Developmental Aspects of Lung Disease Flashcards
What are the different stages of lung development?
Embryonic (3-8wks) - bronchi form.
Pseudoglandular (5-17wks) - bronchioles form.
Canalicular (16-26wks) - respiratory portion forms.
Saccular (36wks-3yrs) - alveolar ducts form, surfactant production occurs.
Alveolar (3-8yrs) - alveolar sacs form.
What are the investigations for antenatal screening?
US.
MRI.
What symptoms suggest developmental lung disease?
Newborn - tachypnoea, respiratory distress, feeding issues.
Childhood - stridor, wheeze, recurrent pneumonia, cough, feeding issues.
Asymptomatic - incidental finding.
What is laryngomalacia?
A common upper congenital abnormality in infants; improves within the first year.
Presentation - stridor, worse with feeding / upset / excited.
Concern if it affects feeding, growth, or causes apnoeas.
What is tracheomalacia?
An upper congenital abnormality that can be isolated in healthy infants.
Associated with genetic conditions.
May be caused by external compression from vessels or tumours.
What is the presentation, management and progression of tracheomalacia?
Presentation - barking cough, recurrent ‘croup’, breathless on exertion, stridor, wheeze.
Management - physio, abx when unwell.
Progression - resolves with time.
What is a TOF?
An upper congenital abnormal connection between the trachea and oesophagus; is associated with genetic conditions.
What are the diagnosis, presentation, treatment and complications of TOF?
Diagnosis - antenatally or postnatally.
Presentation - choking, colour change, cough with feeding, unable to pass NG.
Treatment - surgical repair.
Complications - tracheomalacia, strictures, leak and reflux.
What is CPAM?
Congenital Pulmonary Airway Malformation.
A lower congenital abnormality - non-functioning lung tissue that occurs sporadically.
80% of cases are detected antenatally.
What is the progression, management and treatment of CPAM?
Progression - may resolve spontaneously in utero (possible risk of malignant change).
Management - conservative, if asymptomatic.
Treatment - surgical intervention (if required).
What is a congenital diaphragmatic hernia?
A lower congenital abnormality - the tissues around the diaphragm do not close properly.
Different types (Bochdalek = 90% of cases).
Usually the left side is affected.
What are the diagnosis, management and prognosis of a congenital diaphragmatic hernia?
Diagnosis - mostly antenatal.
Management - surgical repair.
Prognosis - depends on the degree of lung hypoplasia.
What is transient tachypnoea of newborns?
Absorption of fluids into the lungs on inflation on the first breath.
Associated with C-sections.
Improves within 1-2 days.
What is Respiratory Distress Syndrome?
In preterm infants and some term infants due to surfactant deficiency.
Also called hyaline membrane disease.
Treatment - antenatal steroids, surfactant replacement, ventilation and nutrition.
What is chronic lung disease?
Associated with prematurity where ongoing oxygen requirement is at term, and increased childhood respiratory morbidity.
Also called bronchopulmonary dysplasia.
Multifactorial causes.
Leads to chronic obstructions in later life.
