Hernia and Congenital Diaphragmatic Issues

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Questions and Answers

What is the immediate treatment for congenital diaphragmatic hernia?

Use supplemental oxygen

Administer antibiotics

Intubate immediately (correct)

Perform surgery after 24 hours

What defines a tracheoesophageal fistula?

Atresia of the lower esophagus

Blockage of the trachea

Atresia of the upper esophagus with communication to the trachea (correct)

Abnormal connection between the trachea and lungs

Which of the following is NOT a characteristic of Pierre-Robin Syndrome?

Big tongue

Short jaws

Small chin

Cleft lip (correct)

What is a significant complication related to meconium aspiration?

Obstruction and air leaks Signup and view all the answers

What causes choanal atresia?

Congenital malformation resulting in blockage of the nasal passages Signup and view all the answers

What condition is characterized by the leakage of air into perivascular tissues of the lung due to overdistention?

Pulmonary Interstitial Emphysema Signup and view all the answers

Which management approach is recommended for Pulmonary Interstitial Emphysema?

Minimal ventilatory support (CPAP) Signup and view all the answers

In hyperbilirubinemia, what type of bilirubin is fat-soluble and unconjugated?

Unconjugated bilirubin Signup and view all the answers

What is the primary cause of epiglottitis?

Haemophilus influenzae type B Signup and view all the answers

What is a main characteristic of cystic fibrosis?

Excessive viscid secretions Signup and view all the answers

Which sign is commonly associated with croup/laryngotracheobronchitis?

Steeple sign Signup and view all the answers

What is the primary diagnostic test for cystic fibrosis?

Sweet chloride test Signup and view all the answers

Which pathogen is NOT commonly associated with cystic fibrosis infections?

Escherichia coli Signup and view all the answers

What are common signs of epiglottitis?

Drooling and stridor Signup and view all the answers

What is a significant risk factor for Sudden Infant Death Syndrome (SIDS)?

Prone sleeping position Signup and view all the answers

What is the main difference between acyanotic and cyanotic heart disease?

Acyanotic involves shunting of oxygenated blood; cyanotic involves deoxygenated blood Signup and view all the answers

Which condition is caused by necrotizing inflammation of the colon and ileum due to intestinal ischemia?

Enterocolitis Signup and view all the answers

Which systemic corticosteroid is used to treat croup?

Dexamethasone Signup and view all the answers

What is a common feature of epiglottitis management?

Avoiding supine position Signup and view all the answers

What is a common pathogen associated with croup?

Parainfluenza virus Signup and view all the answers

What physiological abnormality characterizes pulmonary hypoplasia?

Too few lung cells or alveoli Signup and view all the answers

At what age range is croup most commonly observed?

6 months to 3 years Signup and view all the answers

Which treatment causes vasoconstriction in croup management?

Racemic epinephrine Signup and view all the answers

What condition usually requires both an ASD and a PDA for survival?

Cyanosis Signup and view all the answers

Which defect is characterized by a holosystolic murmur and shunting from left to right?

Ventricular Septal Defect Signup and view all the answers

What is the primary consequence of the ductus arteriosus failing to close after birth?

Increased blood flow to the lungs Signup and view all the answers

Which of the following defects is a cyanotic condition characterized by four accompanying defects?

Tetralogy of Fallot Signup and view all the answers

In what condition is there a constriction of the aorta resulting in different blood pressures in the upper and lower extremities?

Coarctation of Aorta Signup and view all the answers

Which defect is associated with left to right shunting of blood due to a communication between the right and left atria?

Atrial Septal Defect Signup and view all the answers

What syndrome is primarily associated with obstruction of blood flow out of the left ventricle?

Aortic Stenosis Signup and view all the answers

Which condition is primarily associated with the need for a Patent Ductus Arteriosus (PDA) to ensure adequate blood flow?

Pulmonary Stenosis Signup and view all the answers

What is the primary cause of persistent pulmonary hypertension (PPHN) after birth?

Failure of pulmonary vascular resistance to fall Signup and view all the answers

Which condition presents with a 'wet lung' diagnosis in newborns?

Transient Tachypnea of Newborn Signup and view all the answers

What signs are indicative of Transient Tachypnea of Newborn (TTNB)?

Grunting and increased work of breathing Signup and view all the answers

What is the hallmark finding on a chest X-ray for congenital airway obstruction?

Asymmetric coarse pattern Signup and view all the answers

How does bronchopulmonary dysplasia (BPD) primarily arise in infants?

Insufficient surfactant leading to ventilation dependence Signup and view all the answers

Which management strategy is NOT typically associated with managing RDS/HMD?

Intravenous fluids only Signup and view all the answers

What is a significant consequence of atelectasis in RDS?

