Respiratory Tract Disorders Flashcards Preview

Nelson - Exam 2 (Neonat) > Respiratory Tract Disorders > Flashcards

Flashcards in Respiratory Tract Disorders Deck (44)
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1
Q

Absence of airflow but persistent chest wall motion

A

Obsturctive apnea

2
Q

Airflow and chest wall motion are absent

A

Central apnea

3
Q

Most important determinant of respiratory control

A

Gestational age

4
Q

MC pattern of idiopathic apnea in preterm neonates

A

Mixed apnea

5
Q

Increase central respiratory drive by lowering threshold of response to hypercapnia, enhancing contractility of the diaphrag, and preventing diaphragmatic fatigue

A

Methylxanthines

6
Q

T/F Apnea of prematurity is a risk factor for SIDS

A

F

7
Q

Major constituents of surfactant

A

1) Lecithin (phosphatidylcholine) 2) Phosphatidylglycerol 3) Apoproteins 4) Cholesterol

8
Q

Surfactant is present in high concentrations in fetal lung homogenates by

A

20 weeks AOG

9
Q

Surfactant appears in amniotic fluid when

A

28-32 weeks AOG

10
Q

Mature level of pulmonary surfactant are present usually when

A

After 35 weeks AOG

11
Q

Signs and symptoms of RDS reach a peak within

A

3 days, after which improvement is gradual

12
Q

Improvement of RDS is often heralded by

A

1) Spontaneous diuresis 2) Improved blood gas values at lower FiO2 levels/ventilatory support

13
Q

Characteristic BUT NOT PATHOGNOMONIC appearance on radiographs of RDS

A

Fine reticular granularity of the parenchyma AND air bronchograms

14
Q

Measures of respiratory failure

A

ABG 1) pH less than 7.2 2) pCO2 ≥60mmHg 3) O2sat less than 85% at FiO2 40-70% and CPAP 5-10cmH2O

15
Q

Mild BPD, less than 32 weeks AOG

A

Need for O2 support for >28 days PLUS breathing room air at 36 weeks PMA or at discharge, whichever comes first

16
Q

Moderate BPD, less than 32 weeks AOG

A

Need for O2 support for >28 days PLUS need for O2 support less than 30% FiO2 at 36 weeks PMA or at discharge, whichever comes first

17
Q

Severe BPD, less than 32 weeks AOG

A

Need for O2 support for >28 days PLUS need for O2 support ≥30% FiO2 and/or PPV or NCPAP at 36 weeks or at discharge PMA or at discharge, whichever comes first

18
Q

Point of BPD assessment of neonates ≥32 weeks AOG

A

> 28 days or less than 56 days postnatal age, or at discharge, whichever comes first

19
Q

Most infants with TTN recover rapidly within

A

3 days

20
Q

TTN is believed to be secondary to

A

Slow absorption of fetal lung fluid

21
Q

Condition of severe morbidity and mortality reported in infants born by elective CS who initially present with signs and symptoms of TTN the demonstrate refractory hypoxemia due to pulmonary hypertension and require ECMO support

A

Malignant TTN

22
Q

MAS develops in ___% of patients with MSAF

A

5%

23
Q

___% of patients with MAS require mechanical ventilation

A

30%

24
Q

___% of patients with MAS die

A

3-5%

25
Q

MAS usually improves within

A

72 hours

26
Q

Typical chest X-ray of MAS

A

1) Patchy infiltrates 2) Coarse streaking of both lung fields 3) Increased AP diameter 4) Flattening of the diaphragm

27
Q

Condition suggested by a normal CXR, severe hypoxemia, and no cardiac malformation

A

Pulmonary hypertension

28
Q

T/F Amnioinfusion decreases the risk of MAS

A

F

29
Q

Administration of ___ and/or ___ to infants with MAS and hypoxemia respiratory failure or pulmonary hypertension requiring mechanical ventilation decreases the need for ECMO support

A

1) Exogenous surfactant 2) iNO

30
Q

Predisposing factors to PPHN

A

1) Birth asphyxia 2) MAS 3) Earl onset sepsis 4) RDS 5) Hypoglycemia 6) Polycythemia 7) Maternal use of NSAIDs 8) Maternal use of SSRIs 9) Pulmonary hypoplasia

31
Q

Parameters that suggest right-to-left shunting through the DA (preductal vs post ductal)

A

1) PaO2 gradient >20mmHg on ABG 2) O2sat gradient >5% on pulse oximetry

32
Q

Goals of mechanical ventilation in PPHN

A

1) PaO2 50-70mmHg 2) PaCO2 50-60mmHg

33
Q

The term congenital diaphragmatic hernia typically refers to what type

A

Bochdalek or posterolateral diaphragmatic defect

34
Q

Major limiting factor for survival in CDH

A

Associated pulmonary hypoplasia

35
Q

T/F In some cases of CDH, pulmonary hypoplasia precede the development of diaphragmatic hernia

A

T

36
Q

T/F re CDH: Females affected twice as often as males

A

T

37
Q

CDH is more common on what side

A

Left (85%), occasionally bilateral (5%)

38
Q

Cardinal sign of CDH, which may occur immediately after birth, or there may be a honeymoon period of up to 48hrs

A

Respiratory distress

39
Q

Poor prognostic sign of CDH

A

Early respiratory distress within 6 hours of life

40
Q

Anteromedial diaphragmatic defect

A

Foramen of Morgagni hernia

41
Q

Defect in Foramen of Morgagni hernia is caused by

A

Failure of the sternal and crural portions of the diaphragm to meet and fuse

42
Q

Foramen of Morgagni hernia is more common on what side

A

Right (90%)

43
Q

MCC of pneumothorax

A

Overinflation

44
Q

Pneumoediastinum occurs in at least ___% of patients with pneumothorax and is usually asymptomatic

A

25