92R. Respiratory Disease in Childhood Flashcards
Are kids like small adults
no they are different
what anatomy/physiology is different in children relating to their larynx, airways, ribs, resp rate, O2 requirement
higher anterior larynx
Neonates breath through their noses
Airways are narrower
Compliant chest, horizontal ribs and diaphragm
resp rate is faster
higher O2 requirement
is Surfactant a protein, lipid, phospholipid or enzyme
phospholipid with apoproteins
if a baby is born early and has a lack of surfactant what impact does this have on the baby
atelectasis and impairment of gas exchange
what is atelectasis
when the lungs collapse partially or completely
describe the lungs in children with a lack of surfactant
stiff
partially/completely collapsed
no gas exchange
what stage is surfactant produced in the lungs of babies
30-32/40 weeks
pregnant women at risk of pre term delivery might receive what before birth to help the baby’s lungs produce more surfactant
Antenatal steroids
what are the management steps is the baby doesn’t have good airflow/lacks surfactant
keep warm - prevents additional stress and complications
NCPAP- Nasal cotinous positive airway pressure
incubation and ventilation - surfactant delivery
what is the name for having air in the pleural space
pneumothorax - lungs cant expand properly
risk factors that increase the likelihood of a pneumothorax
CPAP (continuous positive airway pressure)
ventilation
RDS (respiratory distress syndrome)
IPPV (Intermittent Positive pressure ventilation)
baby with grunting
Indicates that the baby is having difficulty keeping the airways open
DUE TO:
-Respiratory Distress Syndrome (RDS)
- Transient Tachypnea of the Newborn (TTN)
-Infection
what signs tell you a baby is hypoxic
cold, infection, struggling
what is transient tachypnoea of the newborn
presence of lung fluid, consider infection
lasts 24-48 hrs
what so you look for when doing a paediatric respiratory assessment
history, weight, clubbing, signs of chronic illness, chest shape, auscultations, heart sounds
what breathing tests do you do to investigate during a paediatric resp exam
peak flow
spirometry
what is a chronic respiratory problem in children
Cystic Fibrosis
describe cystic fibrosis in terms of symptoms
long cough, loose stools, failure to thrive
which systems does CF effect
Resp - lung infections, cough, SOB
Digestive- pancreatic insufficiency
Reproductive- infertility, delayed puberty
what is the deletion in CF
F508
what is raised in CF
IRT levels - Immunoreactive trypsinogen
what are differential diagnosis of CF
Immune deficiency
Primary Ciliary Dyskinesia
Asthma
Kartageners syndrome
what is Kartagener’s syndrome
Kartagener’s syndrome is a subtype of PCD characterized by the presence of situs inversus, where the internal organs are mirrored from their normal position
what is the carrier incidence of CF
1 in 25
what could be the case in wheezing children
asthma and acute asthma
what is the management of asthma in children
preventers and reliver
AIR and MARD
Steroids
Inhalers
in asthma in children what is useful in assessing lung function
flow volume loops
what are symptoms of acute asthma
obstructed bronchioles leading to wheezy, noisy breathing out
what is the treatment for children in acute asthma
Oxygen
Nebulised bronchodilators- to open the airways
Oral Prednisolone - to reduce inflammation
IV Aminophylline - for severe cases
IV Magnesium - additional bronchodilator
Ventilatory Support
Bronchiolitis is common infection in children how old
under 18 months
what virus causes Bronchiolitis
RSV - Respiratory Syncytial Virus
Symptoms of Bronchiolitis
Poor feeding
distressing cough
tachypnoea
Apnoea
what is the treatment for Bronchiolitis
supportive care
hydration
oxygen therapy
hand hygiene and avoiding sick contacts
what are the long term effects of bronchioles
increased incidence of wheezing
higher risk of resp issues in the next 10 years
