WEEK 2 NEONATAL AND PEDIATRIC DISEASES & PHARMACOLOGY
STUDYGUIDE QUESTIONS AND CORRECT ANSWERS
Question:
1. respiratory distress syndrome (RDS)
Answer:
Incidence is inversely related to gestational age IE. 24 weeks gestation> greater chance of RDS
then a 32 week gestation neonate
Question:
2. Neonatal version of ARDS
Answer:
respiratory distress syndrome
Question:
3. The earlier an infant is born the more susceptible to
Answer:
Respiratory distress syndrome RDS
Question:
4. Increased risk facts for RDS
Answer:
Maternal diabetes Multiple births- kate plus eight Cesarean delivery- doesn't vaginal squeeze out
of the fluid Fetal asphyxia- baby is down at birh Cold stress Previous affected infants in maternal
history Incidence is highest in preterm male and Caucasian infants
Question:
5. Reduces RDS deaths
Answer:
maternal prophylactic steroids surfactant delivery High Frequency Ventilation
Question:
6. Steroids help develop
Answer:
lungs faster in-utero
Question:
7. Steroids put the mother at risk for
Answer:
early delivery and other high risk factors
Question:
8. Surfactant delivery ventilation
,Answer:
Allows for ventilation with decrease Peak Inspiratory Pressure and decrease in FiO2 needed
Question:
9. RDS: Preterm infant chest wall
Answer:
extremely compliant reducing alveolar recruitment
Question:
10. RDS characteristics
Answer:
Decreased FRC Decreased pulmonary compliance Increased pulmonary resistance Ventilation
perfusion mismatch Patchy infiltrates, or "fluffy" x-ray may be seen
Question:
11. RDS causes
Answer:
Hypoxia-> leads to vasoconstriction, hypercapnia, and respiratory acidosis constrict the
pulmonary arteries and decrease pulmonary blood flow
Question:
12. RDS: Hypoxia, hypercapnia, and resp acidosis leads to
Answer:
-an increase in pulmonary hypertension -Decrease in PaO2 and SpO2
Question:
13. RDS: Pulmonary hypertension
Answer:
increases right to left shunt across the PDA; increasing hypoxemia which increases pulmonary
vascular resistance further increasing hypoxemia
Question:
14. RDS clinical disease presentation
Answer:
Labored breathing(grunting, headbobbing, nose flaring) -Retractions, grunting, tachypnea,
cyanosis and apnea may all be present Diminished breath sounds Unresponsive infant Atelectasis
on x-ray Hypoxemia and acidosis present on blood gas Increase in ventilator and FiO2
requirements
Question:
15. RDS treatment
Answer:
-High frequency ventilation my decrease pulmonary damage Reduce damaging oxygen free
radicals with low FiO2 Address acidosis quickly-acidosis can increase pulmonary hypertension
, PreNatal maternal prophylactic steroids in high risk patients can help speed up fetal lung
development Surfactant administration as early as clinically possible/necessary -Surfactant
deficiency is the primary cause of RDS -Surfactant administration will increase compliance
allowing less PIP and FiO2 necessary for oxygenation and ventilation
Question:
16. Radiology of RDS
Answer:
Hazy and retrogranular densities or air bronchograms
Question:
17. Bronchopulmonary dysplasia (BPD)
Answer:
severe chronic lung injury in premature infants who survived RDS-> caused by high vent settings
Question:
18. BPD presentation
Answer:
Oxygen dependent Possible positive pressure ventilation requirement- pts can be trached due to
no positive pressure provided by them Chronic lung disease ( similar in clinical presentation to
COPD)-decrease in number of alveoli, which decreasing available surface area for gas exchange.
