Respiratory Flashcards
What is the most common cause of apnea in an otherwise healthy premature infant?
In an otherwise well premature infant, apnea is thought to be secondary to an incompletely developed respiratory center.
What is transient tachypnea of the newborn?
Transient tachypnea of the newborn is usually seen after a scheduled cesarean delivery, but can be seen in infants born via cesarean after a trial of labor, as well as in
spontaneous vaginal deliveries. The condition is a result of retained fetal lung fluid. These patients have tachypnea, retractions, grunting, and sometimes cyanosis. The chest examination is usually normal; the chest radiograph demonstrates prominent pulmonary vascular markings with fluid in the fissures and hyperexpansion (flat diaphragms). Therapy is supportive, with maintenance of normal oxygen saturation. Resolution usually occurs in the first 3 days of life.
What should you think in a neonate with increased work of breathing with an upper brachial plexus injury?
Ipsilateral phrenic nerve paralysis. Ultrasound or fluoroscopy is diagnostic and will show a seesaw movement of the diaphragm during respiration
What does a spiking fever, respiratory distress, and inspiratory and expiratory stridor suggest, without drooling?
Bacterial tracheitis (drooling might suggest epiglottitis) Treatment is intubation and antibiotics
What are characteristics of epiglottitis?
In the past, epiglottitis was most commonly caused by invasive H influenzae type B. Due to the widespread use of the Hib vaccine, this condition is now more
commonly caused by group A β-hemolytic streptococcus, Moraxella catarrhalis, or S pneumoniae. The radiography shows the typical “thumb” sign of a swollen epiglottis. The course of the illness is brief and prodromal symptoms are lacking. The patient experiences a sudden onset of sore throat, high fever, and prostration that is out of proportion to the duration of the illness. Drooling and difficulty in swallowing, a muffled voice, and preference for a characteristic sitting posture with the neck
hyperextended may be noted.
What is congenital cystic adenomatoid malformation (CCAM)?
Thought to arise from an embryonic disruption before the 35th day that causes improper development of bronchioles. The cystic mass is usually identified on prenatal ultrasound around the 20th week. Large lesions may compress the affected lung and cause pulmonary hypoplasia, and cause midline shift away from the lesion. Treatment is typically surgical excision of the affected lobe.
What are risk factors for developing respiratory distress syndrome (RDS) in newborn infants?
Prematurity, male sex, perinatal asphyxia, maternal diabetes, and C-section without labor
Why can maternal diabetes cause RDS in a newborn?
High levels of circulating insulin in the infant antagonize cortisol and block the maturation of sphingomyelin
What is the most common causative agent for pneumonia in children with cystic fibrosis?
Staph aureus. Pseudomonas becomes predominant in late adolescence to early adulthood
What are features of laryngomalacia in infants?
Inspiratory stridor that is worse when supine and improves when prone
What are features of a vascular ring in infants?
Biphasic stridor that improves with neck extension
