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Surgery 2 > PED: Neonatal Respiratory Distress > Flashcards

PED: Neonatal Respiratory Distress Flashcards

1
Q

What is the most common esophageal abnormality

A

Esophageal Atresia

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2
Q

Esophageal atresia is classified under A B C D E, which is the most common, and explain it

A

Type C, an esophageal atresia with distal fistula

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3
Q

What is the earliest clinical sign of EA?

A

Excessive drooling and salivation

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4
Q

On exam of EA, what do we see?

A

Manifestations of respiratory distress and intercostal retractions are noted

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5
Q

What clinical exam do we do that confirms EA?

A

Try putting in a nasogastric tube, obviously won’t pass.

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6
Q

What do we do differently when doing an X-ray for EA?

A

Pass the nasogastric tube, as to see the level of the EA.

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7
Q

Air in the stomach and bowl on XR of EA indicates what

A

EA with Transesophageal fistula

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8
Q

Abscence of air in stomach and bowel on XR of EA indicates what

A

EA without TEF

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9
Q

Pre op management of EA

A

Vit K, antibiotics, and IV fluids

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10
Q

Operative treatment of EA with TEF

A

Right sided extrapleural thoracotomy in 4th ICS

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11
Q

Treatment of EA without TEF

A

Gastrotomy tube to allow enteral feeding

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12
Q

Procedure to conserve patient’s esophagus

A

Delayed primary anastomosis at 2-3 months of life

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13
Q

What is Congenital Diaphragmatic hernia?

A

Life threatening developmental defect of the diaphragm

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14
Q

There are 3 types of CDH hernia, explain the Bochdalek hernia

A

Posterolateral defect

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15
Q

Explain the CDH Morgagni hernia

A

Anteromedial defect

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16
Q

Bochdalek Hernia clinical manifestation

A

Severe RDS at birth or first few hours, clinically shows mediastinal shift, absent breath sounds on affected side

17
Q

Bochdalek hernia X-ray finding

A

Inestinal loops in the chest

18
Q

When resuscitating a Bochdalek hernia patient, why do we intubate and not use an ambu bag?

A

To avoid abdominal distention of the stomach and inteestinesvthat may be in the thoracic cavity

19
Q

Prenatal intervention for Bochdalek hernia

A

FETO procedure (Fetoscopic endoluminal tracheal occlusion)

20
Q

Postnatal intervention for Bochdalek hernia

A

Thorascopy or laparoscopy(not preferred)

21
Q

How do most surgeons approach the Bochdalek hernia through which incision and why

A

Subcostal, as it offers good exposure and easy reduction of the abdominal viscera

22
Q

Why is Laparoscopy not preferred to treat Bochdalek hernia?

A

The pneumoperitoneum prevents easy reduction of the thoracic contents

23
Q

What is the most commonly diagnosed bronchopulmonary malformation?

A

CPAM (congenital pulmonary airway malformation)

24
Q

Explain CPAM

A

Benign tumors characterized by overgrowth of pulmonary bronchioles

25
Q

CPAM patients will present in the first few years with what

A

Recurrent respiratory infections, or pulmonary abscess

26
Q

Diagnosis of CPAM

A

Chest CT with IV contrast

27
Q

When it comes to treatment of CPAM, what surgery is recommended to be done between 3-6 months of age and why?

A

Open or Thorascopic lobectomy, this is due to the risk of such CPAM turning malignant later on in life.

28
Q

CLE, congenital lobar emphysema is what

A

Air trapping and over distention of the lung lobes

29
Q

Asymptomatic children with CLE, or only mild symptoms treatment

A

Safely/conservatively managed without resection

30
Q

CLE treatment

A

If presenting with RDS, urgent open lobectomy is the appropriate treatment

31
Q

BPS treatment for extralobar sequestration

A

Division and ligation via thoracotomy or thorascopy

32
Q

BPS treatment for Intralobar sequestration

A

Lobectomy, also via thoracotomy or thorascopy

33
Q

GERD surgery

A

Nissen Fundoplication

34
Q

GERD diagnostic modality

A

Barium studies and Endoscopy

Surgery 2 (21 decks)

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