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The chest x-ray would reveal ground glass opacities and the fundoscopic image depicting a complication of the treatment is Figure C
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The chest x-ray would reveal tracheal deviation and the fundoscopic image depicting a complication of the treatment is Figure A
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The chest x-ray would reveal an interstitial infiltrate and the fundoscopic image depicting a complication of the treatment is Figure A
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The chest x-ray would reveal tracheal deviation and the fundoscopic image depicting a complication of the treatment is Figure C
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The chest x-ray would reveal ground glass opacities and the fundoscopic image depicting a complication of the treatment is Figure B
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Neonatal respiratory distress syndrome is treated with artificial surfactant, high supplemental oxygen, and mechanical ventilation. Chest x-ray will reveal ground glass opacities. A potential complication of the high supplemental oxygen therapy is retinopathy of prematurity shown in Figure B. Neonatal respiratory distress syndrome is caused by surfactant deficiency which leads to an increase in surface tension and alveolar collapse. Patients with neonatal respiratory distress syndrome require high levels of supplemental oxygen which can result in retinopathy of prematurity. In this ocular condition, the retinal vasculature is not fully developed and there is ischemia in the periphery resulting in upregulation of vascular endothelial growth factor and neovascularization leading to retinal detachment and vision loss. Risk factors for neonatal respiratory distress syndrome include prematurity, maternal diabetes (as a result of elevated insulin levels), and cesarean delivery (due to decreased release of fetal glucocorticoids). Treatment involves maternal steroids prior to birth to increase surfactant production, as well as artificial surfactant and thyroxine. Hermansen and Lorah discuss respiratory distress in the newborn. The most common etiology of neonatal respiratory distress is transient tachypnea of the newborn, which is triggered by excess lung fluid. Symptoms usually resolve spontaneously. Respiratory distress syndrome in premature infants, on the other hand, requires intervention with oxygen ventilation and surfactant replacement. Prenatal administration of corticosteroids between 24 and 34 weeks gestation reduces the risk of respiratory distress syndrome when the risk of premature labor is high. Fleck discusses management of retinopathy of prematurity. Treatment includes injection of bevacizumab, an anti-vascular endothelial growth factor agent, in addition to photocoagulation of new abnormal blood vessels growing along the ischemic zone. The addition of agents to target vascular endothelial growth factor is a new development in the management of this disease. Surgery may be necessary for severe cases. Figure A depicts papilledema, indicative of elevated intracranial pressure. Figure B depicts the characteristic findings in retinopathy of prematurity. Note the whitish avascular zone along the periphery indicative of immature vasculature. Figure C depicts a retinoblastoma. Incorrect Answers: Answers 1-4: These choices include the incorrect fundus photograph. Furthermore, tracheal deviation is a sign of spontaneous or tension pneumonthorax. An interstitial infiltrate may occur with atypical pneumonias, fibrotic lung disease or volume overload. Neither of these radiographic appearances is found in neonatal respiratory distress syndrome.
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