L4: Neonatal Respiratory Diseases & Cyanosis Flashcards

1
Q

Def of Neonatal Respiratory Distress

A
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2
Q

Etiology of Neonatal Respiratory Distress

A
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3
Q

Etiology of Neonatal Respiratory Distress

  • Respiratory
A
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4
Q

Etiology of Neonatal Respiratory Distress

  • Respiratory (Pulmonary)
A
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5
Q

Etiology of Neonatal Respiratory Distress

  • Respiratory (Airway obstruction)
A
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6
Q

Etiology of Neonatal Respiratory Distress

  • CVS
A
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7
Q

Etiology of Neonatal Respiratory Distress

  • Neurologic Causes
A
  • hypoxic ischemic encephalopathy
  • Intraventricular hemorrhage
  • Meningitis and Encephalitis
  • Seizure
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8
Q

Etiology of Neonatal Respiratory Distress

  • Hematologic Disorders
A
  • anemia
  • Polycythemia
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9
Q

Etiology of Neonatal Respiratory Distress

  • Metabolic Disorders
A
  • Hypoglycemia
  • metabolic acidosis
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10
Q

Etiology of Neonatal Respiratory Distress

  • Miscellaneous Disorders
A
  • Sepsis
  • Hypothermia
  • Hyperthermia
  • congenital diaphragmatic hernia
  • phrenic nerve paralysis
  • pleural effusion
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11
Q

Def of Transient Tachypnea of Newborn (TTN)

A
  • It is a self-limited disease present within first few hours of life with tachypnea and increased oxygen requirement.
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12
Q

Incidence of Transient Tachypnea of Newborn (TTN)

A
  • It can occur in both term and preterm neonates.
  • it is the most common cause of respiratory distress in the full-term infant.
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13
Q

Etiology of Transient Tachypnea of Newborn (TTN)

A

Unknown, but it is believed to be due to delayed drainage of fetal lung fluid.

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14
Q

RF for Transient Tachypnea of Newborn (TTN)

A

The incidence may be increased in:
โ–ช Male infants + Infants born via caesarean section.

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15
Q

CP of Transient Tachypnea of Newborn (TTN)

A
  • Tachypnea immediately after birth and persists for 24-48 h.
  • Occasionally grunting and nasal flaring.
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16
Q

INVx for Transient Tachypnea of Newborn (TTN)

A
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17
Q

INVx for Transient Tachypnea of Newborn (TTN)

  • Labs
A

Arterial blood gases reveals:
โ–ช Respiratory acidosis and mild-to moderate hypoxemia.

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18
Q

INVx for Transient Tachypnea of Newborn (TTN)

  • Rads
A
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19
Q

TTT of Transient Tachypnea of Newborn (TTN)

A
  • TTN is generally a benign, self-limited disease that usually responds well to oxygen therapy.
  • Mechanical ventilation seldom โ€œrareโ€ is needed.
  • Many infants require nasal continuous positive airway pressure (CPAP) support.
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20
Q

Prognosis of Transient Tachypnea of Newborn (TTN)

A

Full recovery is expected within 2 to 5 days

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21
Q

Incidence of Meconium Aspiration Syndrome

A
  • It occurs in approximately 10% to 25% of all deliveries.
  • It occurs almost exclusively in term and post-term deliveries.
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22
Q

Pathogenesis of Meconium Aspiration Syndrome

A
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23
Q

CP of Meconium Aspiration Syndrome

A
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24
Q

INVx for Meconium Aspiration Syndrome

A
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25
Q

TTT of Meconium Aspiration Syndrome

A
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26
Q

TTT of Meconium Aspiration Syndrome

  • Immediate TTT
A
  • Suctioning the oropharynx and trachea before the first breath and before resuscitation if the baby is flaccid and not vigorous.
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27
Q

TTT of Meconium Aspiration Syndrome

  • General TTT
A
  • Endotracheal intubation and suctioning may be indicated to remove meconium from the airway if there is airway obstruction.
  • Empty the stomach to avoid further aspiration.
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28
Q

