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Respiratory > Disease in Childhood (Respiratory) > Flashcards

Disease in Childhood (Respiratory) Flashcards

1
Q

What is term?

A

37-42 weeks gestation.

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2
Q

What is the normal breathing rate of a neonate?

A

60.

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3
Q

How can you tell that a baby is in respiratory distress?

A

The sternum will depress, they get tracheal tug so heads go forward.

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4
Q

What noise do babies make when they are struggling to breathe and why?

A

Grunt, due to epiglottis being closed for longer to maintain pressure.

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5
Q

What arterial catheter can you use in babies that you cannot use in adults?

A

Umbilical arterial catheter.

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6
Q

What is respiratory distress syndrome and when is it predominantly seen?

A

Relative surfactant deficiency. Preterm.

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7
Q

What is surfactant made of?

A

Phospholipid, apoproteins.

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8
Q

When is surfactant secreted?

A

30-32 weeks.

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9
Q

What is the management of respiratory distress syndrome?

A

Mum in premature labour given steroid injections. Lots will need intubated and artificial surfactant given prophylactically.

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10
Q

What is there an increased incidence of pneumothorax with in the newborn?

A

IPPV (intermittent positive pressure ventilation), CPAP (continuous positive airway pressure) and ventilation.

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11
Q

What are the risk factors of pneumothorax in the newborn?

A

Respiratory distress syndrome, stiff lungs.

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12
Q

Why do they try and ventilate babies for as little time as possible?

A

They could get a tension pneumothorax needing treated with a chest drain.

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13
Q

When would a baby have chronic lung disease?

A

Oxygen requirement beyond 36 weeks corrected gestation plus evidence of pulmonary parenchymal disease of CXR.

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14
Q

What can cause chronic lung disease?

A

RDS, barotrauma (pressure damage), volume trauma, high inspired oxygen.

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15
Q

What is the healing stage of chronic lung disease?

A

Continued lung growth over 2-3 years, often wheezy.

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16
Q

What is dextrocardia?

A

When the heart is on the wrong side.

17
Q

What is a diaphragmatic hernia?

A

When the intestines are in the chest.

18
Q

Why is there associated pulmonary hypoplasia with a diaphragmatic hernia?

A

Lung doesn’t develop due to pressure on lung bud.

19
Q

What are the commonest diaphragmatic herniae?

A

Posterolateral (Bochdalek), left-sided.

20
Q

Why would you avoid a bag mask IPPV in diaphragmatic hernia?

A

Some air will go into gut, blow up small bowel and cause more problems, need to put a tube into trachea.

21
Q

What is transient tachypnoea of the newborn?

A

Lung fluid present in term babies.

22
Q

Why does transient tachypnoea of the newborn occur more in C section than vaginal birth?

A

When a baby goes through labour, the stress causes them to absorb the amniotic fluid in their lungs. Sometimes doesn’t happen in C section.

23
Q

How is transient tachypnoea of the newborn resolved?

A

Usually absorb fluid over time but can be quite ill?

24
Q

What other reason could there be for fluid in the lungs of newborns?

A

Infection (grunting can be for other reasons than respiratory).

25
Q

When can you start doing spirometry?

A

7 or 8 years old.

26
Q

What is the differential diagnosis of CF in a child?

A

Immune deficiency, ciliary dyskinesia (cilia aren’t moving right), asthma, Kartagener’s/immotile cilia syndrome (rare).

27
Q

Who is part of the cystic fibrosis team?

A

Clinicial, specialist nurse, clinical psychologist, social worker, physiotherapist, dietician.

28
Q

Why can 2 children with CF not be in the same room together?

A

They will give each other infections.

29
Q

What should you do if there is a high, intermediate of low probability of a child having asthma?

A

High - trial of drugs, further investigations if poor response. Intermediate - watchful waiting, spirometry, drugs and evaluate.
Low - consider investigations and referral.

30
Q

What are the stages of management of children with asthma?

A

1: inhaled beta agonists. 2: regular inhaled steroids. 3A: regular inhaled steroids and LABA. 3B: 3A and leukotriene antagonists. 4: high dose steroids.

31
Q

What virus is bronchiolitis caused by?

A

RSV (respiratory syncytial virus).

32
Q

What age range does bronchiolitis affect and when is it more severe?

A

Under 18 months. More severe in younger babies, ex premature, family of smokers.

33
Q

What are the symptoms of bronchiolitis?

A

Tachypnoea, poor feeding, irritating cough, apnoea in small babies.

34
Q

What do children with bronchiolitis have increased incidence of in the next 10 years?

A

Wheezing episodes.

35
Q

What are the common microbes in pneumonia in neonates, infants and school age children?

A

Neonates: GBS, e.coli, staph aureus.
Infants: strep pneumoniae, chlamydia.
School age: strep pneumo, staph aureus, Gr A strep, Bordetella, mycoplasma, legionella.

Respiratory (30 decks)

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