fallot

48
Q

How do you close a pda

A

Indomethacin
Ibuprofen
Oxygen

49
Q

How to keep pda open

A

Prostaglandin e

50
Q

When does pda normally close

A

5-7 days after birth

51
Q

What causes left ventricular outflow obstruction

A

Coarction of the aorta

Hypoplastic left heart syndrome

52
Q

What increases risk of sids

A

Male gender
Sga
Prematurity
Low apgar score

53
Q

What is gerd

A

Regurgitation of stomach contents into esophagus

54
Q

What respiratory problems can present with gerd

A 
Reactive airway disease
Aspiration pneumonia 
Laryngospasm
Chronic cough
Stridor 
Apnea
55
Q

What virus causes bronchiolitis

A

Rsv

56
Q

Patho of bronchiolitis

A

Inflammation and obstruction of small bronchi
Commonly occurs after a viral upper resp infection
Can cause wheezing and increased raw

57
Q

Signs of bronchiolitis

A

Dyspnea
Tachypnea
Inspiratory and expiratory wheezing

58
Q

Who is recommended to get a rsv vax

A

Infants less than 2 with history of
Bpd
Infants born at less than 32 weeks
Infants with chd

59
Q

Treatment for bronchiolitis

A

Humidity, oral decongestants and oxygen if needed

60
Q

What is the ventilation strategy for bronchiolitis if required

A

Low resp rates and long expiratory time due to air trapping

61
Q

What virus typically causes croup

A

Parainfluenza virus

62
Q

What does croup cause

A

Subglottic swelling and obstruction

63
Q

What does a X-ray with croup show

A

Subglottic narrowing, aka steeple sign

64
Q

Symptoms of croup

A

Slow, progressive inspiratory and expiratory stridor

Barking cough

65
Q

Treatment of croup

A

Corticosteroids and racemic epi for severe stridor

66
Q

What is epiglottitis

A

Supraglottic swelling of epiglottis

67
Q

What does X-ray of epiglottis show

A

Swelling of epiglottis or thumb sign

68
Q

What typically causes epiglottitis

A

H. Influenzae b

69
Q

Symptoms of epiglottis

A 
High fever
Sore throat 
Stridor
Muffled voice 
Drooling
70
Q

Treatment of epiglottis

A

Elective intubation done in the or by the most experienced provider

71
Q

What is cystic fibrosis

A

A hereditary disease that causes production of thick mucous, respiratory digestive and reproductive problems

72
Q

How is cf diagnosed

A

Sweat chloride test

73
Q

Sweat chloride greater than __ confirms diagnosis of cf

A

60 meq

74
Q

Treatment for cf

A

Airway clearance therapy
Antibiotics
Lung transplant

Egans 11th (13 decks)

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