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Dt retained or slow resorption of fetal alveolar fluid causing decreased lung compliance
Transient Tachypnea of Newborn (TTN)
DX: >60breaths/min, cyanosis, inc. WOB; within first 2hrs after delivery
TTN
Embryonic defect in lateral separation of foregut into esophagus and trachea
Tracheoesophageal Fistula (TEF)
Polyhydramnios; choking, coughing, and cyanosis after 1st feeding
TEF
Copious salivation, respiratory distress, inability to feed
TEF
Esophagus does not terminate in stomach… blind end pouch
Esophageal Atresia
DX: Inability to pass catheter to stomachh
TEF
TX: TEF
Surgical Ligation
AKA Hyaline Membrane Dz
RDS
Typically not seen in term births; common in premies
RDS
Deficiency of pulmonary surfactant
RDS
S/SX: Cyanosis, tachypnea, nasal flaring, intercostal/sternal retractions, grunting; first 72 hours: increasing resp. distress and hypoxemia
RDS
Edema, apnea, respiratory failure
Severe RDS
CXR: Atelectasis (ground glass appearance with air bronchograms)
RDS
ABG: show hypoxemia responsive to supp. O2, PaCO2 norm and progressively worsens
RDS
MC acute complication of RDS
Pulmonary air leak leading to pneumothorax..
MC chronic complication of RDS
Bronchopulmonary Dysplasia
TX: RDS
Intratracheal Surfactant, CPAP, mechanical ventilation
Given to infants <30 weeks gestation with RDS
Prophylactic Surfactant
Given to infants >30 weeks gestation with RDS
Rescue surfactant
Lung damage as a result of prolonged mecahnical ventilation in premature infants with severe RDS
Bronchopulmonary dysplasia
S/Sx: Persistent signs of respiratory distress, req for supplemental O2, radiographic abnormalities beyond 30days old
BPD
Consequences of lung injury (3)
Oxygen toxicity, barotrauma, inflammation
Low birth wt < 1000 g, < 30 weeks
BPD
S/Sx: O2 dependence, hypercapnia, compensatory metabolic alkalosis, pulmonary HTN, RSHF
BPD
PE: Tachypnea, mild to severe retractions, scattered rales, expiratory wheezing
BPD
CXR: Diffusely hazy, w/w/o pulmonary edema; SPONGE LIKE Appearance
BPD
Infants with severe BPD can develop ___________ and ___________.
Pulmonary HTN and cor pulmonale
Tx: BPD
inc. caloric intake for inc. WOB, Surfactant
Congenital malformation reuslting in a defect in the diaphragm that allows abdominal viscera to herniate into the the hemithorax
Congenital diaphragmatic hernia
T/F Congenital diaphragmatic hernias usually occur on the left side and are rarely bilateral.
TRUE
Vitamin A toxicity/ deficiency, thalidomide, anticonvulsants, quinine; MCC sporadic. Can also be genetic
CDH
T/F Congenital diaphragmatic hernias (CDH) can be diagnosed prenatally
TRUE
MC cause of death due to CDH
Liver Herniation
S/Sx: severe Resp. distress within first few hours of birth, barrel shaped chest, scaphoid abdomen, absence of breath sounds on affected side, heart sounds displace to the right side
CDH
Tx: CDH
Intubation + Ventilation, ECMO, Surgery
Congenital anomaly of the anterior skull base characterized by closure of one or both posterior nasal cavities
Choanal Atresia
S/Sx: upper airway obstruction, noisy breathing, cyanosis that WORSENS with feeding and IMPROVES with crying
Bilateral Choanal Atresia (medical 911)
S/Sx: Presents later in life with unilateral nasal discharge and/or obstruction
Unilateral Choanal Atresia
Parents C/O: Difficulty breathing while feeding
Choanal Atresia
Tx: Choanal Atresia
Oral airway, tube feeding, surgical repair
Most severe life threatening sequela of allergies
Anaphylaxis
Can delay development of allergies in atopic prone infants
Breastfeeding
Food allergies are triggered by Ig__ mediated immunologic reaction
E
S/Sx: VAGUE: HA,fatigue, colic, diarrhea, vomiting
Food Allergies
How To DX food allergies
Skin testing, Serum RAST, double blind placebo controlled food challenge
Tx: Food Allergies
Food Elimination
Occurs when large quantities of inflammatory mediatrs are rapidly released from mast cells and basophils after exposure to allerge in a previously sensitized patient
Anaphylaxis
S/Sx: Shock, Upper airway edema, bronchial obstruction
Anaphylaxis
Cutaneous Anaphylaxis S/Sx
Ertyhema, Uticaria, Angioedema
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