Rds

Question 1

What is the incidence of pulmonary hemorrhage (PH) in extremely preterm infants?

Answer 1

Occurs in about 10% of extremely preterm infants.

Question 2

What is the most common association with pulmonary hemorrhage?

Answer 2

Usually associated with a patent ductus arteriosus (PDA).

Question 3

What is the primary cause of pulmonary hemorrhage?

Answer 3

Hemorrhagic pulmonary edema due to high pulmonary capillary pressures.

Question 4

What is the typical clinical presentation of pulmonary hemorrhage?

Answer 4

Increased respiratory distress, apnea, pallor, and bradycardia before hemorrhage.

Question 5

What is the treatment for pulmonary hemorrhage?

Answer 5

High PEEP, endotracheal epinephrine, activated recombinant factor VII, and surfactant therapy.

Question 6

What is the mortality rate for pulmonary hemorrhage in preterm infants?

Answer 6

Mortality rates range from 30% to 60%.

Question 7

What is the incidence of spontaneous pneumothorax in term infants?

Answer 7

Occurs in approximately 1% of infants born vaginally at term.

Question 8

What is the most common cause of pneumothorax in newborns?

Answer 8

Overdistention of alveoli due to positive pressure ventilation or bronchial obstruction.

Question 9

What is the typical presentation of a symptomatic pneumothorax?

Answer 9

Respiratory distress, tachypnea, cyanosis, and chest asymmetry.

Question 10

What is the treatment for pneumothorax in newborns?

Answer 10

Needle thoracentesis, chest tube insertion, and oxygen therapy.

Question 11

What is persistent pulmonary hypertension of the newborn (PPHN)?

Answer 11

Severe unresponsive hypoxic respiratory failure due to failure of fetal-to-neonatal circulation transition.

Question 12

What is the incidence of PPHN?

Answer 12

Occurs at a rate of 1 to 2 per 1,000 live births.

Question 13

What is the most common comorbidity associated with PPHN?

Answer 13

Perinatal asphyxia is the most common associated comorbidity.

Question 14

What is the primary treatment goal for PPHN?

Answer 14

Optimize oxygenation, ventilation, and acid-base status to reduce pulmonary vascular resistance (PVR).

Question 15

What is the typical chest radiograph finding in PPHN?

Answer 15

Usually appears normal or shows associated pulmonary parenchymal disease.

Question 16

What is the incidence of congenital diaphragmatic hernia (CDH)?

Answer 16

Between 1 in 2,000 and 1 in 5,000 live births.

Question 17

What is the most common type of CDH?

Answer 17

Bochdalek hernia, which occurs through a posterior defect in the diaphragm.

Question 18

What is the primary complication of CDH?

Answer 18

Pulmonary hypoplasia due to herniation of abdominal contents into the thorax.

Question 19

What is the prenatal diagnostic tool for CDH?

Answer 19

Fetal ultrasound, which can reveal abdominal organs in the thorax.

Question 20

What is the initial management of CDH in the delivery room?

Answer 20

Placement of a double-lumen orogastric tube to reduce air in the bowel.

Question 21

What is the survival rate for live-born infants with CDH?

Answer 21

Overall survival is 71%.

Question 22

What is the role of surfactant therapy in CDH?

Answer 22

No reported benefits and may cause clinical deterioration.

Question 23

What is the preferred ventilation strategy for CDH?

Answer 23

Gentle ventilation allowing for higher PaCO2 and lower preductal oxygen saturation.

Question 24

What is the role of nitric oxide in CDH?

Answer 24

Not as effective as in PPHN and is not routinely recommended.

Question 25

What is the surgical approach for CDH?

Answer 25

Surgical repair is delayed until the infant is hemodynamically stable.

Question 26

What is the most common location for CDH?

Answer 26

Left-sided (85% of cases).

Question 27

What is the typical presentation of a large left-sided CDH?

Answer 27

Scaphoid abdomen and significant respiratory distress at birth.

Question 28

What is the prognosis for CDH with liver herniation?

Answer 28

Liver in the thoracic cavity is a poor prognostic feature.

Question 29

What is the role of ECMO in CDH?

Answer 29

Used for preoperative stabilization in severe cases.

Question 30

What is the most common associated anomaly in CDH?

Answer 30

Cardiovascular lesions are common, occurring in up to 30% of cases.

Question 31

What is the typical chest radiograph finding in CDH?

Answer 31

Abdominal organs in the thorax and mediastinal shift.

Question 32

What is the primary cause of pulmonary interstitial emphysema (PIE)?

Answer 32

Air leaks from alveoli into the perivascular and peribronchial spaces.

Question 33

What is the treatment for severe localized PIE?

Answer 33

Selective bronchial intubation and high-frequency ventilation.

Question 34

What is the typical presentation of pneumomediastinum?

Answer 34

Usually asymptomatic, but can cause respiratory distress if severe.

Question 35

What is the treatment for pneumopericardium?

Answer 35

Prompt evacuation of entrapped air to prevent cardiac tamponade.

Question 36

What is the typical presentation of pneumoperitoneum?

Answer 36

May mimic intestinal perforation and can cause abdominal compartment syndrome.

Question 37

What is the primary cause of pulmonary hypoplasia?

Answer 37

Reduced amniotic fluid volume (e.g., oligohydramnios) or decreased fetal breathing movements.

Question 38

What is the typical presentation of pulmonary hypoplasia?

Answer 38

Small thorax, severe hypoxia, and hypercapnia.

Question 39

What is the primary treatment for pulmonary hypoplasia?

Answer 39

Supportive care, including mechanical ventilation and oxygen therapy.

Question 40

What is the typical presentation of tension pneumothorax?

Answer 40

Sudden respiratory distress, cyanosis, and signs of shock.

Question 41

What is the treatment for tension pneumothorax?

Answer 41

Emergency decompression with needle thoracentesis followed by chest tube insertion.

Question 42

What is the primary cause of pulmonary hemorrhage after surfactant administration?

Answer 42

Rapid increase in pulmonary blood flow due to improved lung function.

Question 43

What is the typical chest radiograph finding in pulmonary hemorrhage?

Answer 43

Bilateral alveolar infiltrates.

Question 44

What is the primary risk factor for pulmonary hemorrhage in preterm infants?

Answer 44

Patent ductus arteriosus (PDA).

Question 45

What is the typical presentation of pneumothorax in newborns?

Answer 45

Hyperresonance, diminished breath sounds, and chest asymmetry.

Question 46

What is the primary cause of PPHN in term infants?

Answer 46

Failure of the pulmonary vascular resistance to decrease after birth.

Question 47

What is the typical presentation of PPHN?

Answer 47

Severe unresponsive cyanosis and respiratory distress.

Question 48

What is the primary treatment for PPHN?

Answer 48

Inhaled nitric oxide (iNO) and mechanical ventilation.

Question 49

What is the typical presentation of CDH in the delivery room?

Answer 49

Scaphoid abdomen, respiratory distress, and bowel sounds in the chest.

Question 50

What is the primary cause of mortality in CDH?

Answer 50

Severe pulmonary hypoplasia and associated anomalies.

Question 51

What is the role of antenatal steroids in reducing RDS?

Answer 51

Reduces the incidence and severity of RDS in preterm infants.

Question 52

What is the typical presentation of RDS in preterm infants?

Answer 52

Tachypnea, grunting, retractions, and cyanosis shortly after birth.