Developmental Aspects of Lung Disease Flashcards

1
Q

In what stage of morphogenesis does surfactant being to develop

A

Saccular stage

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2
Q

Common upper congenital abnormalities

A

Tracheal anagenesis and stenosis
Tracheomalacia
Tracheo-oesphageal fistula

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3
Q

Common lower congenital abnormalities

A

Lung anagenesis/pulmonary hypoplasia
Bronchogenic cyst
Congenital pulmonary airway malformation (CPAM)
Congenital diaphragmatic hernia

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4
Q

Presenting features in antenatal scanning

A

Ultrasound - show up more at 20 weeks scan

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5
Q

Presenting features in newborns

A

Tachypnoea
Respiratory distress
Feeding issues

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6
Q

Tachypnoea

A

Abnormally rapid breathing

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7
Q

Presenting features in childhood

A

Stridor/wheeze
Recurrent pneumonia
Cough
Feeding issues

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8
Q

Asymptomatic presenting features

A

Incidental finding

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9
Q

Tracheal agenesis

A

Trachea is absent or underdeveloped

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10
Q

Presentation of tracheal agenesis

A

Acute respiratory distress at birth

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11
Q

Tracheal stenosis

A

Tracheal cartilage rings are completed too early, may be generalised or segmental

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12
Q

Time of detection of tracheal stenosis

A

At birth or within first year

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13
Q

Tracheomalacia

A

Dynamic abnormal collapse of tracheal walls

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14
Q

Presentation of tracheomalacia

A

Braking cough
Recurrent croup
Breathless on exertion
Stridor/wheeze

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15
Q

Management of tracheomalacia

A

Physiotherapy and antibiotics when unwell, natural resolution with time

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16
Q

Causes of tracheomalacia

A

Genetic conditions

External compression

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17
Q

Tracheo-oesphageal fistula

A

Abnormal connection between trachea and oesophagus

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18
Q

Presentation of tracheo-oesphageal fistula

A

Choking
Colour change
Cough with feeding
Unable to pass nasal-gastric tube

19
Q

Treatment of trachea-oesphageal fistula

A

Surgical repair (rejoin or elongation)

20
Q

Complications of trachea-oestophageal fistula

A

Tracheomalacia
Strictures
Leak
Reflux

21
Q

Time of detection of trachea-oesphageal fistula

A

Antenatal or postnatal

22
Q

Congenital pulmonary airway malformation (CPAM)

A

Abnormal non-functioning lung tissue, occurs sporadically

23
Q

Management of CPAM

A

May resolve spontaneously in utero
Conservative treatment id asymptomatic
Surgical intervention

24
Q

Time of detection of CPAM

A

80% detected antenatally

25
Q

Diaphragm development

A

Develops from multiple tissue at 7 weeks and closes by 18 weeks

26
Q

Cause of congenital diaphragmatic hernia

A

Failure of closure of diaphragm (usually left side)

27
Q

Time of diagnosis of congenital diaphragmatic hernia

A

Most antenatally, some cases late

28
Q

Management of congenital diaphragmatic hernia

A

Surgical repair - primary closure

29
Q

Eventration of diaphragm

A

Abnormal elevation of dome of diaphragm in which all or part of it is largely composed of fibrous tissue

30
Q

Change in lungs after birth

A

Lungs inflate and fluid in lungs is absorbed

31
Q

Transient tachypnoea of newborn

A

Accumulation of fluid in lungs due to no squeezing of lungs after birth

32
Q

At which weeks do type II pneumocytes differentiate

A

Weeks 24-34

33
Q

What is surfactant made up of

A

Phospholipids and lipophilic proteins

34
Q

Other name of RDS

A

Hyaline membrane disease

35
Q

What causes RDS

A

Surfactant deficiency

36
Q

Treatment of RDS

A

Antenatal steroids (matures lungs)
Surfactant replacement
Appropriate ventilation and nutrition

37
Q

Bronchopulmonary dysplasia

A

Chronic lung disease that results from damage to lungs caused by mechanical ventilation and long term use of oxygen

38
Q

Remodelling

A

Alteration of airway structure following external influence

39
Q

Result of remodelling

A

Interference of inter-cellular signalling

40
Q

Causes of remodelling

A
Environmental influences
Chronic diseases in childhood
Infection
Gene interactions
Antenatal programming
Early allergy
41
Q

Remodelling in asthma

A
Chronic inflammation 
Increased bronchial responsiveness
Increase mucus secretion
Airway oedema
Airway narrowing
42
Q

Remodelling in chronic lung disease

A

Chronic inflammation
Interference of inter-cellular signalling
Treatment toxicity - can cause structural change in airways

43
Q

Pros of prediction of future lung development

A

Allows identification of illnesses that will appear later in life and so allows for earlier treatment