Acute Respiratory Illnesses in Paediatrics Flashcards
What causes pneumonia?
It is caused by a virus, bacteria or mycoplasma
What occurs during the immune response to infective process of pneumonia?
- release of cytokines
- subsequent inflammation and cell destruction
- alveoli fill with fluid made of various white blood cells
- oxygenation is impaired as a result
What are the early signs of pneumonia?
- cough
- pyrexia
- breathlessness
- chest pain
- vomiting
- convulsions
- loss of consciousness
How is pneumonia diagnosed?
Chest x-ray
What is involved in the general management of pneumonia?
- antibiotic therapy
- pain relief
- fluids
What is the most common severe lower respiratory tract disease in infancy?
Bronchiolitis
What is bronchiolitis?
A viral infection of the respiratory tract commonly caused by Respiratory Syncytial Virus (RSV)
What pathophysiology is involved in bronchiolitis?
- acute inflammation, oedema and necrosis of the epithelial cells lining the bronchioles
- immune response
- bronchospasm
- obstruction of the small airways
Clinical presentation of bronchiolitis
- runny nose
- lethargy
- coughing
- auscultation: wheeze +/- fine inspiratory crackles
- increased work of breathing
What is the common name for pertussis, and what causes it?
Whooping cough is caused by the organism Bordatella pertussis
Clinical presentation of pertussis
- cold like symptoms for 7-10 days
- paroxysmal cough with thick tenacous sputum
- hypoxia and apnoea, leading
Clinical presentation of pertussis
- cold like symptoms for 7-10 days
- paroxysmal cough with thick tenacous sputum
- hypoxia and apnoea, leading to seizures, intracranial bleeding and encephalopathy
Is there any indication for physiotherapy for the management of pertussis?
No
What is croup?
Inflammation of the upper airway triggered by recent infection
What are the common symptoms of croup?
- coryzal, harsh barking cough
- hoarse voice
- stridor
- respiratory failure
What does the medical management of croup involve?
- oxygen and minimal handling
- nebulised adrenaline
- glucocorticoids
- intubation if necessary
What does the medical management of croup involve?
- oxygen and minimal handling
- nebulised adrenaline
- glucocorticoids
- intubation if necessary
Is physiotherapy indicated for the management of croup?
No, physiotherapy is contraindicated in the non-intubated child with croup
What is asthma?
Chronic inflammatory process within the airway
What are the common triggers of asthma?
- Allergens (dust, pollen)
- Exercise
- Emotion
What is involved in the medical management of asthma?
- Education
- Asthma Action Plans
- Drug therapy
Is there any indication for physiotherapy in the management of asthma?
No routine indication for chest physiotherapy in asthma
What percentage of cerebral palsy deaths are caused by penumonia?
39.4%
What factors can predict respiratory dysfunction in children with cerebral palsy?
- Spinal deformity
- Neck rotation deformity
- Severe asymmetrical posture
- Severity of motor dysfunction
What problems does medical management of lung disease in children with cerebral palsy attempt to address?
- Pulmonary aspiration
- Impaired mucociliary clearance
- Infection
- Scoliosis
- Upper airway obstruction
- Lower airway obstruction
How is pulmonary aspiration managed in CP children with lung disease?
- Thickened feeds and anti-reflux treatment
- Gastrostomy and fundoplication
How is pulmonary aspiration managed in CP children with lung disease?
- Thickened feeds and anti-reflux treatment
- Gastrostomy and fundoplication
- Control of saliva
How is impaired mucociliary clearance managed in CP children with lung disease?
- inhalation of saline/hypertonic saline or bronchodilators
- physical therapy to assist secretion removal
When are airway clearance techniques indicated for the management of children with cerebral palsy?
If they have difficulty clearing excessive secretions of lower respiratory tract