TTT of Meconium Aspiration Syndrome

  • Specific Lines
A
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29
Q

Another Name of RDS

A

Hyaline Membrane Disease

30
Q

Incidence of RDS

A
31
Q

Pathogenesis of RDS

A
32
Q

RF for RDS

A
33
Q

INVx for RDS

A
34
Q

INVx for RDS

  • Labs
A
35
Q

INVx for RDS

  • Rads
A
36
Q

Prevention of RDS

A
37
Q

TTT of RDS

A
38
Q

TTT of RDS

  • General
A
  • The baby needs to be nursed in a neonatal intensive care unit.
  • Basic support including thermal regulation and parenteral fluid
  • Mild cases may only need oxygen (warm and humidified) via head box or nasal cannula.
39
Q

TTT of RDS

  • Specific
A

Surfactant replacement therapy:
โ–ช Given by instillation down endotracheal tube.
โ–ช Often improves pulmonary mechanics.
โ–ช Decreases RDS severity and reduces mortality.

40
Q

TTT of RDS

  • Respiratory Support
A

Continuous positive air pressure (CPAP):
โ–ช Can help to prevent alveolar and airway collapse.

Mechanical ventilation may be required:
โ–ช If the patient continues to deteriorate.

41
Q

CPAP

A
  • It is a continuous flow of a mixture of O2 and air past the infantโ€™s airway at a set pressure of 5-8 cm H20 maintaining an elevated end-expiratory lung volume while the infant breaths spontaneously.
42
Q

Prognosis of RDS

A
43
Q

Incidence of Air Leak Syndrome

A
  • Mostly seen in infants with lung disease who are on ventilatory support and may occur spontaneously.
  • The more severe the lung disease, the higher the incidence of pulmonary air leak.
44
Q

Types of Air Leak Syndromes

A
  • Pneumomediastinum.
  • Pneumothorax.
  • pulmonary interstitial emphysema.
  • pneumopericardium.
45
Q

Pathogenesis of Air Leak Syndrome

A

Overdistension of alveolar sacs or terminal airways โ€”-> disruption of airway integrity โ€”-> dissection of air into surrounding spaces.

46
Q

RF for Air Leak Syndrome

A
  • Ventilatory support
  • Meconium aspiration syndrome
  • Vigorous resuscitation.
47
Q

CP of Air Leak Syndrome

A
48
Q

INVx for Air Leak Syndrome

A
49
Q

Prevention of Air Leak Syndrome

A

judicious use of ventilatory support and self-inflating bags.

50
Q

TTT of Air Leak Syndrome

A
51
Q

Types of Pneumonia in Newborn

A
52
Q

Etiology of Pneumonia in Newborn

A

Most common causes
- Group B streptococci, Escherichia coli, Klebsiella and listeria.

53
Q

RF for Pneumonia in Newborn

A
  • Prematurity.
  • Premature rupture of the membranes.
  • Chorioamnionitis.
  • Maternal fever.
54
Q

CP of Pneumonia in Newborn

A
55
Q

INVx for Pneumonia in Newborn

A
56
Q

INVx for Pneumonia in Newborn

  • Labs
A

๏ƒพ ABG.
๏ƒพ CBC.
๏ƒพ Cultures.

57
Q

INVx for Pneumonia in Newborn

  • Rads
A
58
Q

TTT of Pneumonia in Newborn

A
59
Q

CP of Congenital Heart Disease

A
60
Q

Infants who have CHD may present with โ€ฆโ€ฆ.

A

cyanosis or heart failure

61
Q

Infants who have isolated CHD usually do not have โ€ฆโ€ฆ.

A

hypercapnia

62
Q

Metabolic acidosis is slightly more common in patients who have low COP because of CHD.

A

โ€ฆ

63
Q

Signs that are generally consistent with CHD include โ€ฆ..

A
64
Q

Infants who have cyanotic heart diseases

  • Typically, do not present with severe chest retraction however, tachypnoea is common
A

โ€ฆ

65
Q

Infants who have cyanotic heart diseases

  • Oxygen saturation is usually decreased
A

โ€ฆ.

66
Q

Infants who have cyanotic heart diseases

  • Increasing the concentration of inspired oxygen to 100% for 20 minutes (hyperoxia test) will not produce a significant increase in Pao2.
A

โ€ฆ

67
Q

Value of (hyperoxia test)

A

Suggests the origin of cyanosis.

68
Q

Method of (hyperoxia test)

A
69
Q

Results of (hyperoxia test)

A
70
Q

INVx for Congenital Heart Disease

A

Echo:
- It is the definitive investigation.