Pulm Things To Memorize

Question 1

Stages of Lung Development

Answer 1

Embryonic
Pseudoglandular
Cannicular
Saccular
Alveolar

Question 2

Embryonic

Answer 2

3-6 weeks

lung bud originates from endoderm
formation of major bronchopulmonary segments

TEF

Question 3

Pseudoglandular

Answer 3

6-16 weeks

tubular branching
FGF-10

Question 4

Cannalicular

Answer 4

16-26 weeks

Angiogenesis
Preliminary gas exchange
Lung is viable

Question 5

Saccular

Answer 5

26-36 weeks

Primitive alveoli
Double capillary network

Question 6

Alveolar

Answer 6

36 weeks to 2 years

Double capillary layers

Question 7

Anomalies that occur in the Cannalicular Stage

Answer 7

Pulmonary hypolplasia
Surfactant Deficiency
Alveolar capillary dysplasia

Question 8

Sixth aortic arch

Answer 8

Gives rise to the pulmonary arteries

Question 9

Anomalies that occur in the Pseudoglandular

Answer 9

CDH when pleural peritoneal folds do not close at 7 weeks

Congenital Lobar Emphysema
-LUL and LML most affected

CPAM
-most common congenital lung lesion
-5 types ordered by tracheobronchial tree

Bronchopulmonary sequestration
-Blood supply from aorta

Question 10

Anomalies in Saccular

Answer 10

Pulmonary Hypoplasia
Surfactant Deficiency

Question 11

Fetal lung fluid at birth is

Answer 11

20-30 ml/kg

Question 12

Near-term fetal lung fluid production is

Answer 12

4-5 ml/kg/hr

Question 13

Fetal Lung Fluid Clearance

Answer 13

Prenatal 35%
Active Labor 30%
Postnatal 35%

Question 14

Surfactant Facts

Answer 14

• Mostly dipalmitoyl phosphatidylcholine
• Hydrophilic SP A and SP D
• Hydrophobic SP B and SP C
• Most abundant is SP A and induced by steroids

Question 15

SP A

Answer 15

Most Abundant
Hydrophillic
Assists with tubular myelin formation
Enhances phospholipid uptake
Immunologic properties
Induced by steroids

Question 16

SP B

Answer 16

Critical for surfactant function
Hydrophobic
Induced by steroids
Assists with tubular myelin formation

Question 17

SP C

Answer 17

Critical for surfactant function
Hydrophobic
Induced by steroids

Question 18

SP D

Answer 18

Hydrophillic
Structurally similar to SP A
Immunologic Properties

Question 19

CPAM

Answer 19

Congenital Pulmonary Airway Malformation
- Communicates with tracheobronchial tree
- blood supply from pulmonary circulation

Question 20

Bronchogenic Cyst

Answer 20

• anomalous budding of foregut
• Can connect with the airway
• Xray: unilateral common in lower lobes

Question 21

Acetazolamide

Answer 21

-Carbonic Anhydrase Inhibitor
-Inhibit NaHco3 reabsorption
-Proximal Tubule

Question 22

Lasix

Answer 22

-Blocks chloride transport
-Ascending loop of henle
-Increases urine K, Na, Cl, Ca, Mg, contraction metabolic alkalosis

Question 23

Diuril

Answer 23

-Inhibits NaC reabsorption
-Distal Tubule
-Increases urine Na, K, Mg, Cl, Hc03, and phosphate
-Decreased renal excretion of Ca
-inhibits pancreatic release of insulin leading to hyperglycemia
-displaces bilirubin from albumin-use cautiously if hyperbilirubenemia

Question 24

Methylxanthines
Caffeine

Answer 24

-MOA increase cyclic AMP production as well as changing intracellular calcium levels
-Long term outcome: decreased incidence of BPD, lower incidence of cognitive delay, improved survival

Question 25

6 Contraindications to ECMO

Answer 25

1. Preterm infant GA < 34 weeks
2. Severe IVH
3. Coaugulopathy
4. Irreversible lung disease
5. Irreversible severe neurologic complications
6. Congenital anomalies incompatibile with a good long-term outcome