Week 5: Developmental Aspects of Lung Disease

Question 1

Stages of development

Answer 1

EPCSA

• embryonic 3-8w
• pseudoglandular 5-17w
• canalicular 16-28w : MINIMAL DELIVERY d/t gas exchange dev.
• saccular 24-38w: surfactant prod
• alveolar 36-2/3y/o

Question 2

Upper tract abnormalities

Answer 2

1. LARYNGOMALACIA: self-improve; feeding compl. + stridor & apnoea,
2. TRACHEOMALACIA: natural resolution; recurrent barking cough croup, breathless exertion
3. TRACHEO-OESOPHAGEAL FISTULA: oesoph. atresia, postnatal issues, surgical tx.

Question 3

Lower tract abnormalities

Answer 3

1. CPAM: congenital pulmonary airway malformation 80% antenatal, sporadic non-functioning lung tissue
   => natural res. / => malignant change
2. Congenital diaphragmatic hernia: antenatal, variations: RHS poorer outcome, malignant change

Question 4

Neonatal Lung Diseases

Answer 4

1. RDS: pre-term & term infants:
   => antenatal steroids; surfactant replacement; ventilation + nutrition planning
2. Chronic Lung disease:↑childhood infection and risk in adult life
   => ongoingO2 @ term
3. Transient Tachyopnoea of Newborn: c-sect association
   => resp support

Question 5

Remodelling

Answer 5

Airway alteration due to external influences
> environmental
> chronic disease
>infection
>abn airway d/t interference of signalling