Paediatric - Pathophysiology

Question 1

Asthma

Answer 1

• chronic inflammatory disorder, trigger in the air is breathed in, intiates inflammatory response, muscles in the airway become tight & inflammed and produce excessive mucous

Question 2

Bronchiolitis

Answer 2

• caused by viral infection, infection makes bronchioles swell & become inflamed, mucous collects in the airway making breathing difficult

Question 3

Croup - Acute Laryngotracheobronchitis

Answer 3

• acute viral infection, causes larynx, trachea and broncioles to swell, interferes with ability to breathe due to decrease in surface area, barking cough

Question 4

Pertussis

Answer 4

• bacterial infection - caused by pertussis - exudate forms in the respiratory tract, compromises the small airways, first colonizes the cilia, leads to coughing due to the irritation to the cilia

Question 5

Gastroenteritis

Answer 5

• infective diarrhoea and vomiting resulting from acute infection of the bowel, pathogen (viral - rotavirus) ingested, colonises, destroys mucosal cells & villi of small intestine, decreases intestinal surface area, reduced capacity for fluid and electrolyte absorption leads to diarrhoea, aggravation of the stomach & intestines leads to vomiting to rid the body of the toxin

Question 6

Urinary Tract Infection

Answer 6

micro-organism enters urinary tract, through the urethra and proceed to the bladder where they multiply

Question 7

Febrile Illness

Answer 7

• fever is natural and normal response to infection, is bodies natural defense against invasion of micro-organisms
• body raises temperature to attempt to kill off any foreign bodies that are within itself

Question 8

Pathological & Physiological differences between children & adults

Answer 8

• size & proportions
  
  • large head
  • higher total body weight is water - water is mostly extracellular
  • higher metabolic rate
  • renal immaturity
• respiratory
  
  • smaller airway diameter, smaller lung capacity
  • flexible larynx, large tongue
  • obligatory nose breathers
  • poorly developed intercostal muscles
• circulatory differences
  
  • less circulatory volume
  • extracellular fluid (blood/plasma) makes up a large proportion of total body fluid
  • blood pressure is lower in children, heart rate higher
  • decreased ability to concentrate urine
• metabolism
  
  • high glucose needs, low gylcogen stores
  • increased calorie requirements
  • breast milk & digestion
  • fasting - children digest / process faster, dehydrate faster, can have clear fluids up to 2hrs prior to surgery, and breast milk up to 4hrs before
• neurological differences
  
  • large head, poorly developed neck muscles
  • incomplete myelinisation - signals don’t get sent from brain to peripheries effectively
  • emotionally & cognitively immature, underdeveloped communication skills
  • poor thermoregulation
• communication
  
  • development & acquisition of language - can’t localise pain or describe pain
  • parental involvement
  • cognition & understanding, literal thinkers, egocentric