Surfactant

Question 1

Surfactant is synthesized by which type of alveolar cells?

Answer 1

Type II alveolar cells

Question 2

Surfactant consists primarily of which phospholipid?

Answer 2

Dipalmitoylphosphatidylcholine (DPPC)

Question 3

What is the primary function of surfactant?

Answer 3

Lines the alveoli and keeps them dry

Question 4

How does surfactant affect lung compliance?

Answer 4

Increases lung compliance (makes it easier to fill)

Question 5

At what gestational week is surfactant almost always present in the fetus?

Answer 5

Week 35

Question 6

What lecithin:sphingomyelin ratio in amniotic fluid reflects mature levels of surfactant?

Answer 6

Greater than 2:1

Question 7

What condition is characterized by a deficiency of surfactant?

Answer 7

Neonatal respiratory distress syndrome (NRDS)

Question 8

What radiological sign is often seen in NRDS?

Answer 8

Ground-glass appearance of lung fields

Question 9

Collapsed alveoli are a finding in which condition?

Answer 9

ARDS

Question 10

A preterm baby with Type 2 pneumocyte deficiency is likely to suffer from which condition?

Answer 10

ARDS

Question 11

What is the main cause of ARDS?

Answer 11

Reduced production of surfactant by Type 2 alveolar cells

Question 12

Decreased surfactant leads to which condition?

Answer 12

ARDS

Question 13

What is the characteristic finding of ARDS in a drowned patient who was resuscitated?

Answer 13

Pulmonary interstitial edema

Question 14

A premature baby of 25-week gestation with ARDS is likely to have what physiological issue?

Answer 14

Increased surface tension

Question 15

In surfactant deficiency what is the most likely finding in the lungs?

Answer 15

Patchy atelectasis

Question 16

What does surfactant activity most directly prevent in the lungs?

Answer 16

Atelectasis

Question 17

What keeps alveoli from collapsing?

Answer 17

Surfactant

Question 18

What effect does surfactant have on lung compliance?

Answer 18

Increases lung compliance

Question 19

What happens in the lungs when there is a deficiency of surfactant?

Answer 19

Increased surface tension and decreased compliance

Question 20

Which of the following will happen in surfactant deficiency?

Answer 20

Decreased lung compliance

Question 21

What does the absence of surfactant cause in the lungs?

Answer 21

Decrease in compliance

Question 22

In which condition did a 27-year-old man improve due to surfactant increasing lung compliance?

Answer 22

Adult respiratory distress syndrome (ARDS)

Question 23

How does surfactant deficiency affect surface tension and compliance?

Answer 23

Increases surface tension and decreases compliance

Question 24

Which of the following is NOT a feature of surfactant?

Answer 24

Increases the surface tension of the alveolar fluid

Question 25

What set of changes occur in a preterm infant with surfactant deficiency?

Answer 25

Increased alveolar surface tension and decreased compliance

Question 26

A 28-week pregnant lady delivers a baby with respiratory distress. What is the most likely finding in the lung tissue?

Answer 26

Decreased lamellar bodies in Type II pneumocytes

Question 27

What type of cells secrete surfactant?

Answer 27

Type II pneumocytes Type 2 alveolar epithelial cells Type Il pneumocytes

Question 28

What is the major component of surfactant?

Answer 28

A mixture of phospholipids (mainly dipalmitoylphosphatidylcholine) carbohydrates (glycosaminoglycans) and proteins

Question 29

If Type II alveolar cells are damaged what will happen?

Answer 29

Def of surfactant

Question 30

A diabetic mother's baby is most likely to develop

Answer 30

Respiratory Distress Syndrome (NRDS)

Question 31

NRDS stands for

Answer 31

Neonatal Respiratory Distress Syndrome

Question 32

NRDS is caused by

Answer 32

Surfactant deficiency causing alveolar collapse

Question 33

ARDS stands for

Answer 33

Acute Respiratory Distress Syndrome

Question 34

ARDS is caused by

Answer 34

Diffuse alveolar damage and increased capillary permeability

Question 35

Capillary leakage in ARDS leads to

Answer 35

Protein-rich fluid in alveoli (non-cardiogenic edema)

Question 36

Hyaline Membrane Disease is another name for

Answer 36

NRDS

Question 37

ARDS is not due to heart failure because

Answer 37

PCWP is normal

Question 38

SARS virus causes ARDS by damaging

Answer 38

Type II pneumocytes

Question 39

Surfactant deficiency leads to

Answer 39

Increased surface tension and alveolar collapse

Question 40

X-ray appearance in NRDS

Answer 40

Ground-glass opacities

Question 41

ARDS and NRDS lead to

Answer 41

Decreased lung compliance

Question 42

Common complications of NRDS

Answer 42

Metabolic acidosis

Question 43

Risk factors for NRDS

Answer 43

Prematurity

Question 44

In maternal diabetes

Answer 44

fetal insulin

Question 45

Lecithin:Sphingomyelin (L:S) ratio < 1.5 means

Answer 45

Immature fetal lungs

Question 46

L:S ratio ≥ 2 indicates

Answer 46

Mature fetal lungs

Question 47

Gold standard drug to mature fetal lungs

Answer 47

Betamethasone

Question 48

Which corticosteroid is better for fetal lung maturity?

Answer 48

Betamethasone > Dexamethasone

Question 49

Pulmonary surfactant activity is

Answer 49

Decreased in diabetic mothers

Question 50

ARDS diagnosis includes

Answer 50

PaO2/FiO2 < 300 and bilateral infiltrates

Question 51

Classic ARDS value for severe case

Answer 51

PaO2/FiO2 < 200

Question 52

How to differentiate ARDS from CCF?

Answer 52

PCWP (normal in ARDS

Question 53

ARDS can result from

Answer 53

Sepsis

Question 54

ARDS after drowning is due to

Answer 54

Pulmonary interstitial edema

Question 55

In a patient with ARDS

Answer 55

cause of edema is

Question 56

Inverse I:E ratio ventilation is used in

Answer 56

ARDS (to maintain auto-PEEP)

Question 57

ARDS seen in ICU patient with

Answer 57

SOB and symmetrical ground-glass opacities

Question 58

Burn victims are at risk of

Answer 58

ARDS

Question 59

ARDS X-ray shows

Answer 59

Bilateral pulmonary infiltrates