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
CPAM patients will present in the first few years with what
Recurrent respiratory infections, or pulmonary abscess
26
Diagnosis of CPAM
Chest CT with IV contrast
27
When it comes to treatment of CPAM, what surgery is recommended to be done between 3-6 months of age and why?
Open or Thorascopic lobectomy, this is due to the risk of such CPAM turning malignant later on in life.
28
CLE, congenital lobar emphysema is what
Air trapping and over distention of the lung lobes
29
Asymptomatic children with CLE, or only mild symptoms treatment
Safely/conservatively managed without resection
30
CLE treatment
If presenting with RDS, urgent open lobectomy is the appropriate treatment
31
BPS treatment for extralobar sequestration
Division and ligation via thoracotomy or thorascopy
32
BPS treatment for Intralobar sequestration
Lobectomy, also via thoracotomy or thorascopy
33
GERD surgery
Nissen Fundoplication
34
GERD diagnostic modality
Barium studies and Endoscopy