Respiratory distress syndrome (Acute and Neonatal)

Question 1

neonatal respiratory distress syndrome - pathophysiology

Answer 1

surfactant deficiency –> increased alveolar surface tension –> alveolar collapse

Question 2

lab test predictive for neonatal respiratory distress syndrome

Answer 2

1. lecithin/sphingomyelin ration in amniotic fluid –>
   - if more than 2 –> healthy
   - if less than 1.5 –> predictive of NRDAS
2. foam stability test
3. surfactant/albumin ratio

Question 3

neonatal respiratory distress syndrome - CXR

Answer 3

ground glass appearance of lung fields

Question 4

neonatal respiratory distress syndrome - persistently low O2 tension - risk of

Answer 4

1. PDA
2. metabolic acidosis
3. necrotizing enterocolitis

Question 5

neonatal respiratory distress syndrome - therapeutic supplemental of O2 can result in

Answer 5

1. retinopathy of prematurity
2. Intraventricular haemorrhage (brain)
3. Bronchopulmonary dysplasia

Question 6

Intraventricular hemorrhage of the newborn is….

Answer 6

bleeding into the fluid-filled areas (ventricles) inside the brain

Question 7

neonatal respiratory distress syndrome - risk factors

Answer 7

1. prematurity
2. maternal diabetes
3. C-section delivery

Question 8

maternal diabetes as a risk factor of neonatal respiratory distress syndrome

Answer 8

increased fetal insulin (insulin decreases surfactant production)

Question 9

C-section delivery as a risk factor of neonatal respiratory distress syndrome

Answer 9

lack of stress induced steroids (steroids induce synthesis of surfactant)

Question 10

neonatal respiratory distress syndrome - treatment

Answer 10

1. maternal steroids before birth

2. artificial surfactant for infant

Question 11

neonatal respiratory distress syndrome - clinical feature after birth

Answer 11

1. hypoxemia with cyanosis

2. increased respiratory efforts (tachypnea, use of accessory muscles, grunting )

Question 12

neonatal respiratory distress syndrome - oxygen supplement may induce problems because of (nomizw)

Answer 12

free radicals

Question 13

NRDS

Answer 13

neonatal respiratory distress syndrome

Question 14

ARDS

Answer 14

acute respiratory distress syndrome

Question 15

ARDS definition

Answer 15

clinical syndrome characterized by

1. acute onset respiratory failure,
2. bilateral lung opacities
3. decreased Pa02/Fi02 ratio
4. no HF

Question 16

ARDS is a clinical syndrome characterized by

Answer 16

1. acute onset respiratory failure,
2. bilateral lung opacities
3. decreased Pa02/Fi02 ratio
4. no HF

Question 17

ARDS may be caused by

Answer 17

1. trauma 2. sepsis 3. shock 4. gastric aspiration

5. uremia 6. acute pancreatitis 7 .amnionic fluid embolism 8. Pneumonia

Question 18

ARDS management

Answer 18

1. mechanical ventilation with LOW TIDAL VOLUMES

2. address underling cause

Question 19

ARDS - pathophsyiology

Answer 19

diffuse alveolar/endothelial damage –> increased capillary permeability –> protein reach leakage into alveoli and noncarcinogenic pulmonary edema (normal PCWP) –>results in formation of intra-alveolar hyaline membranes

Question 20

ARDS - PCWP

Answer 20

normal (noncardiogenic edema)

Question 21

ARDS - diffuse alveolar damage is caused by

Answer 21

release of neutrophilic substances toxic to alveolar wall, activation of coagulation cascade, and oxygen-dervied free radicals

Question 22

neonatal respiratory distress syndrome - CXR

Answer 22

ground glass appearance of lung fields