Prematurity (Week 3)

Question 1

What time period classifies a baby as premature?

Answer 1

born less than 37 weeks gestation

Question 2

How many premature infants have neurodevelopmental disabilities?

Answer 2

1/2

Question 3

LBW size?

Answer 3

5 1/2 lbs

Question 4

VLBW size

Answer 4

3 1/2 lbs

Question 5

ELBW size

Answer 5

2 1/2 lbs

Question 6

micro-premie size

Answer 6

1 3/4 lbs

Question 7

What is the difference b/w symmetric and asymmetric SGA?

Answer 7

symmetric SGA: baby is proportionally small in weight, length, head size

assymmetric SGA: baby weight is small but length and head size is typical

Question 8

3 reasons for small baby

Answer 8

1. mom issue such as illness or substance abuse
2. placenta problem
3. baby issue such as genetic factor or toxin exposure

Question 9

Define apnea in a baby

Answer 9

if they stop breathing for 15-20 seconds

Question 10

What is Persistent pulmonary hypertension of the newborn (PPHN)? Which side?

Answer 10

• right side of the heart is compromised

Question 11

What is respiratory distress syndrome?

How many weeks premature?

Answer 11

• baby is born before 34 weeks and they do not have right level of surfactant to prevent the alveoli from collapsing
• acute condition when lungs are immature

Question 12

What is respiratory syncytial virus?

What can it cause?

Answer 12

• similar to cold virus in adult but in a newborn

- most common cause of bronchiolitis

Question 13

What is foramen ovale?

Answer 13

• opening for blood to flow from R. atria to L. atria in a fetus
• once born closes off and is called fossa ovalis

Question 14

What is the ductus arteriosus?

Answer 14

• vessel that connects the pulmonary trunk to the aorta in a fetus so that any blood that enters the R. ventricle is pumped thru this vessel into the aorta and not the lungs
• after birth becomes the ligamentum arteriosum

Question 15

When does the:

1. heart develop
2. start pumping blood
3. heard thru stethoscope?

Answer 15

1. develop = 5th week GA
2. pump = 6th week GA (can see on ultrasound)
3. heart = 22 week GA

Question 16

Name the 2 shunts a fetal heart has.

Answer 16

1. Patent Ductus Arteriosus (PDA)

2. Patent Foramen Ovale (PFO)

Question 17

Most common heart defect in premature babies

List some common symptoms

Answer 17

• Patent Ductus Arteriosus (PDA) not closing after birth
• Symptoms bc body not getting enough O2: poor growth, cry & sweat during eating, tachypnea or SOB (shortness of breath), tired easily, tachycardia, dusky or blue skin

Question 18

What will eventually happen to a premie if there is mixing of deoxygenated and oxygenated blood?

Answer 18

• pulmonary hypertension and then heart failure

Question 19

List 5 types of pulmonary hypertension

Answer 19

• 1. Congenital heart defect
• 2. Left side heart failure
• 3. Bronchopulmonary Dysplasia
• 4. Any type of clot
• 5. Combo of these or another rare disease

Question 20

What is it called when there is a condition with the shunt b/w atria?

Answer 20

atrial septal defect (ASD)

Question 21

What is it called when there is a condition with the wall b/w ventricles?

Answer 21

ventricular septal defects (VSD)

Question 22

What is the condition called when there is a combination of ASD, VSD, and AV valve abnormalities?

Answer 22

AV Canal defecits

Question 23

What is coarctation of the aorta?

Answer 23

narrowing of the aorta

Question 24

What is transposition of the great arteries?

Answer 24

When the aorta and pulmonary artery are in the reverse positions and need surgery to correct it

Question 25

What is tetrology of fallot?

Answer 25

combo of 4 cardiac defecits

Question 26

What procedure may be done if a baby has ASD, VSD, or PDA?

Answer 26

cardiac catheterization

Question 27

What procedure may be done if a baby has ASD, VSD, AV canal deficits, transposition of great arteries, or tetralogy of fallot?

Answer 27

Open heart surgery

Question 28

What stimulates the closure of the foramen ovale?

Answer 28

first breath

Question 29

What is the earliest stage a premie can survive and why?

Answer 29

- 25 weeks bc at this point the bronchial trees have developed so they are capable of gas exchange but there is no surfactant - called the canalicular stage of fetal lung development

Question 30

What is the saccular stage?

Answer 30

- stage of fetal lung development when surfactant is detected, and alveoli develop - 26-36 weeks

Question 31

List the stages of fetal lung development

Answer 31

1. embryonic 2. pseudo-glandular 3. canalicular 4. saccular 5. alveolar

Question 32

What pulmonary condition has the following symptoms: Cyanosis, apnea, grunting, nasal flaring, rapid shallow breath

Answer 32

Respiratory distress syndrome

Question 33

What pulmonary condition has the following symptoms and what causes it: Productive cough, chest pain, vomiting or diarrhea, loss of appetite, fatigue, fever and headache

Answer 33

- pneumonia | - Inflammation of lungs caused by bacterial, viral, or chemical irritation

Question 34

What pulmonary condition has the following symptoms and what causes it: Cough, wheezing, tachycardia, tachypnea, retractions, flaring, dehydration and poor appetite, fever, lethargy, and apnea

Answer 34

- bronchiolitis | - acute respiratory tract inflammation and infection, viral, bacterial

Question 35

What pulmonary condition has the following symptoms and what causes it: Tachycardia, tachypnea, respiratory distress, frequent desaturation, weight loss

Answer 35

- bronchopulmonary dysplasia | - chronic pulmonary condition that causes fibrotic change in the lungs

Question 36

What is pediatric cystic fibrosis?

Answer 36

- Chronic progressive condition affecting exocrine glands - Autosomal recessive 4:1 - thick mucus gland obstructions that affect the respiratory, GI, and reproductive systems

Question 37

According to the AAP at what age is it ok to let children watch TV?

Answer 37

2 yrs old

Question 38

What are 3 common acute pulmonary conditions

Answer 38

- RDS - pneumonia - bronchiolitis

Question 39

What are 3 common chronic pulmonary conditions

Answer 39

- Bronchopulmonary dysplasia - CF - asthma

Question 40

This disorder is characterized by children who are >/10 weeks premature who require ventilation and RDS

Answer 40

bronchiopulmonary dysplasia

Question 41

This disorder is characterized by an incomplete lung development with inadequate alveoli and circulation

Answer 41

pulmonary hypoplasia

Question 42

The tripod position and retractions are commonly seen in this disorder

Answer 42

RDS

Question 43

This is a common cause of bronchiolitis

Answer 43

RSV respiratory syncytial virus

Question 44

This is a common virus that is seen in adults and children

Answer 44

RSV

Question 45

Incubation and tracheostomy can be a treatment of which disorder?

Answer 45

bronchopulmonary dysplasia

Question 46

This procedure decreases airflow and pressure in the upper airways

Answer 46

tracheostomy

Question 47

4 common symptoms seen post-tracheostomy?

Answer 47

decrease in smell and taste aphonia and voice difficulties weak cough dysphagia

Question 48

what is a chronic progressive disease that effects exocrine glands causing gland obstructions

Answer 48

CF

Question 49

The chronic and reactive airway disease that inflames and narrows airways?

Answer 49

asthma