Pathoma: Resp Distress Syndromes

Question 1

How does ARDS present?

Answer 1

• hypoxemia
• cyanosis
• respiratory distress

Question 1

This is respiratory distress due to inadequate surfactant levels.

Answer 1

neonatal respiratory distress syndrome

Question 2

What is the key component of surfactant?

Answer 2

lessafin/phosphatidylcholine

Question 3

What is the problem with formation of hyaline membranes?

Answer 3

1. thickened diffusion membrane —> hypoxemia/cyanosis 2. increased surface tension –> collapse

Question 4

Name a complication of ARDS recovery.

Answer 4

interstitial fibrosis

Question 5

What are the xray findings in neonatal RDS?

Answer 5

diffuse granularity of the lung

Question 7

What does ARDS stand for?

Answer 7

acute respiratory distress syndrome

Question 7

How do pts with neonatal respiratory distress syndrome present?

Answer 7

• increased work of breathing
• tachypnea
• use of accessory muscles
• grunting cyanosis

Question 7

Why are free radicals bad in neonates?

Answer 7

they can travel to the retina and cause blindness, or it can damage the lung to cause bronchopulmonary dysplasia

Question 8

This type of cells act as the lung stem cell and produces surfactant.

Answer 8

type II pneumocyte

Question 8

How does maternal diabetes cause neonatal RDS?

Answer 8

Insulin is an inhibitor of surfactant production. Increased sugars causes pancreas to produce more insulin in baby.

Question 9

In ARDS, activation of neutrophils induces protease-mediated and free-radical damage of ______.

Answer 9

type I and II pneumocytes

Question 10

How is adequacy of surfactant screened before birth?

Answer 10

the L:S ratio

Question 11

What is the tx for ARDS?

Answer 11

treat the underlying condition:

• ventilation with positive end expiratory pressure (PEEP)

Question 11

What are the 2 functions of type II pneumocytes?

Answer 11

• act as the lung stem cell
• to produce surfactant

Question 12

_____ increases risk of free radical injury, a possible complication of neonatal RDS.

Answer 12

Supplemental O2

Question 14

What is neonatal respiratory distress syndrome?

Answer 14

respiratory distress due to inadequate surfactant levels

Question 16

Why does interstitial fibrosis occur in ARDS?

Answer 16

type II pneumocytes were depleted (they’re the stem cells) so instead of regeneration of the lung, it’s instead repaired

Question 17

What is the underlying problem in ARDS?

Answer 17

diffuse damage to the alveolar-capillary interface w/I the air sac –> leaking of protein rich fluid –> fluid reorganizes into formation of hyaline membranes

Question 18

Hypoxemia increases the risk of ______ and _____ in neonatal RDS.

Answer 18

patent ductus arteriosus (PDA) and necrotizing enterocolitis

Question 21

In _____, activation of neutrophils induces protease-mediated and free radical damage of type I and II pneumocytes.

Answer 21

ARDS

Question 22

_____ is produced by type II pneumocyte in the lungs.

Answer 22

Surfactant

Question 24

What are the 3 main causes of neonatal RDS?

Answer 24

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

Question 25

What can cause ARDS?

Answer 25

1. sepsis
2. infection
3. shock
4. trauma
5. aspiration
6. pancreatitis
7. DIC
8. hypersensitivity rxn
9. drugs

Question 25

In ARDS, activation of _____ induces protease-mediated and free radical damage of type I and II pneumocytes.

Answer 25

neutrophils

Question 25

What do L and S stand for in the L:S ratio of surfactant adequacy?

Answer 25

L = lessafin (increases w/ increasing surfactant production) S = sphingomyolin (constant)

Question 25

What causes bronchopulmonary dysplasia?

Answer 25

free radical damage to the lungs

Question 26

Why can C-section delivery cause neonatal RDS?

Answer 26

a vaginal birth stresses the bay, causing steroid release that helps produce and release surfactant. C-section babies don't get this stressor.

Question 28

What do steroids do to surfactant?

Answer 28

1. increase production 2. increase its release from the type II pneumocytes

Question 29

What are the xray findings in ARDS?

Answer 29

diffuse white out

Question 31

In ARDS, activation of neutrophils induces _____ and ____ damage of type I and II pneumocytes.

Answer 31

protease-mediated; free radical

Question 32

\_\_\_\_\_\_ increases the risk of patent ductus arteriosus (PDA) and necrotizing enterocolitis in neonatal RDS.

Answer 32

Hypoxemia

Question 33

At what value or greater is the L:S surfactant ratio considered adequate/a mature lung?

Answer 33

2