Diseases of infancy and childhood II

Question 1

what are the main ascending infection pathogens?

Answer 1

e. coli, GBS, HSV-2,

Question 2

what inflammations are associated with ascending infection?

Answer 2

chorioamnionitis, funisitis (umbilical cord), placentitis, villitis

Question 3

what is villitis?

Answer 3

lymphocytic infiltrate of the chorionic villi, associated with recurrent miscarriage and fetal growth restriction

Question 4

what are the main agents responsible for early onset neonatal sepsis?

Answer 4

GBS, e. coli (Gn), klebsiella (Gn)

Question 5

what are the main agents responsible for late onset neonatal sepsis?

Answer 5

staph, h. influenzae, listeria, chlamydia, mycoplasma, candida

Question 6

what are the complications of early onset neonatal sepsis?

Answer 6

meningitis, pneumonia

Question 7

what are the most important risk factors for early onset neonatal sepsis?

Answer 7

previous infant with GBS disease, GBS bacteruria during pregnancy, delivery before 37 weeks

Question 8

what is the most common cause of neonatal respiratory disease?

Answer 8

hyaline membrane disease

Question 9

what are the risk factors for hyaline membrane disease?

Answer 9

prematurity, diabetic mothers, c-section, male

Question 10

what is the cause of hyaline membrane disease?

Answer 10

deficiency of alveolar surfactant

Question 11

what is the cause of hyaline membranes in hyaline membrane disease?

Answer 11

1. lack of surfactant results in atelectasis followed by hypoxemia and increased CO2 2. pulmonary artery vasoconstriction and right to left shunting ensues 3. acidosis, pulmonary vasoconstriction, hypoperfusion 4. ischemia damages alveolar and endothelial cells - leakage of plasma proteins into alveolar space causes hyaline membranes (fibrin)

Question 12

what is the diagnosis for hyaline membrane disease?

Answer 12

lecithin / sphingomyelin ratio >2, phosphoglycerol present

Question 13

what is the histologic presentation of hyaline membrane disease?

Answer 13

alternating atelectatic alveoli and alveolar ducts that are dilated and lined by eosinophilic fibrin-rich thick hyaline

Question 14

when does chronic lung disease (bronchopulmonary dysplasia) occur?

Answer 14

in premature newborns (

Question 15

what are the clinical findings of chronic lung disease (bronchopulmonary dysplasia)?

Answer 15

hyperplasia and squamous metaplasia of bronchial epithelium, sponge-like on radiology, cobblestoning gross appearance, thick interstitial fibrosis

Question 16

what attributes to the alveolar hypoplasia seen in chronic lung disease (bronchopulmonary dysplasia)?

Answer 16

oxygen and inflammatory cytokines blocking alveolar septation at saccular stage level

Question 17

what is the cause of necrotizing enterocolitis?

Answer 17

hypoxemia (intestinal ischemia, general hypoperfusion), intestinal bacterial colonization, and oral feeding (intraluminal substrate)

Question 18

definitions: hydrops fetalis, cystic hygroma

Answer 18

1. hydrops fetalis - generalized edema of the fetus 2. cystic hygroma - localized edema accumulation in soft tissues of the neck

Question 19

what is the cause of immune hydrops?

Answer 19

blood group incompatibility

Question 20

what is the cause of non-immune hydrops?

Answer 20

infections, chromosomal anomalies, twin pregnancy, cardiovascular defects

Question 21

what is the pathogenesis of fetal hydrops?

Answer 21

1. anemia, heart and liver failure 2. edema results from increased venous capillary pressure and decreased oncotic pressure

Question 22

how can immune hydrops be differentiated from non-immune hydrops?

Answer 22

1. in immune hydrops, ascites and pericardial effusion are early signs; pleural effusion comes later 2. in non-immune hydrops, pleural effusion is a common finding in combination with usually present fluid collections in other body compartments

Question 23

which antibodies pass transplacentally from mother to fetus during hydrops fetalis?

Answer 23

anti-Rh D IgG

Question 24

what are the most common vascular tumors of infancy?

Answer 24

hemangiomas

Question 25

what are cavernous hemangiomas?

Answer 25

components of VHL disease - can be in cerebellum, brain stem, pancreas, liver

Question 26

what is the histologic appearance of capillary hemangioma?

Answer 26

thin walled capillaries with scant stroma

Question 27

what is the histologic appearance of cavernous hemangioma?

Answer 27

large, cavernous blood filled vascular spaces separated by CT stroma