Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neonatal Board Questions > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Most appropriate next step for pneumediastinum

A

Observation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ion responsible for creating fetal lung fluid

A

Chloride (by active transort)

Chloride Creates Critical fluid
Sodium Secretion Sends it back out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ion responsible for clearing fetal lung fluid

A

Sodium

Chloride Creates Critical fluid
Sodium Secretion Sends it back out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diaphragmatic paralysis: Unilateral or Bilateral more common?

A

Unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diaphragmatic paralysis: Right or left side more common?

A

Right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does diaphragm move during paralysis?

A

Rises with inspiration and falls with expiration = Kienboeck’s sign
ie. collapses with inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

OI equation

A

MAP X FiO2 / postuductal PaO2 x 100

> 25 severe lung disease
40 ECMO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stages of lung development

A 
Embryonic 
Pseudoglandular
Cannalicular
Saccular
Alveolar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When does Embryonic stage of development happen?

A

0-7 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When does Pseudoglandular stage of development happen?

A

7-17 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When does Cannalicular stage of development happen?

A

17-27 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does Saccular stage of development happen?

A

27-36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When does Alveolar stage of development happen?

A

36 weeks - 3-8 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Equation for Oxygen content

A

1.34 mL O2/g Hb x Hb x O2 sat + [0.003 x paO2]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

There is a profound effect in oxygen content with changes in ____

A

hemoglobin concentration

1.34 mL O2/g Hb x Hb x O2 sat + [0.003 x paO2]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ways to increase MAP

A 
Increase PEEP (most effective)
Increase PIP
Increase iTime
Increase rate
Increase flow
Decrease expiratory time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Criteria for ECMO

A

FiO2 100% + A-a gradient >600
PIP >35
paO2 <40
OI >40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Contraindications to ECMO

A

Prematurity <35w
Irreversible lung disease or Neuro abnormalities
significant coagulopathy
severe IVH
congenital anomalies with poor long term outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which is connected to pulmonary circulation? CPAM vs BPS?

A

CPAM

BPS = Systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which is connected to tracheobronchial tree? CPAM vs BPS?

A

CPAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ways HFOV work

A 
Bulk convection
Pendelluft effect
Taylor dispersion
Molecular diffusion
Asymmetric velocity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A-a gradient equation

A

pAO2 - paO2 = [FiO2 x (pB - pH2O)] - paCO2/R - paO2

R= 0.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Effects of CPAP

A 
Decreases total airway resistance
Inc FRC
Dec WOB
Dec compliance
Improves gas exchange
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What stage of lung development do Type 1 and 2 pneumocytes form?

A

Canalicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When are lamellar bodies formed and what are they?

A

Canalicular

Storage location of surfactant in type II pneumonytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Survanta made of what

A

Bovine lung, SP-B and C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Infasurf made of

A

Bovine lung, SP-B and C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Curosurf made of

A

Porcine lung (pig), SP-B and C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

La Place’s law

A

Distending P = 2xST / alveolar radius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Alveolarization delayed by

A

antenatal steroids
oxygen
nutritional deficiencies
mechanical ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Total respiratory system resistance

A

chest wall R (25%) + airway R (55%) + lung tissue R (20%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What makes up majority of airway resistance?

A

Nasal passages

remainder of R comes from first few generations of bronchi with distal airways contributing very little

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

CDH due to

A

Failure of closure of the pleuroperitoneal canal at approx 8 weeks

34
Q

Characteristics of new BPD

A 
Arrest of alveolarization: 
- increased alveolar diameters
- Fewer alveoli
- Disruption of the collagen network
- Localization of elastin
- Increased AND dec PECAM staining
CXR: Hyperinflation, minimal cystic emphysema
Less airway reactivity and pulmonary HTN than classic;
Minimal fibrosis
35
Q

MC organism associated with chorio

A

Ureaplama > Mycoplasma

36
Q

How do antenatal steroids mature the lung?

A

Decreasing the amount of mesenchymal tissue and increasing the potential airspace volume –> arrest of alveolar / saccular septation

37
Q

Mild BPD

A

Treatment with O2 for at least 28 days +

RA at 36 weeks or discharge

38
Q

Moderate BPD

A

Treatment with O2 for at least 28 days +

<30% FiO2 at 36 weeks or discharge

39
Q

Severe BPD

A

Treatment with O2 for at least 28 days +

>/=30% FiO2 AND/OR CPAP or NIV at 36 weeks or discharge

40
Q

MCC PHTN in newborns

A

MAS

41
Q

Meconium injures the lungs by

A

Mechanical obstruction –> ball valve mechanism
Chemical pneumonitis (due to release of cytokines)
Activation of complement
Inactivation of surfactant
Vasoconstriction of pulmonary vessels

42
Q

Why does iNO not cause systemic vasodilation?

