Neonatal Respiratory Disorders MCQs

Hyaline membrane disease Also called as respiratory distress syndrome (RDS) Major cause of this disease is Deficiency of pulmonary surfactant produced by type II alveolar cells Commonly seen in. Premature infants Maternal diabetes (Gestational diabetes mellitus) delivery by cesarean section Reference: Ganong 25th edition page no.631

Surfactant lipids Account for approximately 90% of surfactant Major surfactant lipids is: Dipalmotoyl phosphatidylcholine (DPPC) - Lecithin- most abundant component of surfactant Reference: Ganong 25th edition page no.631

Phospholipid Dipalmitoyl Phosphatidyl Choline acts as surfactant and Acts to reduce surface tension, which helps in proper expansion of Lungs. In preterm babies, it is deficient. So preterm babies are prone for respiratory distress syndrome

Ans. is 'b' i.e., Hypertrophic pyloric stenosis Hypertophic pyloric stenosis Most common cause of nonbilious vomiting is Hypertrophic pyloric stenosis. Male > female. Vomiting starts with 3 week of age. Palpable mass is seen in epigastric region. Visible peristalsis is seen soon after feeding. Confirmed by USG abdomen. Contrast study shows : . Shoulder sign . Double tract sign. Treatment surgery = Ramstedt procedure.

The given clinical scenario is highly suggestive of Hyaline membrane disease or Respiratory distress syndrome which is due to defective production of surfactant. The active component of surfactant is phosphatidylcholine(lecithin) Choline + PA→ phosphatidylcholine (PC) (lecithin) Ethanolamine + PA→ phosphatidylethanolamine (PE) (cephalin) It is a component of cell membrane and plays a role in blood coagulation Serine + PA → phosphatidylserine (PS) (option c) It plays a role in programmed cell death Inositol + PA → phosphatidylinositol (PI)(option d) It plays a role as a secondary messenger Reference: Harper's illustrated biochemistry 32nd edition and LIPPINCOTT illustrated reviews 6 th edition biochemistry page 204-6.

Mild Supplement O2 (for 28 days) and diagnostic criteria of mild BPD.

Ans. is `b' i.e., Asymptomatic abdominal mass Wilm's tumor (Nephroblastoma) Most common malignant tumor of kidney. 80% of tumor present below 5 year of age. Presention :? Asymptomatic abdominal mass (M.C.). Haematuria (10-25%). Hypertension (25%). Abdominal pain (30%). Fever (20%).

Multicystic dysplastic kidney- MCDK is the most common cause of an abdominal mass in the newborn, but the vast majority are nonpalpable at birth. In most cases, it is discovered incidentally during prenatal sonography. Contralateral hydronephrosis is present in 5-10% of patients. Sonography shows the characteristic appearance of a kidney replaced by multiple cysts of varying sizes that do not communicate, and no identifiable parenchyma is present. Serial USGs done at 3 month initially and then every 6 monthly post infancy show regression of the cysts. Most cysts resolve by 7 years of age. References: Nelson 21 st Edition, Chapter 552; OP Ghai 10 th Edition, Pages 528-529.