Childhood Respiratory Disease Flashcards
What respiratory condition affects children commonly after a preterm birth?
Relative Surfactant deficiency
When is surfactant normally secreted?
Between 30-32/40 weeks gestation
How is surfactant production stimulated in preterm babies?
Steroids
Relative surfactant deficiency causes what symptoms in babies?
- Lack of surfactant results in atelectasis (lung collapse)
=> impairment of gas exchange
What increases the risk of a pneumothorax in neonates?
- IPPV, CPAP and ventilation
- Relative surfactant deficiency (stiff lungs)
How often are babies born with a pneumothorax?
- occurs in around 1% vaginal deliveries
- 1.5% caesarean sections
How is chronic lung disease in children defined?
- O2 requirement beyond 36 weeks gestation
- Evidence of parenchymal disease on CXR
- Generally follows surfactant deficiency
How long does it take for chronic lung disease to heal in young children?
- Healing stage over 2-3 years as lung grows
- children remain wheezy during this time
What is a diaphragmatic hernia and when does it usually present?
- Bowel taking up space where lung should be expanding
=> lung doesn’t develop properly (pulmonary hypoplasia) - Usually presents with severe breathlessness just after birth
- Most common Posterolaterally (left-sided)
How is a diaphragmatic hernia treated?
Respiratory support
- surgery
How does Transient Tachypnoea of the Newborn usually present?
- Term baby delivered by C-Section
- without vaginal delivery, baby does not expel fluid from lungs
- Baby begins grunting after delivery
Describe how Cystic Fibrosis usually presents in young children?
prolonged history of:
- cough
- loose stools
- failure to thrive
CF patients are known to get recurrent chest infections. What organisms are commonly grown on culture?
Staph Aureus
Pseudomonas may be grown
How does asthma usually present in children?
cough worse at night OR during active play
other symptoms:
- Atopy (personal / FHx)
- Wheeze on auscultation
What effect does passive smoking have on children?
- Reduces birthweight
- pregnancy los
- Teratogenic to airways + cleft lip/palate
- Glue ear
- Carcinogenic
- Increase likelihood of asthma attack
If a child has an acute asthma attack, how is this treated?
- Oxygen
- Nebulised bronchodilator
- Oral prednisolone
- IV salbutamol
- IV aminophylline
- IV magnesium
- Ventilation
What is the most common cause of bronchiolitis in children and how is it treated?
- Viral infection – RSV
=> Tx = supportive
When does Bronchiolitis usually present?
- <18 months old
- More severe in younger babies family of smokers
How do babies normally present with bronchiolitis?
- Tachypnoea
- poor feeding
- irritating cough
How does pnuemonia commonly present in children?
- cough
- high fever
- sputum production
- previously well
O/E
- Dullness on percussion
- Bronchial breathing
Which pneumonia organisms commonly infect each age group (Neonates, Infants, School Age)?
Neonates: E.coli, Klebsiella, Staph aureus
Infants: Strep pneumoniae, Chlamydia
School age: Strep pneu., Staph aureus, Group A strep, Bordetella, Mycoplasma, Legionella
If a 1 y/o child was to present with a barking cough and difficulty in breathing of sudden onset, what owuld be your differential diagnoses?
Inhaled foreign body
Epiglottitis
Allergy
Croup
What is croup and how is it treated?
- Viral laryngotracheobronchitis
Symptoms: - Stridor
- barking cough
Treatment = oral steroid to reduce inflammation
