Developmental aspects of lung disease Flashcards
what are the 5 stages of lug morphogenesis?
Embryonic Pseudo-glandular Canicular Saccular Alveolar
at what stage in the lung morphogenesis is extra uterine life possible?
at the late canicular/early saccular stage
at what stage do you begin to see left and right lobes of the lungs?
pseudoglandular
at what stage does gas exchange occur for the first time?
canalicular
how many alveoli are present at birth and how much does this grow to after birth?
born with 100-150 million
200-600 million at 3-8 years
at what week and stage is surfactant detectable in the amniotic fluid?
week 24- saccular stage
at what week is the alveolar stage?
week 36
when does the development of the lungs begin?
week 4
what is airway malacia?
muscles haven’t developed properly in the airways causing floppy airways.
what is sequestration?
the normal lung is not connected or has a different blood supply
how are majority of congenital anomalies detected?
foetal ultrasound
in newborns, what is the presentation of a respiratory anomaly?
respiratory distress (chest wall retraction) tachypnoea
in childhood, what is the presentation of a respiratory anomaly?
stridor/wheeze
recurrent pneumonia
incidental finding
what is the clinical presentation of trachea-bronchomalacia?
barking/seal like cough
early onset/recurrent croup
stridor / wheeze
breathlessness on exertion
what is the management of trachea-bronchomalacia?
chest physiotherapy
antibiotics
avoid asthma treatment (it causes relaxation of airways but problem in malaria is that the airways are too relaxed due to incomplete muscle formation)
what are the 2 most common congenital lung diseases?
tracheo-bronchomalacia
pulmonary adenomatoid malformation
when is the closure of the diaphragm?
18 weeks
at what side is a diaphragmatic hernia most common?
left side
what is a diaphragmatic hernia associated with?
pulmonary hypoplasia
persistent pulmonary hypertension
what is eventuation?
outputting of diaphragm into the thoracic cavity
what foetal complication is associated with caesarean section delivery?
‘wet lungs’
normally at birth, the baby lungs change from fluid secretion to fluid absorption but sometimes the baby doesn’t change as quick as it should resulting in wet lungs.
when does wet lung usually resolve?
24-48 hours
what is the presentation of wet lung in newborns?
transient tachypnoea
what is the treatment for acute respiratory distress syndrome?
antenatal glucocorticosteroids
surfactant replacement
what is another name for ARDS?
hyaline membrane disease
what causes acute respiratory distress?
surfactant deficiency
what is bronchopulmonary dysplasia / CLD prematurity?
chronic lung disease which mostly affects pre mature newborns
what is the aetiology of bronchopulmonary dysplasia / CLD prematurity?
Antenatal infection
barotrauma / oxygen toxicity
genetic
patent ductus arteriosus
what is bronchopulmonary dysplasia / CLD prematurity associated with?
increased childhood respiratory morbidity
increased risk of future COPD / asthma
what are the antenatal origins of adult lung disease?
inutero nicotine exposure fetal infection maternal infection maternal nutrition low birth weight / prematurity maternal micronutrients / vitamins
what are the post natal origins of adult lung disease?
infection growth Alpha 1 antitrypsin deficiency environmental pollution micronutrients/ vitamins
what does the term remodelling mean?
alteration of structure following an external influence
what complications can prenatal nicotine exposure cause?
lung hypoplasia reduced alveolarisation reduced lung function in small airways increased incidence of wheeze syndrome increased suscpetibility to infection
what is the remodelling in asthma?
external influence i.e allergen/atopy , exercise , emotion etc causes chronic inflammation which leads to remodelling of the airways; - increased bronchial responsiveness increase mucous secretion airway oedema airway narrowing
what is the name for the outputting of the diaphragm into the thoracic cavity?
eventuation
what is the name for bronchi/lung which is separate or has a different blood supply?
sequestration
what is pulmonary adenomatoid malformation?
air filled cystic lesions in the lungs
they may resolve on their own in utero but if not then conservative management if asymptomatic.
they have a possible risk of malignant change
when is the closure of the diaphragm?
week 18
when do type II pnuemocytes first appear in utero?
week 12-14
pre natal nicotine exposure causing lung hypoplasia and reduced alveolarisation is an example of ………….
remodelling
