Briefly explain what cystic fibrosis is and how dornase alfa acts to solve the problem.

• Cystic fibrosis is a genetic defect leading to reduced secretions in various organs.

Dornase alfa (rhDNase I) hydrolyses extra-cellular DNA from the neutrophils in the bronchial mucus, increasing its liquidity drastically.

Briefly explain what neonatal respiratory distress syndrome is, what the general treatment strategies involve and how cortisone and exogenous surfactants solve the problem.

• Neonatal respiratory distress syndrome is when the surface-active material which covers the respiratory unit of the airways is not yet formed, resulting in disrupted gas exchange and the possibility that the lungs may collapse.

 The general treatment strategies include monitoring, oxygenation, continuous positive airway pressure and drugs.

These surfactants are administered exogenously or during acute respiratory distress syndrome to the neonate to augment lung surfactant.

A short course of corticosteroids is also effective to boost endogenous surfactant production.

Systemic administration of betamethasone to the mother just before labour can induce neonatal endogenous surfactant production within 24 hours.

What is the role of oxygen therapy in neonatal respiratory distress syndrome?  What do the dangers of oxygen toxicity involve?

• The role of oxygen therapy is to ensure oxygenation. Increased oxygen over long term leads to retinal damage and blindness.

Briefly explain what neonatal apnoea is and how the methylxanthines solve the problem.  Which methylxanthine is used?

• Neonatal apnoea occurs when the respiratory centre in the medulla of the premature baby has not yet developed sufficiently to stimulate continuous breathing.

Caffeine and theophylline