Flashcards in Diseases of infancy and childhood II Deck (27)
what are the main ascending infection pathogens?
e. coli, GBS, HSV-2,
what inflammations are associated with ascending infection?
chorioamnionitis, funisitis (umbilical cord), placentitis, villitis
what is villitis?
lymphocytic infiltrate of the chorionic villi, associated with recurrent miscarriage and fetal growth restriction
what are the main agents responsible for early onset neonatal sepsis?
GBS, e. coli (Gn), klebsiella (Gn)
what are the main agents responsible for late onset neonatal sepsis?
staph, h. influenzae, listeria, chlamydia, mycoplasma, candida
what are the complications of early onset neonatal sepsis?
what are the most important risk factors for early onset neonatal sepsis?
previous infant with GBS disease, GBS bacteruria during pregnancy, delivery before 37 weeks
what is the most common cause of neonatal respiratory disease?
hyaline membrane disease
what are the risk factors for hyaline membrane disease?
prematurity, diabetic mothers, c-section, male
what is the cause of hyaline membrane disease?
deficiency of alveolar surfactant
what is the cause of hyaline membranes in hyaline membrane disease?
1. lack of surfactant results in atelectasis followed by hypoxemia and increased CO2 2. pulmonary artery vasoconstriction and right to left shunting ensues 3. acidosis, pulmonary vasoconstriction, hypoperfusion 4. ischemia damages alveolar and endothelial cells - leakage of plasma proteins into alveolar space causes hyaline membranes (fibrin)
what is the diagnosis for hyaline membrane disease?
lecithin / sphingomyelin ratio >2, phosphoglycerol present
what is the histologic presentation of hyaline membrane disease?
alternating atelectatic alveoli and alveolar ducts that are dilated and lined by eosinophilic fibrin-rich thick hyaline
when does chronic lung disease (bronchopulmonary dysplasia) occur?
in premature newborns (
what are the clinical findings of chronic lung disease (bronchopulmonary dysplasia)?
hyperplasia and squamous metaplasia of bronchial epithelium, sponge-like on radiology, cobblestoning gross appearance, thick interstitial fibrosis
what attributes to the alveolar hypoplasia seen in chronic lung disease (bronchopulmonary dysplasia)?
oxygen and inflammatory cytokines blocking alveolar septation at saccular stage level
what is the cause of necrotizing enterocolitis?
hypoxemia (intestinal ischemia, general hypoperfusion), intestinal bacterial colonization, and oral feeding (intraluminal substrate)
definitions: hydrops fetalis, cystic hygroma
1. hydrops fetalis - generalized edema of the fetus 2. cystic hygroma - localized edema accumulation in soft tissues of the neck
what is the cause of immune hydrops?
blood group incompatibility
what is the cause of non-immune hydrops?
infections, chromosomal anomalies, twin pregnancy, cardiovascular defects
what is the pathogenesis of fetal hydrops?
1. anemia, heart and liver failure 2. edema results from increased venous capillary pressure and decreased oncotic pressure
how can immune hydrops be differentiated from non-immune hydrops?
1. in immune hydrops, ascites and pericardial effusion are early signs; pleural effusion comes later 2. in non-immune hydrops, pleural effusion is a common finding in combination with usually present fluid collections in other body compartments
which antibodies pass transplacentally from mother to fetus during hydrops fetalis?
anti-Rh D IgG
what are the most common vascular tumors of infancy?
what are cavernous hemangiomas?
components of VHL disease - can be in cerebellum, brain stem, pancreas, liver
what is the histologic appearance of capillary hemangioma?
thin walled capillaries with scant stroma