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CVPR Pulmonary (Exam 3) > Pathoma: Resp Distress Syndromes > Flashcards

Pathoma: Resp Distress Syndromes Flashcards

1
Q

How does ARDS present?

A
  • hypoxemia
  • cyanosis
  • respiratory distress
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1
Q

This is respiratory distress due to inadequate surfactant levels.

A

neonatal respiratory distress syndrome

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2
Q

What is the key component of surfactant?

A

lessafin/phosphatidylcholine

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3
Q

What is the problem with formation of hyaline membranes?

A
  1. thickened diffusion membrane —> hypoxemia/cyanosis 2. increased surface tension –> collapse
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4
Q

Name a complication of ARDS recovery.

A

interstitial fibrosis

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5
Q

What are the xray findings in neonatal RDS?

A

diffuse granularity of the lung

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7
Q

What does ARDS stand for?

A

acute respiratory distress syndrome

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7
Q

How do pts with neonatal respiratory distress syndrome present?

A
  • increased work of breathing
  • tachypnea
  • use of accessory muscles
  • grunting cyanosis
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7
Q

Why are free radicals bad in neonates?

A

they can travel to the retina and cause blindness, or it can damage the lung to cause bronchopulmonary dysplasia

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8
Q

This type of cells act as the lung stem cell and produces surfactant.

A

type II pneumocyte

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8
Q

How does maternal diabetes cause neonatal RDS?

A

Insulin is an inhibitor of surfactant production. Increased sugars causes pancreas to produce more insulin in baby.

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9
Q

In ARDS, activation of neutrophils induces protease-mediated and free-radical damage of ______.

A

type I and II pneumocytes

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10
Q

How is adequacy of surfactant screened before birth?

A

the L:S ratio

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11
Q

What is the tx for ARDS?

A

treat the underlying condition:

  • ventilation with positive end expiratory pressure (PEEP)
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11
Q

What are the 2 functions of type II pneumocytes?

A
  • act as the lung stem cell
  • to produce surfactant
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12
Q

_____ increases risk of free radical injury, a possible complication of neonatal RDS.

A

Supplemental O2

14
Q

What is neonatal respiratory distress syndrome?

A

respiratory distress due to inadequate surfactant levels

16
Q

Why does interstitial fibrosis occur in ARDS?

A

type II pneumocytes were depleted (they’re the stem cells) so instead of regeneration of the lung, it’s instead repaired

17
Q

What is the underlying problem in ARDS?

A

diffuse damage to the alveolar-capillary interface w/I the air sac –> leaking of protein rich fluid –> fluid reorganizes into formation of hyaline membranes

18
Q

Hypoxemia increases the risk of ______ and _____ in neonatal RDS.

A

patent ductus arteriosus (PDA) and necrotizing enterocolitis

21
Q

In _____, activation of neutrophils induces protease-mediated and free radical damage of type I and II pneumocytes.

A

ARDS

22
Q

_____ is produced by type II pneumocyte in the lungs.

A

Surfactant

24
Q

What are the 3 main causes of neonatal RDS?

A
  1. prematurity
  2. C-section delivery
  3. maternal diabetes
25
Q

What can cause ARDS?

A
  1. sepsis
  2. infection
  3. shock
  4. trauma
  5. aspiration
  6. pancreatitis
  7. DIC
  8. hypersensitivity rxn
  9. drugs
25
Q

In ARDS, activation of _____ induces protease-mediated and free radical damage of type I and II pneumocytes.

A

neutrophils

25
Q

What do L and S stand for in the L:S ratio of surfactant adequacy?

A

L = lessafin (increases w/ increasing surfactant production) S = sphingomyolin (constant)

25
Q

What causes bronchopulmonary dysplasia?

A

free radical damage to the lungs

26
Q

Why can C-section delivery cause neonatal RDS?

A

a vaginal birth stresses the bay, causing steroid release that helps produce and release surfactant. C-section babies don’t get this stressor.

28
Q

What do steroids do to surfactant?

A
  1. increase production
  2. increase its release from the type II pneumocytes
29
Q

What are the xray findings in ARDS?

A

diffuse white out

31
Q

In ARDS, activation of neutrophils induces _____ and ____ damage of type I and II pneumocytes.

A

protease-mediated; free radical

32
Q

______ increases the risk of patent ductus arteriosus (PDA) and necrotizing enterocolitis in neonatal RDS.

A

Hypoxemia

33
Q

At what value or greater is the L:S surfactant ratio considered adequate/a mature lung?

A

2

CVPR Pulmonary (Exam 3) (42 decks)

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