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diseases Flashcards

1
Q 
In BPD an ecg may reflect?
I. Right axis deviation
II. Right ventricle hypertrophy
III. Left axis deviation
IV. Left ventricle hypertrophy
A. I, II, III
B. I, II
C. I, IV
D. I only
A

B. Right axis deviation, right ventricle hypertrophy

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2
Q

T or F: in BPD you may see increased bicarb levels

A

True

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3
Q

In BPD what would you want to keep PaO2 and PaCO2 around?

A 
PaO2 = 50=70
PaCO2 = 45-55
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4
Q

Another important means of treating BPD in regards to the ET tube is?

A

Leak around ET tube

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5
Q

What medication may be used in treatment of BPD?

A

Theophylline

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6
Q

What medication may be used in treatment of right heart failure?

A

Digoxin

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7
Q

What is a normal nutritional level to give?

A

24-28 cal/ounce

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8
Q

A syndrome where pulmonary changes in function are seen in premature neonate without underlying lung disease is called?

A

Wilson-Mikity Syndrome (pulmonary dismaturity)

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9
Q

One sign of IVH/ICH is a drop in what level?

A

Hct

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10
Q

T or F: You would expect to see apnea as a sign of IVH/ICH

A

True

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11
Q

What are the results of the four stages of IVH/ICH?

A 
I= into germinal matrix
II= germinal matrix to ventricles
III= dilation of ventricles
IV= dilation of ventricles to brain perenchyma
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12
Q

What are triggers of IVH/ICH?

A

shock, acidosis, blood transfusion or rapid blood volume expension, seizures, mechanical ventilation, increased ICP, maternal alcohol intake

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13
Q

What medication has been shown to help in treatment of IVH/ICH?

A

Low dose indomethacin

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14
Q

Asyhyxia is a combination of what 3 conditions?

A

Hypoxia, Hypercarbia, acidosis

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15
Q

Presence of ______ at birth can cause asphyxia

A

meconium

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16
Q

Wilson Mikity is also known as?

A

pulmonary dismaturity

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17
Q

On a chest xray if you see irregular densities, hyperinflation and you have a full term infant you may have ?

A

MAS

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18
Q

TorF: widespread atelectasis is not a sign of MAS

A

False; widespread atelectasis is a sign of MAS

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19
Q

T or F: Positive pressure ventilation is the most effective treatment of MAS?

A

False; no PPV until meconium is gone; treat with blow by at 100%

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20
Q

_________ is very rare condition in neonates but has no treatment.

A

Pulmonary air embolism

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21
Q

What variables does OI use to predict liklihood of mortality and at what level?

A

Mean airway pressure, FIO2, PaO2
MAP x (Fio2/PaO2) x 100
Score greater than 40 means 80% liklihood of mortality

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22
Q

What treatment may be used in PPHN and may prevent need for ECMO

A

NO

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23
Q

What clinical dosing of NO should be used?

A

Start at 20 ppm; then after 4 hrs if stable:
Stable means PO2 < 60 & pH < 7.55
decrease to 5 ppm;
Leave at 5 ppm until FIO2 < 70% & paO2 = 60-100

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24
Q

When treating with NO after titration to 5 ppm a patient should be left at this rate until the paO2 = ______ at ______ FIO2

A

PaO2 is = 60-100 on less that .70 FIO2

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25
Q

What is a side effect of NO

A

Met Hb

26
Q

This disorder is typically seen in term to near term infants who undergo c-section?

A

TTN

transient tachypnea of newborn

27
Q

In TTN, what type of blood gas can you expect?

A

May be normal acid/base with varying degrees of hypoxia

28
Q

T or F: CPAP may be a treatment for TTN to treat symptoms.

A

True

29
Q

If a baby is delivered & you see a scaphoid belly and absent breath sounds you can suspect what condition is present?

A

Congenital diaphragmatic hernia

30
Q

What steps should be taken with a baby suspected of congenital diaphragmatic hernia?

A

Immediately place orogastric tube, intubate & avoid BVM, avoid high pressures

31
Q

With congenital diaphragmatic hernia, it is best to keep _______
A. acidotic
B. alkalotic

A

B. best to keep more alkalotic than acidotic

32
Q

What would you see on xray in congentital diaphragmatic hernia?

A

Bowel would be present at chest

33
Q

What is a contributor to BPD, often develops from RDS

A

PIE

34
Q

In the case of right heart failure with BPD you may treat with what medication and with closure of PDA?

A

Digoxin

35
Q

What medication may stimulate the diaphragm?

A

Theophylline

36
Q

What is the formula for MAP?

A

(2 x diastolic) + systolic BP / 3

37
Q

MAP is used as an indication of what function?

A

Left ventricular afterload to represent the resistance against which the left ventricle must pump

38
Q

At what stage of ROP should treatment begin?

A

Stage III

39
Q

Apnea is a pathological condition in which breathing cease for ____ seconds or longer.

A

20 seconds

40
Q

The most common type of apnea seen in newborns is

A

Central apnea

41
Q

How can apnea in newborns be treated?

A

Caffeine or theophylline (methylxanthines)

42
Q

Common causes of obstructive apnea include

A

enlarged or obstruction by tongue, pierre robin syndrome, facial anomolies

43
Q

Name 4 hallmarks of RDS seen on Xray?

A

decreased lung volumes
lung opacification
air bronchograms
reticulogranularity

44
Q

What type of shunt will you see in RDS:?

A

L-R shunt

45
Q

With ROP considerations it is best to keep PaO2 maintained at what level?

A

92%

46
Q

Incomplete opening into the nasopharynx due to membranous or bony structures is?

A

Bilateral Choanal Atresia

47
Q

Indomethacin is a treatment for ____.

A

PDA in newborn

48
Q

The tension that must be generated in the heart muscle in order to eject is?

A

Afterload

49
Q

The volume of blood that must be ejected by the ventricle is

A

Preload

50
Q

The intrinsic ability of cardiac muscle to shorten with an appropriate stimulus is

A

Contractility

51
Q

Factors that influence pulmonary vascular tone?

A

Acidosis, hypoxia, altitude, heat, NO, vagal stimulation, baroreceptors, vasoactive agents

52
Q

T or F: central cyanosis normally reflects a cardiac problem

A

True

53
Q

How do neonates compensate?
A. increasing Vt
B. Increasing respiratory rate
C. Both A & B

A

B. neonates cannot increase their Vt, only their RR

54
Q

An acceptable pH in NICU is?

A

7.25 or higher

55
Q

TTN is also known as?

A

wet lung

56
Q

TTN treatment, first line is?

A

nasal CPAP

57
Q

Main causes of BPD are?

A 
o2 toxicity
barotrauma
PDA presence
RDS treatment
Fluid overload
58
Q

PIE looks like _____ on xray?

A

Bubbly, cystic areas, micro holes

59
Q

PaO2 with PPHN can be as low as

A

37-45

60
Q

PPHN is shunting?

A

R to L

Peds (6 decks)

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