Congenital Anomalies

Question 1

Pulmonary Hyperplasia

Answer 1

Defective development of a lung

Cause: compression in utero – oligohydraminos, congenital diaphragmatic hernia

Question 2

Tracheoesophageal Fistula

Answer 2

1. Abnormal communication b/t esophagus & trachea d/t congenital esophageal atresia
2. MC blind proximal esophagus, distal esophagues attached to trachea
3. excessive drool/cough, spitting up, dyspnea w/ feeding
4. Associated with trisomys

Question 3

Foregut Cysts

Answer 3

Develop from abnormal detachment of foregut; located in mediastinum

Question 4

Pulmonary Sequestration

Answer 4

Mass of lung tissue w/o connection to tracheobronchial tree & has its own blood supply; Caused by abnormal lung buds

Question 5

Types of Pulmonary sequestration

Answer 5

Intralobar: lung tissue is associated w/ a whole lung, but w/ extrinsic blood supply
Extralobar: lung tissue is external to lung w/ extrinsic blood supply

Question 6

Hyaline Membrane Disease/ Respiratory Distress Syndrome

Answer 6

MCC of respiratory failure in newborns

1. Associated with Premature infants and Maternal Diabetes
2. Caused by lack of surfactant
3. Respiratory Distress in 1st few minutes of life

Question 7

Dx and Tx of HMD/RDS

Answer 7

CXR: Ground glass haziness, distorted heart borders
Histo: Hyaline membranes

Tx: Prenatal betamethasone/dexamethasone, Induce lung maturation via corticosteroids prior to delivery

Question 8

Transient Tachypnea of the Newborn Tx and Dx

Answer 8

Dx:
CXR: prominent pulmonary vasculature (peri-hilar linear streaking)
Tx: O2, Diuretics are NOT indicated

Question 9

Causes of Reactive Airway Disease

Answer 9

1. Croup
2. Foreign Body
3. GERD
4. Laryngotracheomalacia
5. Bronchioitis

Question 10

Croup

Answer 10

Can cause Reactive Airway Disease

1. Parainfluenza type 1
2. Hoarse voice, “barking cough”, stridor, retractions
3. Symptoms worse @ night and improve w/ exposure to cool/moist air
4. Steeple sign (CXR), budesonide

Question 11

GERD

Answer 11

SSx: sour taste in mouth, heartburn pain
Dx: gold standard is pH probe test
Tx: H2 blockers (ranitidine) or PPIs (omeprazole), avoid triggers

Question 12

Laryngotracheomalacia

Answer 12

1. Congenital deformity of cartilage w/ “floppy cartilage”
2. SSx: stridor & retractions since birth
3. Tx: Supportive

Question 13

Bronchiolitis

Answer 13

MCC is RSV

1. Starts as URI
2. Tx with albuterol

Question 14

Dx and Tx of Asthma

Answer 14

Dx: PFT (gold standard), Peak flow for monitoring
Tx: Inhaled corticosteroid to prevent remodeling