RDS In Neonate Flashcards
What are the signs of respiratory distress?
(Tachypnea + cyanosis)
Grunting, Nasal flaring, Chest retraction
What is the test that is most accurate and fast to differentiate cardiac vs respiratory causes of cyanosis
Hyperoxia test of oxygen more than 150 is respiratory cause
Othe differentiating factor for respiratory causes of cyanosis
History of: preterm, maternal fever, CS, Exam of: crackles, rhonchi, retraction, temp CXR: abnormal chest parynchema ECG: normal ABG: PCO2 increased
In which group of population isi transient tachypnea of the newborn is more common?
Respiratory distress type 2 is common in term, preterm and CS
What are the positive findings of TTN?
Wet lung and tachypnea
How is the outcome of TTN?
Starts 2hrs post delivery and resolves within 24hours
How to treat TTN?
Supportive and could give CPAP but no need for medics
What are the most important signs in tachypnea of the newborn?
- increased lung volume
- fluids filling the transverse fissures
Less:
- pulmonary congestion
- perihilar streaking
- cardiac boarder not clear
In a diabetic mother, which type of RDS is common to occur
RDS type 1
In CS mother, which type of RDS might occur
TTN
What is the cause of RDS 1
Surfactant deficency
How to manage RDS 1
CPAP\ventilaition and then surfactant
Differentiate between lung volume in RDS 1 and 2, and pneumonia
1: decreased lung volume
2: increased lung volume
3: normal lung volume
What are the x-ray findings of RDS1
1- ground glass appearance
2- air bronchogram
3- deecreased lung volume
4-bell shape (no pleural effusion)
In which parynchymal lung disease do we see the cardiac shadow very clear
Meconium aspiration
Pneumonia
What is the X-ray findings in meconium aspiration?
- Lung over inflation
- patchy density cloud like
- cardiac shadow
How to treat meconium aspiration?
Decrease lung pressure and NO
Mechonium aspiration is common in which age?
Post term
What are the pathogens that cause early pneumoina?
Step pneumonia HEmophillus GABHS Ecoli Klebsiell & chlymedia
What is early and late pneumon9oa
Early is less than 7 days
Late is more
In which group of population do we expect pneumonia to cause RDS
Preterm, PROM, maternal fever, term
How to treat pneumonia in neonate
1- AB
2- Vasopressor (dopamine or dobutamine)
3- O2 therapy & ventilator
What are the x-ray finding of pneumonia?
1- pleural effusion
2- see the heart
3- air bronchogrm’
4- granular appearance
What is the most common CDH??
Left side bochdaleck hernia
What do you expect to see in CDH Examination of neonate?
Scaphoid abdomen and dsiplaced heart sound
What is the immidiate thing to do in CDH?
Intubate the child
What do you expect to see in CDH?
Bowel in thorax, mediastinal shift and decrease lung volume (lung hypoplasia)
Differentiate between lobar emphysema and pneumonthorax
We can’t see demarcation line
What is the most common lobe affected in lobar emphysema
Left upper lobe
What are the x-ray finidngs of CCAM?
Whole lobe is dilated, mediastinal shift, and we can’t see demarcated line
How to treat CDH?
Intubate, ventilate, NGT
What is the common site for conginital cystic adenomatoid malfromation
Right sided
What is the outcome of CCAM?
100% survival after surgery except in hydrops fetalis
What are the x-ray finidng of CcAM?
Unilateral lobe or cyst in right side - bronchioles are dilated
What is the typical presentation of pulmonary sequstration?
Recurrent infection
What is pulmonary sequestration?
Abnormal lung tissue with no connection with tracheobronchial tree nor pulmonary circulation
What are the finidngs in pulmonary sequestration?
- triangular opacity and rarely bronchogram
What is the gold standard for diagnosing pulmonary sequestration
Angiogram
What is the test that comomnly done to patients suspected to have pneumothorax? (Done instead of CXR)
Translumination
Who’s at high risk of developing pneumonthorax?
Infant with
RDS, MAS, ventialation, intubation
What is the thing that you’ll notice during exam of pneumonthoax?
Displaced apex beat
X-ray finding of pneumothorax?
Air over diaphragm. Mediatinal shift, and outline of the affected lung
