Acute and chronic respiratory illness Flashcards
Bronchiectasis
- Definition/ pathology
- Presentation
Irreversible dilatation of the bronchial tree leading to excess mucus production.
Can be a result of:
- Cystic fibrosis
- Primary ciliary dyskinesia
- Severe pulmonary infections
- Airway obstruction (foreign body, tumour)
Presentation
- Chronic, mucus cough
- Persists after infection
- Recurrent purulent lung infections
Which protein is most commonly affected in cystic fibrosis
Cystic fibrosis transmembrane regulator (CFTR)
Cystic fibrosis is inherited in a _____ manner on chromosome _____ primarily affecting the _____ gene
Autosomal recessive inheritance
- Chromosome 7
- CFTR gene
Complications of CF
Chronic lung disease
Recurrent airway infections
Pancreatic insufficiency
- Steatorrhoea
- Vitamin K deficiency
- Failure to thrive
Infertility
Signs of CF
Chronic resp disease
- Chronic, productive cough
- Finger clubbing
- Barrell chest
- Recurrent LRTIs
Pancreatic insufficiency
- Meconium ileus
- Failure to thrive
Bilteral atresia of vans deferens
Diagnosis of CF
At birth
- Newborn blood spot test
Chloride sweat test
- >60 mmol/L
Genetic testing
Most common mutation in CF
Delta-F508
Reproductive complication in males with CF
Bilateral vans deferens atresia
Common bacterial infections in CF (6)
- Staphylococcus aureus
- Haemophilus influenza
- Klebsiella pneumoniae
- Escherichia coli
- Burkhodheria cepacia
- Pseudomonas aeruginosa
Management of meconium ileus in CF
Enema/ osmotic laxative
Management of respiratory infections in CF
Prophylactic antibiotics
Bronchodilators/ chest physio
Inhaled mucolytic (mannitol, hypertonic saline)
Oxygen/ ventilation
Most common cause of pnuemothorax in children is…
Chest wall trauma
Presentation of pneumothorax
Dyspnoea
Chest pain
Shoulder pain (referred)
Signs
- Hyperresonance on percussion
- Reduced air entry
- Subcutaneous emphysema
Management of spontaneous pneumothorax
If <2cm rim, <20% volume= supplemental oxygen
> 20% volume, >2cm rim
- Needle aspiration/ in-dwelling tube
Consistent leak/ failure of lungs to re-expand= surgery
Tension pneumothorax must be treated with…
Immediate needle decompression
