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mmm21
Okay i might be retarded, but why i canโt understand that they r asking about the thing that is damaged ? ๐๐
+8
sahusema
Seriously! The question says "the goal of treatment is the protection of which of the following structures?" If too much O2 damages the retina, how is this treatment supposed to be protective to the retina?
+2
ratadecalle
I think too much oxygen would be with the ventilator having a high FiO2 setting, which they don't mention here but I'm guessing thats the thing they're controlling to avoid oxygen toxicity?
+2
burak
they didn't give the patient fio2 100%, question asks the reason for it. but in a very stupid way
+31
naught
Supplemental O2 may also cause bronchopulmonary dysplasia or intraventricular hemorrhage (germinal matrix, located in subventricular zone NOT choroid plexus)
+1
fkstpashls
92-95% isn't high, but it's enough to get everything else oxygenated. Because it's not 100% high flow the retinas don't over-vascularize and lead to damage/hemorrhage, and shit like that.
+1
soccerfan23
In other words....the question is basically asking why they gave the patient a fio2 of 92-95% instead of 100%. The reason is because 100% oxygen would lead to retinopathy of prematurity. The lower 92-95% oxygen levels protect the retina from damage. The wording of the question sucks tho imo.
+3
randi
FA 2019 p210 under Free radical injury examples
+
Wikipedia pathophysiology section of "retinopathy of prematurity" explains this pretty well. Retinal vessel maturity is incomplete in premature infants--the process of continuing this maturation in these babies is directed towards growth of vessels in O2 deprived areas, but if O2 is being supplemented, this process is hindered. Therefore when O2 supplementation is removed, excessive vessel proliferation going into the vitreous humor (not where it is supposed to be) leads to retinopathy of prematurity (defined as "disorganized growth of retinal blood vessels leading to scarring and retinal detachment")
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whoissaad
yes same question, both retinopathy and intraventricular hemmorage can occur due to high oxygen levels..
+
cienfuegos
I mistakenly chose choroid plexus too, based on wiki seems this is most common cause of IVH in term infants: IVH in the preterm brain usually arises from the germinal matrix whereas IVH in the term infants originates from the choroid plexus. However, it is particularly common in premature infants or those of very low birth weight... Most intraventricular hemorrhages occur in the first 72 hours after birth. The risk is increased with use of extracorporeal membrane oxygenation in preterm infants.
https://en.wikipedia.org/wiki/Intraventricular_hemorrhage#Babies
+
burak
choroid plexus is different than germinal amtrix
+
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SPOILER ALERTTTTTTTT
lollll i got this right because of This is Us.
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submitted by โhyoscyamine(59)
FA pg 217. Too much oxygenation can cause free radical damage leading to retinopathy of prematurity