Lung Development (anne Greenough) Flashcards
What is pulmonary agenesis?
Failure of respiratory development beyond the carina
What is pulmonary agenesis associated with?
Anencephaly
Deficiency of which vitamin can cause unilateral pulmonary agenesis?
Vitamin A
Which side does unilateral pulmonary agenesis most commonly occur on?
Left
What is pulmonary hypoplasia?
Incomplete development of lungs
Name 2 causes of secondary pulmonary hypoplasia
Oligohydramnios, compression (congenital diaphragmatic hernia)
What is the normal amount of foetal lung fluid at term?
20ml/kg
What effect does adrenaline have on the foetal lung fluid?
Stops secretion, increases resorption
Which 2 hormones are needed to mature the foetal lung response to adrenaline?
Thyroid hormone and cortisol
What can chronic drainage of foetal lung fluid lead to?
Pulmonary hypoplasia?
Which syndrome is characterised by lung hypoplasia, limb contractures, talipes, dislocated hips and flattened nose and ears?
Potter’s syndrome ⚡
When in pregnancy could an amniocentesis be done safely?
2nd trimester
What is mortality in babies with congenital diaphragmatic hernias due to?
Pulmonary hypoplasia
Which side are congenital diaphragmatic hernias most common?
Left
What is hydrops fetalis and what is a cause of it?
It is diminished venous return and congestive heart function. It is caused by pleural effusion
How is foetal pleural effusion managed?
Thoracocentesis
What is oesophageal atresia?
Oesophagus ends in a blind ended pouch
What is a tracheo-oesophageal fistula
Abnormal separation of the primitive trachea and oesophagus
What is the presentation of tracheo-oesophageal fistula?
Maternal polyhydramnios, small/absent foetal stomach bubble, postnatally baby dribbles saliva, choking, coughing, acid aspiration, gastric distension
At which week if gestation does surfactant start to be produced ?
24 weeks
What is surfactant composed of?
Phospholipids, neutral lipids and proteins
What does surfactant protein B do?
Increased the spreading of phospholipids in the air water interface
What is the outcome of surfactant B deficiency?
Lethal respiratory failure
What does surfactant protein A do?
Synthesis, secretion and recycling of phospholipids. Acts as an opsonin for phagocytosis of viruses
What does surfactant protein C do?
Enhances adsorption and spreading
What does surfactant protein D do?
Immune defence of the lung
What does a deficiency in surfactant C lead to?
Interstitial lung disease
What does a polymorphism in surfactant D lead to?
Severe RSV infection