Decreased lung compliance Signup and view all the answers

Which bacterial infection is most commonly associated with pneumonia in newborns?

Group B Streptococcus Signup and view all the answers

Which structural issue causes stridor and dyspnea due to decreased radius on inspiration?

Tracheomalacia Signup and view all the answers

What is considered the gold standard for diagnosing and assessing cardiac conditions in newborns?

Echocardiogram Signup and view all the answers

Study Notes

Hernia and Diaphragmatic Defects

Congenital diaphragmatic hernia occurs due to failure/malformation of the diaphragm's posterior lateral portion before 8 weeks, causing a pressure opening between peritoneal and pleural cavities.
Immediate treatment includes intubation and administration of nitric oxide to reduce pulmonary hypertension.

Tracheoesophageal Fistula

Characterized by atresia of the upper esophagus and communication with the trachea.
Diagnosis involves the inability to pass a catheter into the stomach; management requires ventilating the patient in an upright position to minimize aspiration risks.

Pierre-Robin Syndrome

Associated with mandibular hypoplasia, presenting as a big tongue and small chin.
Management focuses on positioning the patient prone and utilizing a nasotracheal tube.

Choanal Atresia

A congenital defect due to blockage or absence of the choana, may be unilateral or bilateral.
Diagnosis is confirmed by inability to pass a suction catheter; management includes oral airway intubation and neonatal cryotherapy.

Persistent Pulmonary Hypertension (PPHN)

Occurs when pulmonary vascular resistance fails to fall after birth, leading to persistently elevated pulmonary artery pressures.
Evaluated using echocardiograms to identify shunting through the ductus arteriosus and foramen ovale.

Transient Tachypnea of Newborn (TTNB)

Known as "wet lung," this condition results from fluid in the lungs, increased dead space, and poor lung compliance.
Symptoms include grunting, increased work of breathing (WOB), and respiratory rate above 140; management includes CPAP and high-flow oxygen therapy.

Respiratory Distress Syndrome (RDS) / Hyaline Membrane Disease (HMD)

Mainly occurs due to prematurity and insufficient surfactant, leading to atelectasis and compromised lung compliance.
Management involves oxygen support, positive pressure ventilation, surfactant replacement, and the use of nitric oxide for pulmonary vascular resistance.

Bronchopulmonary Dysplasia (BPD) / Chronic Lung Disease (CLD)

Develops in infants receiving mechanical ventilation over respiratory distress, characterized by prolonged oxygen or ventilation dependence.
Treatment includes minimizing ventilation settings while encouraging growth, and using permissive hypercapnia strategies.

Pneumonitis

Typically caused by bacterial infections, with Streptococcus B being the most common.
Symptoms involve inflammation of lung tissue, leading to respiratory distress.

Necrotizing Enterocolitis (NEC)

Involves necrosis of the colon and ileum, typically due to ischemia.
Management includes minimal ventilatory support, often using CPAP.

SIDS and Risk Factors

Sudden Infant Death Syndrome can be influenced by sleep position (prone), environmental factors (smoking), and developmental brain issues.
Recommendations include placing infants in a supine sleep position to prevent SIDS.

Hyperbilirubinemia

Also known as jaundice, occurs due to the breakdown of hemoglobin and insufficient biliary excretion.
Divided into conjugated (water-soluble) and unconjugated (fat-soluble) forms.

Cystic Fibrosis

An autosomal recessive disorder affecting exocrine glands, resulting in thick mucus secretions.
Common pathogens include Staphylococcus aureus and Pseudomonas aeruginosa; diagnosis confirmed with sweat chloride tests.

Epiglottitis

Acute bacterial inflammation of the epiglottis, often caused by Haemophilus influenzae type B.
Signs include drooling and stridor, with the thumb sign visible on chest X-ray; management may require airway intervention.

Croup / Laryngotracheobronchitis

Characterized by subglottic inflammation leading to obstruction, commonly due to viral pathogens.
Symptoms include a barking cough and hoarseness; treatment typically involves dexamethasone and nebulized epinephrine.

Congenital Heart Disease

Divided into acyanotic (increased pulmonary blood flow) and cyanotic (decreased pulmonary blood flow) conditions.
Common acyanotic defects include Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD); cyanotic defects often present with severe hypoxemia, such as Tetralogy of Fallot.

Tetralogy of Fallot

Most common cyanotic congenital heart defect, comprising four key components: pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect, and overriding aorta.
Symptomatic management and potential surgical intervention are critical.

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Description

This quiz covers the basics of hernia and congenital diaphragmatic malformations, focusing on their impact and treatment. It discusses the physiological repercussions and the importance of immediate medical intervention. Test your understanding of these crucial concepts in respiratory health.