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Unit 6: Path - Developmental and Genetic Diseases > Prematurity and Intrauterine Growth Retardation > Flashcards

Prematurity and Intrauterine Growth Retardation Flashcards

1
Q

What is the weight of infants considered low-birth-weight infants?

A

<2500 g

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2
Q

Classification of newborns < 1500 g?

A

Very-low-birth-weight infants

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3
Q

Four factors contributing to premature birth of an infant?

A
  • Maternal illness
  • Uterine incompetence
  • Fetal disorders
  • Placental abnormalities
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4
Q

What are the major causal agents that lead to neonatal problems?

A

Organ immaturity

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5
Q

What physiologically occurs that results in respiratory distress in premature infants?

A

Lining of cells in fetal alveoli do not differentiate into type I and type II pneumocytes

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6
Q

What allows alveoli to remain expanded during the respiratory cycle?

A

type II pneumocytes that produce surfactant

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7
Q

What is the ratio of lecithin to sphingomyelin that indicates that a neonate should survive w/o developing RDS?

A

2:1

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8
Q

What indicates the best proof of the maturity of fetal lungs?

A

Presence of phosphatidyl glycerol in the amniotic fluid

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9
Q

What enzyme in absent in an immature liver?

A

Glucuronyl transferase resulting in neonatal jaundice

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10
Q

What does the Apgar scoreindicate?

A

Clinical assessment of neonatal maturity performed at 1 and 5 minutes post-delivery

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11
Q

What does neonatal surfactant deficiency result in?

A

Neonatal Respiratory Distress Syndrome

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12
Q

Describe the general pathogenesis involved with neonatal RDS

A
  • Immature type II pneumocytes
  • No surfactant
  • Lung epithelium adheres and cells leak plasma contents into alveolar space resulting in further binding of surfactant and respiratory insufficiency
  • Lack of ventilation
  • Hypoxia and acidosis
  • Further dysfunction of type II pneumocytes
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13
Q

What is the name given to the uscopic findings of a neonate with RDS?

A

Hyaline membrane disease due to alveolar ducts lined by conspicuous eosinophilic fibrin-rich amorphous structures

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14
Q

Clinical signs of RDS?

A
  • Early on, typically fine
  • Increased respiratory effort
  • > 100 RR
  • Cyanosis and flaccidity
  • Death by asphyxia
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15
Q

What are some major complications of RDS?

A
  • INtraventricular cerebral hemorrhage
  • Persistent patent ductus arteriosus
  • Necrotizing enterocolitis
  • Bronchopulmonary dysplasia
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16
Q

Hemolytic disease caused by maternal antibodies against fetal erythrocytes?

A

Erythroblastosis Fetalis

17
Q

What Rh antibodies typically cause 90% of erythroblastosis fetalsis?

A

Rh D

18
Q

What pregnancies are typically affected by mother Rh antigens?

A

Following the first pregnancy when the mother (Rh-) is sensitized to the Rh+ baby. Following Rh+ babies will be affected.

19
Q

What is the most severe sequela of erythroblastosis fetalis?

A

Death in utero

20
Q

What is the most serious form of erythroblastosis fetalis in liveborn infants?

A

Hydrops fetalis characterized by severe edema due to CHF caused by severe anemia

21
Q

Condition associated with severe jaundice and characterized by bile staining of the brain, particularly in the basal ganglia, pontine nuclei and dentate nuclei in the cerebellum

A

Kernicterus (Bilirubin encephalopathy)

22
Q

What has become the main cause of hemolytic disease in newborns?

A

ABO incompatibility

23
Q

What is the name of the condition in which edema of the scalp occurs caused by trauma to the head during passage through the birth canal?

A

Caput succedaneum

24
Q

Subperiosteal hemorrhage of a single cranial bone?

A

Cephalohematoma

25
Q

What are skull fractures typically caused by?

A

Either the pelvic bones or the obstetric foreceps

26
Q

What can excessive traction on the the head and neck at delivery cause?

A

Brachial palsy

27
Q

What is the bone most susceptible to fracture during delivery?

A

Clavicle

28
Q

What is Sudden Infant Death Syndrome?

A

Sudden death of an infant or young childe which is unexpected by history and in which a thorough postmortem examination fails to demonstrate an adequate cause of death

29
Q

Strongest maternal RFs for SIDS

A
  • Low socioeconomic status
  • Black/Native American population
  • Age < 20
  • Smoking/Drinking during pregnancy
  • Illicit drug use
  • Increased parity
30
Q

Strong RFs for the infant to get SIDS

A
  • Low birth weight
  • Prematurity
  • Illness
  • Subsequent siblings of SIDS victims
  • Survivors of an apparent life-threatening event
31
Q

What is the most common channelopathy that causes SIDS?

A

Loss of Function mutation in cardiac K+ channels that result in long QT syndrome

32
Q

What is likely the most important etiologic factor of SIDS?

A

Maternal smoking

Unit 6: Path - Developmental and Genetic Diseases (4 decks)

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