Quick Recall Tables: Pediatric Pulmonology NEET SS

Sep 1, 2025

Sequence of Fetal Lung Development and Corresponding Defects

Stage of development	Weeks of gestation	Transitions that happen	The pathology that may occur
Embryonic	4-6 weeks	Major bronchi form from the foregut outpouching Main pulmonary arteries also form.	Congenital diaphragmatic hernia, Tracheoesophageal ﬁstula, Lung aplasia.
Pseudo glandular	6-16 weeks	The terminal bronchioles form. Conducting airway branching completed by 16 weeks.	Foregut malformations, including bronchogenic cysts, Congenital pulmonary airway malformation (CPAM), Sequestration
Canalicular	16-26 weeks	Respiratory bronchioles grow Angiogenesis is extensive. Surfactant production begins at 20 weeks of gestation.	The fetus remains unviable till 22- 23 weeks due to a lack of complete pulmonary development.

Saccular	26-36 weeks	Primitive alveolar sacs and primitive alveoli proliferate. Surfactant production is high.	RDS (respiratory distress syndrome) or HMD (hyaline membrane disease)
Alveolar	Beyond 36 weeks	Complexity of alveoli	Incomplete alveolarization

Types of CPAM

Based on Histology

Stage of development	Weeks of gestation	Transitions that happen	The pathology that may occur
Embryonic	4-6 weeks	Major bronchi form from the foregut outpouching Main pulmonary arteries also form.	Congenital diaphragmatic hernia, Tracheoesophageal ﬁstula, Lung aplasia.
Pseudo glandular	6-16 weeks	The terminal bronchioles form. Conducting airway branching completed by 16 weeks.	Foregut malformations, including bronchogenic cysts, Congenital pulmonary airway malformation (CPAM), Sequestration
Canalicular	16-26 weeks	Respiratory bronchioles grow Angiogenesis is extensive. Surfactant production begins at 20 weeks of gestation.	The fetus remains unviable till 22- 23 weeks due to a lack of complete pulmonary development.

Saccular	26-36 weeks	Primitive alveolar sacs and primitive alveoli proliferate. Surfactant production is high.	RDS (respiratory distress syndrome) or HMD (hyaline membrane disease)
Alveolar	Beyond 36 weeks	Complexity of alveoli	Incomplete alveolarization

Also Read: Complete Overview of Primary Ciliary Dyskinesia

Types of Sequestration

Types of Sequestration
Intrapulmonary / Intralobar	Extrapulmonary / extralobar
Most common variety Found in lower lobes Either lung can be aﬀected No pleura of its own Children present with infections Hemoptysis is common in older age CXR shows a mass lesion, sometimes with air-ﬂuid levels 2% show associated congenital malformations	More common in boys Always aﬀects left lung Has its own pleural covering Associated with CDH, pulmonary hypoplasia colonic duplication, and vertebral anomalies Asymptomatic or Symptomatic Can also be sub-diaphragmatic 50% show associated congenital malformations

Also read: Neonatal Cpap (Continuous Positive Airway Pressure) Updates

Mutations in CFTR gene

Class	Description	Type	Examples
I	Absent functional protein due to abnormal truncated RNA	Nonsense Frameshift Canonical splice	Gly542X Trp1282X
II	Trafficking Defect- Misfolded protein gets destroyed	Missense, Deletion	Phe508del
III	Defective Channel Regulation- Reduced Channel Opening	Missense, AA Change	Gly551Asp
IV	Decreased Channel Conductance	Missense, AA Change	Arg117His
V	Reduced Synthesis- Reduced mRNA or protein or both	Splicing Defect Missense	3849+10 kbC→T
VI	Decreased Stability- High turnover at plasma membrane	Missense, AA Change	4326delTC

Also Read: High-Yield One Liners in Pediatric Pulmonology

AEP vs CEP: Key points to remember

AEP	CEP
Acute onset	Subacute to chronic onset
Associated with smoke exposure	Not associated with smoke exposure
No gender prediction	Females>Males
Not associated with Asthma	Strong association with Asthma
No Eosinophilia	Eosinophilia present
Hypoxemia ++	Hypoxemia+/-
No relapse	Relapses on tapering steroids
One time phenomena	Recur, progress to EGPA

Also read: Chylothorax in Infants and Children

Staging of ABPA

Stage	Synonym	Features	Serum IgE
I	Acute	Upper and middle lobe inﬁltration	High
II	Remission	No inﬁltrates, oﬀ steroids for more than 6 months.	Normal to high
III	Exacerbation	Upper and middle lobe inﬁltration	High
IV	CSD Asthma	Minimal inﬁltrates	Normal to high
V	End Stage	Fibrosis and/or bullae	Normal

Also read: Important MCQ's Pediatric Pulmonology & Infections

Primary Ciliary Dyskinesia

Motile cilia

Primary non motile cilia

Nodal cilia

9+2 arrangement (9 microtubules present at the periphery and 2 microtubules present at the center).
Motile-planar motility or linear motility.
Found in -nasopharynx, middle ear, paranasal sinuses, and upper major respiratory tract.
Major function is mucociliary clearance.
Kartagener syndrome, also known as Primary Ciliary Dyskinesia (PCD), is a disorder associated with motile cilia.

It is also called sensory cilia.
9+0 structure PRRSENT.
Non-motile.
Function:- Osmoreception, Mechanoreception, Thermoreception.
Disorders associated with sensory

cilia are polycystic kidney diseases and Joubert syndrome.

They are also called embryonic cilia.
9+0 structure present, with some degree of motility.

Rotational motility.

Function:- guiding the movement of various cell lineages.
Disorders associated Situs

inversus along with Heterotaxia Syndromes.

Also read: Pediatric Asthma GINA Guidelines

Assessment and Management GINA Guidelines 2021 Children 6-11 years, Adolescents and Adults

OLDER Categories for Asthma:

	Frequency of symptoms		% Predicted FEV1 / PEFR	Variability in PRFR
	Day	Night	% Predicted FEV1 / PEFR	Variability in PRFR
Intermittent	< 1 Week	≤ 2 / months	≥ 80%	<20%
Mild Persistent	≥ 1 / Week<1/day	≥ 2 / months	≥ 80%	20-30%
Moderate Persistent	Daily	≥ 1 / week	60-80%	>30%
Severe Persistent	Daily	Frequent	≤ 60%	>30%

Also Read: Important Pediatric Pulmonology Topics 2025

4 Patterns of Bacterial Pneumonias are seen

S. pneumoniae	Staph aureus	Gp A strep	Mycoplasma pneumoniae
Infection: Local edema - Proliferation and local spread Produces classic “Focal Lobar” involvement	Infection: Necrosis, hemorrhage and cavitation Produces “Conﬂuent Bronchopneumonia”	Diﬀuse lung involve with necrosis, edema, hemorrhage and extends into the interalveolar septa Frequent pleural and lymphatic involve “ Interstitial Pneumonia” is the pattern seen	Spread along the bronchial tree. Produces mucus production, submucosal inﬂammation, narrowing of lumen “Similar to viral pneumonia”

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