A

Once in the bloodstream, it binds avidly to hemoglobin, limiting its systemic vascular activity

43
Q

iNO contraindicated in

A

heart disease dependent on R-L shunting across PDA ie. critical aortic stenosis, interrupted AA, hypoplast
TAPVR

44
Q

Variables that help with exogenous surfactant distribution

A 
liquid form
higher volume
faster rate of administration
higher fluid volume in lungs like right after delivery
higher gestational age 
after exposure to ANS
45
Q

Describe apnea due to laryngeal reflex

A

Stimulation of the laryngeal mucosa causes apnea by exaggerated inhibitory reflex mediated by superior laryngeal nerve

46
Q

Methylxanthines MOA

A 
Inhibition of adenosine -->
Decrease hypoxic depression of breathing
Decrease periodic breathing
Improve CO2 sensitivity
Increase diaphragmatic activity
Increase minute ventilation
47
Q

What responds to CO2

A

Central Chemoreceptors on the ventrolateral surface of the medulla

48
Q

What responds to O2

A

Peripheral chemoreceptors in the carotid and aortic bodies

49
Q

Dead space

A

Volume of air that does not take place in gas exchange

Dead ie no blood flow

50
Q

Anatomic dead space

A

Lung areas such as conducting airways which are not involved in gas exchange
Bronchoconstriction decreases it

51
Q

Alveolar dead space

A

Alveoli not involved in gas exchange

52
Q

Physiologic dead space

A

Anatomic dead space + Alveolar dead space

53
Q

Haldane effect

A

Increase in arterial pO2 reduces the affinity of hemoglobin to CO2
(Hemoglobins
Affinity
LDane- CO2)

54
Q

Bohr Effect

A

CO2 and H+ affect affinity of hemoglobin for oxygen
-High CO2 and H+ decrease the affinity of hemoglobin for O2

B
Oxygen
Hydrogen
Released in tissue

55
Q

Airway resistance during inspiration and expiration

A

Decreases during inspiration (bronchodilation)

Increases during expiration

56
Q

Choanal Atresia Mnemonic

A 
CAT FUR
Choanal ATresia
Females
Unilateral 
Right sided
57
Q

Alveolar ventilation

A

(TV-dead space) x RR

Inc in neonates

58
Q

Minute ventilation

A

TV x RR

Inc in neonates

59
Q

Treatment for chylothorax

A

Thoracentesis + MCT formula once eating

B/c lymphatic vessels are not required for absorption of MCT

60
Q

Right side more common in

A

Diaphragmatic paralysis
Choanal Atresia
Chylothorax

61
Q

Characteristics of chylothorax

A 
Transudative
Xanthochromic or milky
Lymphocytic predominance >80%
WBC <1000
pH >7.4
Elevated protein
High TG (>110)
LDH <200
62
Q

Maternal conditions ass with accelerated lung maturation and surfactant production

A 
PIH and chronic HTN
IUGR
Chorio
PROM
Placental infarction
CV disease
Incompetent cervix
Hemoglobinopathies
63
Q

CPAP provided by in NRP

A

Flow inflating bag and T-piece

NOT self inflating bag (no flow of gas when bag not being compressed)

64
Q

Is interrupting breathing normal in utero?

A

Yes. PGE2 from placenta plays a role in it.

65
Q

How does hypoxia induce apnea?

A

Adenosine receptor stimulation in the pons

Caffeine inhibits adenosine

66
Q

Mechanisms of apnea of prematurity

A

Decreased response to hypercarbia (respond with inc in TV not RR)
Irritation of laryngeal mucosa –> inhibitory reflex
Hypoxic ventilatory depression to sustained hypoxia

67
Q

Does GERD cause apnea of prematurity?

A

No. But AOP can cause GERD d/t relaxation of the LES

68
Q

What enzyme does NO work on?

A

Guanylate cyclase in endothelial cells
Converts GTP to cGMP
Cyclic GMP increases calcium efflux leading to vascular smooth muscle relaxation

69
Q

Clinical triad of PPHN

A

1) sat differential >5-10% or PaO2 >/= 20 mmHg
2) OI >/= 15
3) Lability of sats

70
Q

Static lung compliance

A

Measured when no flow of gas

Reflects elastic properties of the lung

71
Q

Dynamic lung compliance

A

Measured during flow of gas
Reflects both elastic properties of the lung and resistance to flow
Impacted by RR

72
Q

Where are Na-K-ATPase pumps located?

A

Basolateral cell membrane

73
Q

Where are ENaC channels located?

A

Apical surface of the respiratory cell

74
Q

P50

A

Oxygen tension at which 50% hemoglobin is saturated with oxygen
Fetal hemoglobin has higher oxygen affinity so has lower P50

75
Q

Things that shift oxyhemoglobin curve to right

A 
Adult hemoglobin (inc offloading)
Dec pH
Inc 2,3 DPG
Inc Temp
Inc altitude
76
Q

Things that shift oxyhemoglobin curve to left

A

Fetal hemoglobin (inc affinity, dec offloading, Lower P50)
Inc pH
Dec 2,3 DPG
Dec Temp

77
Q

At a constant temperature, a given volume of gas varies inversely to to the pressure to which it is subjected

A

Boyle’s law

78
Q

As a gas is warmed it expands, and shrinks as it is cooled

A

Charle’s Law

79
Q

Total pressure exerted by a mixture of gases is equal to the sum of the partial pressure of each gas

A

Dalton’s law

80
Q

Transfer of solute by diffusion is directly proportional to the cross sectional area available for diffusion

A

Fick’s law

81
Q

At a constant temperature, any gas physically dissolves in a liquid in proportion to its partial pressure

A

Henry’s law

“Hank Henry Sank”

82
Q

Cause of Choanal Atresia

A

Failure of the bucconasal membrane to rupture during the 5th and 6th weeks

Neonatal Board Questions (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions