Block 2 Case 12 Answers

 1. An infant of uncertain dates is born via emergent cesarean section after the mother was critically injured in a motor vehicle accident. Birth weight was 1075 g. The infant has poor respiratory effort and you begin bag-mask ventilation but find it extremely difficult to cause chest wall movement.

A chest radiograph reveals diffuse whiteout "ground glass appearance" of both lungs.

The following picture demonstrates the underlying pathology.

a. What is the diagnosis?

Respiratory Distress of the Newborn

b. Less than how many weeks is the gestational age of this infant?

Less than 32 or 34 weeks

c. Using the following Electron Mircrograph of a type II pneumocyte name the major pathophysiological reason behind this event, name what is stored inside the object identified by the arrow, and what gestational week it is synthesized..

d. Name three etiologies of this condition.

Prematurity, Maternal Diabetes, and Cesarean Section

e. The treatment for this is CPAP with endotracheal tube with O2 and surfactant. Name 3 of the 5 complications this syndrome can cause:

Superoxide free radical damage from O2 therapy(may result in blindness and permanent damage to small airways)
Intraventricular hemorrhage
Patent ductus arteriosus
Necrotizing enterocolitis
Hypoglycemia in newborn (Excess insulin decreases serum glucose, producing seizures and damage to neurons)