Patho RDS

Question 1

What’s RDS?

Answer 1

Life-threatening condition where the lungs cannot provide enough oxygen for the rest of the body

Question 2

What’s the two main types?

Answer 2

NRDS affects new born <28 days
ARDS affects any age >28 day days اسمه زمان كان adults

Question 3

The second name of neonatal respiratory distress syndrome? Why?

Answer 3

Hyaline Membrane Disease due to formation of highline membrane

Question 4

What are the risk factors of NRDS?

Answer 4

PRIDAGE اختصار كوبري (جسر)
PR premature before 36 week
I incompletely developed lungs
D decreased in body weight
G Gestational age عمر الحمل

50% in babies born at 26-28 weeks
25% in babies born at 30-32 weeks

Infants born from uncontrolled diabetic mothers

Question 5

What’s the cause of RDS? ⭐️

Answer 5

1. Immature and damaged pneumocytes II
2. pulmonary surfactant deficiency

Question 6

What is surfactant? and its benefits?

Answer 6

1. Surfactant is a complex molecules of lipids &
   glycoproteins which are produced by type II pneumocytes
   & their functions is to decrease the surface tension in the
   alveoli.
2. It helps the prevention of the terminal air-spaces
   atelectasis .
3. Atelectasis = Partial or complete lung collapse

Question 7

What is the pathophysiology of NRDS
? ⭐️⭐️

Answer 7

They are 7 steps???
1 immature or damaged of pneumocytes type two
2 inadequate amount of surfactant
3 collapsed alveoli
4 compensatory over distended alveolus
5 hypoxia alveolar cell damage
6 endothelial damage formation of hyaline membrane
7 hyaline membrane lining and filling the alveoli >more hypoxia> high CO2 > acidosis

Question 8

Hyaline gross appearance of NRDS?

Answer 8

(Waxy-appearing) hyaline
membranes line the collapsed
alveoli of the lung.

The lungs show collapsed
alveoli, compensatory over-
distended alveoli, bleeding &
damage of the airways

Question 9

Hyaline microscopic appearance of NRDS?

Answer 9

Hyaline membranes: An
eosinophilic amorphous(structureless) material
lining / filling the air spaces.

Collapsed alveoli alternating with
compensatory over distended alveoli
(emphysema)+ congested capillaries.

Question 10

Important!! What are the components of hyaline membrane? ⭐️

Answer 10

fibrin + cellular debris (necrotic pneumocystis)+ RBCs +
neutrophils + macrophages

Question 11

The neonatal patient can manifest many signs?

Answer 11

ES/ TTCE يعني دزي T مثقلة 😸
Tachypnea. Tachycardia. Chest wall recession ينشفط على جوا لان كولابس
Expiratory grunting sound and cyanosis
LS/ RF with hypercapnia&raquo_space;high pCO2
Apnea

Question 12

Complication?? Of NRDS

Answer 12

CAAR

Question 13

What’s ARDS?

Answer 13

It is severe lung disorder with marked gas
exchange impairment.

Question 14

What cause ARDS??

Answer 14

ARDS 😛

Question 15

Which of the 3 is the most common cause? SRA سرى ليلي على الطاري ⭐️

Answer 15

Sepsis THE MOST IMPORTANT!!!
Road traffic accident with severe multiple trauma
Aspiration of saliva
/ gastric content (coma-anaesthesia) جزء من السليفا دخل التركيا

Question 16

What is the less common causes?

Answer 16

SDIM سديم صديقتي L
Shock. Diffuse lung damage. Inhalation of toxic. Multiple blood transfusion. Large volume of fluid replacement.

طيب سؤال؟؟؟ ليه لما نسوي بلود ترانسفيوجن أو فلود يصير لنا ARDS??
1 contaminated blood
2 large volumes>overwhelm the lung cause damage alveolar capillary membrane> fluid leaking to alveoli> diffuse alveolar damage>disturb O2 exchange>ARDS

Question 17

Pathophysiology of ARDS?? ⭐️

Answer 17

8 steps important!!!
البداية هنا مو سرفاكتنت لازم ننتبه البداية راح تؤدي إلى خلل بالسرفاكتنت
1 diffuse alveolar capillary damage> inflammation> release
2 capillary vasodilation NML زي النمل تروح على الرئة
3 fluid(exudate) from capillary to interstitiam> alveolo-capillary damage
4 fluid enters alveoli oedema
5 type 2 pneumocystis dysfunction هنا يقلل تصنيع سرفاكتنت
6 hypoxia
7 IMPORTANT (massive right to left shunting within the lung وش معناه؟ دايما الأكسجين يكون كثير بالجهة اليسار لما تخرب الرئة الجهة اليسار كلها تخرب فيصير الجزء اليمين من القلب ارحم وفيه أكسجين افضل من اليسار
8 DAD occurred

Question 18

Describe the gross PP of ARDS? ⭐️

Answer 18

Heavy red boggy ES
firm fibrotic contracted LS one month later

Question 19

Describe the microscopic picture of ARDS?

Answer 19

ES/ 3 words congestion. Oedema. Haemorrhage
Some of hyaline membrane
In fatal cases bronchopneumonia
LS/ fibrosis (organizing) بنلاقي فايبروسس جوا وبرا

Question 20

Clinical pictures of ARDS??

Answer 20

دامه severe condition

Rapid, severe & life-threatening respiratory
insufficiency.
Dyspnea & tachypnea
3. Cyanosis 🚹 and severe arterial hypoxemia
4. Extra-pulmonary organ failure as brain hypoxemia
(causing confusion up to coma)