Lung Devo

Question 1

presentation resp distress

Answer 1

tachypnea, tachycardia

flaring nostrils

chest retraction

expiratory grunt

cyanosis

anxious express

Question 2

preop management TEF and esophogeal aphasia

Answer 2

patient at 30derees

repogle in proximal pouch to handle secretions

Search for comorbidities

identify position of aortic arch

Question 2

risk of post-natal steroids in RDS

Answer 2

cerebral palsy

Question 3

embryonic speculation in CCAM

Answer 3

asynchronous maturation of developing lung bud and surrounding mesenchyme 16-20wks results in overgrowth of terminal air strucutres

Question 3

at __wks, fetal luungs may be able to support life (with assistance)

Answer 3

24-27wks

Question 4

congential cystenic adenoamatoid malformation likely a ___ anaomaly

Answer 4

bronchiole

Question 6

most common repiratory/esophogeal abnormality

Answer 6

esophogeal atresia with distal esophogeal fistula (to trachea)

Question 6

cray findings RDS

Answer 6

low lung volume

diffuse atelectasia (ground glass)

air bronchograms

pneumonia-like (but not isolated region)

Question 7

infants with resp distress often develop ___ in lungs

Answer 7

hyalien membrane

Question 7

lab findings RDS

Answer 7

moderate hypoxia

resp acidosis

metabolic acidosis

Question 8

most common cause of resp distress in preterm infants

Answer 8

RDS

Question 9

presentation esophogeal atresia with distal trachea-esophogeal fistula

Answer 9

air in bowel on X-ray

bronchoscopy indentifies fistula

Question 9

pathogenesis hyaline membrane formation in respiratory distress

Answer 9

Type I cell injury >

breakdown of air/capillary barrier >

serum leak into alveolar lumen >

hyaline forms + surfactant disrupted

Question 10

Lab tests to evaluate risk for RDS

Answer 10

lecithin/spingomyelin ration

presence of phosphatidylglycerol (more accurate)

Question 12

presentation CCAM

Answer 12

single lobe

air trapping > distention

resp distress (rare)

recurrent pulmary infxn

prenatal ultrasound

Question 14

delayed repair candidates for EA with distal TEF

Answer 14

significant pul compromise

sig cardiac anomalies

long gap atresia,

Question 15

= primative alveoli

Answer 15

terminal sacs

Question 16

histological pattern CCAM

Answer 16

adenomatoid

alveolar psaces lined by repsiratory and mucus secreting epithelium =glandular

Question 17

risk factors RDS

Answer 17

Prematurity

preinatal depression

male

maternal diabetes

c section

multiple births

Question 19

CCAM

Answer 19

mass of pulmonary tissue in which there is proliferation of broncial structures at expense of alveolar devo

Question 20

pathophysiology RDS

Answer 20

structural+ fxnl immaturity:

underdeveloped, un-elastic parenchyma

surfactant deficeincy

Question 21

CXR meconium aspiration syndrome

Answer 21

patchy atelectasis or consilidation

Question 22

main mechanistic cause of respiratory distress

Answer 22

inability to keep alveoli filled with air

Question 23

treatment prenatal hydrops

Answer 23

thracentesis

thoraco-amniotic shunt

fetal lobectomy

induce delivery and perform resection

Question 24

inadequate partioning occurs due eto

Answer 24

abnormala or insufficient development of tacheoesophageal septum

Question 26

significant production in surfact at ___wks

Answer 26

35 wks

(begins in cannicular period)

Question 27

associated anomalies esophogeal aphasia and TEF

Answer 27

cardiac (VSD)

GI,

GU,

Musculoskelatal

Question 28

prevention of RDS

Answer 28

arrest preterm labor

antenatal bethamethasone - steroids stimulate type II pneumocytes and surfactant production