E2: Peds RTD

Question 1

what is the patho chain of BPD

Answer 1

1. Mechanical vent with O2 acts as irritant to lung tissue->leads to continuous inflammation->scarring and stiffening of tissues->alveloli fail to multiply->chronic inflammation results in increased mucus and plugging of the alveoli and shunt unit

Question 2

what is the patho chain of asthma in kids

Answer 2

(both large and small airways are affected)

allergens trigger IgE->mast cell degranulation-> edema of bronchial mucosa, bronchospasm, increased mucus production

Question 3

clinical mani of asthma in kids

Answer 3

• wheezing on expiration
• cough (sometimes V)
• irritability, restlessness
• dyspnea, chest tightness
• tachypenea
• nasal flaring
• anxious facial expression

Question 4

patho chain of cystic fibrosis in kids

Answer 4

1. production and stasis of thick tenacious mucus->causing OPD
2. pancreatic exocrine deficiency of trypsin, amylase and lipase-> leading to malabsorption
3. chronic respiratory disease
4. elevated sodium chloride in the sweat due to ineffective chloride movement out of the cell and high reabsorption of sodium into the cells
   5 .complications of fibrosis affect all organ systems

Question 5

respiratory clinical mani of cystic fibrosis

Answer 5

• thick mucus blocks airways, air trapping atelectasis
• frequent resp infections and inflammatory response
• chronic cough
• sputum production
• barrell chest
• chronic rhinitis
• clubbing of fingers-hypoxia

Question 6

clinical GI mani of cystic fibrosis

Answer 6

• emaciated (thin)-malabsorption of calories

- stereatorrhea- fatty, foul smalling BM’s

Question 7

acute larynotrachoea-bronchitis

Answer 7

1. gradual onset
2. rhinitis/fever
3. inspiratory stridor
4. harsh, high crowing noise

Question 8

viral croup

Answer 8

1. sudden onset at night
2. afebrile
3. high pitch stridor
4. muffled voice

Question 9

acute epiglottitis

Answer 9

1. sudden onset (life-threatening)
2. fever
3. inspiratory wheezing
4. restlessness, drooling, difficulty swallowing

Question 10

patho of RDS

Answer 10

1. Premature infant’s lungs are not mature-alveoli unable to be inflated or opened to exchange O2 and CO2 (atelectasis)
2. Pulmonary blood flow is limited by decreased vascular development
3. Decreased surfactant, (a phospholipid that is synthesized by type II cells in the lining of the alveolus, surfactant reduces surface tension in the alveoli and stabliizes the alveoli)
4. Alveoli have difficulty expanding.
5. Need for increased respiratory effort to inhale air and to prevent collapse of the alveoli during expiration
6. Increased pCO2 & decreased pO2 –CO2 & O2 can’t cross alveolar - capillary membrane
   Hypoxemia leads to respiratory acidosis
7. There may be development of fibrin clots or film (hyaline membrane) which decreased gas diffusion in alveolar - capillary interstitium