Breathing Difficulties in a child

Question 1

The majority of ‘chesty’ children have….

Answer 1

a viral URTI or asthma

both may respond to bronchodilators and don’t require antibiotics

Question 2

Apart from asthma and URTI, what other things can cause breathing difficulties in a child?

Answer 2

• Pneumonia: fever, chest pain, intercostal recession, consolidation
• Croup: barking cough VERY COMMON IN WINTER
• Tuburculosis: not immunisd, haemoptysis, night sweats, tb contact
• Bronchiolitis: <2yrs, coryza, issues feeding, apnoea
• Heart Failure: L>R shunts eg VSD, ASD
• Whooping cough/pertussis: paroxysmal cough followed by vomiting, whoop or apnoea

Question 3

Genetic Cause of Cystic Fibrosis?

Answer 3

Gene defect on CTFR gene on chr 7

Question 4

What is the most common CHD?

Answer 4

Ventricular Septal Defect (32% of CHD)

Question 5

What is VSD and how will it present?

Answer 5

Can either be a membranous or muscular defect in the septal wall.

• Left > right shunt, less oxygenated blood pumped through the aorta
• Most are too small, and are asymptomatic and/or close spontaneously
• Heard as a harse pansystolic murmur at left sternal edge, with a parasternal thrill
• If larger they will require surgery

Question 6

What is AVSD and what congenital condition is it associated with?

Answer 6

5% of CHD

Associated with Down syndrome in 40% of cases