Disease scale based upon oxygen requirements and need for PPV or NCPAP (Walsh table 23-3)
Question:
19. Clinical manifestations-BPD
Answer:
Increased o2 requirement-high levels High mechanical ventilator needs Decreased lung
compliance X-ray shows atelectasis, emphysema and fibrosis
Question:
20. BPD x-ray
Answer:
chronic fibrosis
Question:
21. BPD most often developed from one or more clinical injuries
Answer:
Volutrauma Oxygen toxicity Pre/postnatal infection- releasing inflammatory mediators Pulmonary
edema
Question:
22. Meconium
Answer:
STUDYGUIDE QUESTIONS AND CORRECT ANSWERS
Question:
1. respiratory distress syndrome (RDS)
Answer:
Incidence is inversely related to gestational age IE. 24 weeks gestation> greater chance of RDS
then a 32 week gestation neonate
Question:
2. Neonatal version of ARDS
Answer:
respiratory distress syndrome
Question:
3. The earlier an infant is born the more susceptible to
Answer:
Respiratory distress syndrome RDS
Question:
4. Increased risk facts for RDS
Answer:
Maternal diabetes Multiple births- kate plus eight Cesarean delivery- doesn't vaginal squeeze out
of the fluid Fetal asphyxia- baby is down at birh Cold stress Previous affected infants in maternal
history Incidence is highest in preterm male and Caucasian infants
Question:
5. Reduces RDS deaths
Answer:
maternal prophylactic steroids surfactant delivery High Frequency Ventilation
Question:
6. Steroids help develop
Answer:
lungs faster in-utero
Question:
7. Steroids put the mother at risk for
Answer:
early delivery and other high risk factors
Question:
8. Surfactant delivery ventilation
,Answer:
Allows for ventilation with decrease Peak Inspiratory Pressure and decrease in FiO2 needed
Question:
9. RDS: Preterm infant chest wall
Answer:
extremely compliant reducing alveolar recruitment
Question:
10. RDS characteristics
Answer:
Decreased FRC Decreased pulmonary compliance Increased pulmonary resistance Ventilation
perfusion mismatch Patchy infiltrates, or "fluffy" x-ray may be seen
Question:
11. RDS causes
Answer:
Hypoxia-> leads to vasoconstriction, hypercapnia, and respiratory acidosis constrict the
pulmonary arteries and decrease pulmonary blood flow
Question:
12. RDS: Hypoxia, hypercapnia, and resp acidosis leads to
Answer:
-an increase in pulmonary hypertension -Decrease in PaO2 and SpO2
Question:
13. RDS: Pulmonary hypertension
Answer:
increases right to left shunt across the PDA; increasing hypoxemia which increases pulmonary
vascular resistance further increasing hypoxemia
Question:
14. RDS clinical disease presentation
Answer:
Labored breathing(grunting, headbobbing, nose flaring) -Retractions, grunting, tachypnea,
cyanosis and apnea may all be present Diminished breath sounds Unresponsive infant Atelectasis
on x-ray Hypoxemia and acidosis present on blood gas Increase in ventilator and FiO2
requirements
Question:
15. RDS treatment
Answer:
-High frequency ventilation my decrease pulmonary damage Reduce damaging oxygen free
radicals with low FiO2 Address acidosis quickly-acidosis can increase pulmonary hypertension
, PreNatal maternal prophylactic steroids in high risk patients can help speed up fetal lung
development Surfactant administration as early as clinically possible/necessary -Surfactant
deficiency is the primary cause of RDS -Surfactant administration will increase compliance
allowing less PIP and FiO2 necessary for oxygenation and ventilation
Question:
16. Radiology of RDS
Answer:
Hazy and retrogranular densities or air bronchograms
Question:
17. Bronchopulmonary dysplasia (BPD)
Answer:
severe chronic lung injury in premature infants who survived RDS-> caused by high vent settings
Question:
18. BPD presentation
Answer:
Oxygen dependent Possible positive pressure ventilation requirement- pts can be trached due to
no positive pressure provided by them Chronic lung disease ( similar in clinical presentation to
COPD)-decrease in number of alveoli, which decreasing available surface area for gas exchange.
Disease scale based upon oxygen requirements and need for PPV or NCPAP (Walsh table 23-3)
Question:
19. Clinical manifestations-BPD
Answer:
Increased o2 requirement-high levels High mechanical ventilator needs Decreased lung
compliance X-ray shows atelectasis, emphysema and fibrosis
Question:
20. BPD x-ray
Answer:
chronic fibrosis
Question:
21. BPD most often developed from one or more clinical injuries
Answer:
Volutrauma Oxygen toxicity Pre/postnatal infection- releasing inflammatory mediators Pulmonary
edema
Question:
22. Meconium
Answer:
