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Patho 2 > Paediatric Respiratory Conditions > Flashcards

Paediatric Respiratory Conditions Flashcards

1
Q

State Common Paediatric Respiratory pathologies

A
  1. Bronchiolitis
  2. Chest Infections –
    a. Acute Laryngotracheobronchitis (Croup)
    b. Epiglottitis
    c. Pneumonia
    d. Pertussis (whooping cough)
  3. Inhaled foreign body
  4. Cystic Fibrosis
  5. Primary Ciliary Dyskinesia
  6. Asthma
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2
Q

Define Bronchiolitis

A

Most common severe LRT disease in infancy

Caused by human respiratory syncytial virus (RSV

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3
Q

Clinical Presentation of Bronchiolitis

A
  • Initial presentation is common cold type symptoms
  • Develops into a dry irritating cough, wheezing, ↑ RR, & signs of respiratory distress (intercostal recession, tracheal tug)
  • CXR – hyperinflation, areas of collapse or pneumonic consolidation
  • Auscultation – widespread inspiratory crepitation’s & expiratory wheezes
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4
Q

General management of bronchiolitis

A
  • Humidified O2
  • Ribavirin antiviral
  • Ventilation if required
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5
Q

Physiotherapy management of Bronchiolitis

A
  • Careful & regular assessment

* Techniques should be applied only when sputum retention or mucus plugging is a problem

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6
Q

Define Croup (Acute Laryngotracheobronchitis)

A

Viral infection of the upper airway in 6months-4 years

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7
Q

Clinical presentation of Croup

A

• Initial presentation is common cold type symptoms (runny nose)
Develops into fever, harsh barking cough & hoarse voice, stridor on inspiration & signs of respiratory obstruction. Severely affected may develop respiratory failure. May also be a temperature but this is usually below 38.5o if the infection is viral

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8
Q

General management of Croup

A

• Humidified O2
• Glucocorticoids (dexamethasone & budesonide)
• Nebulised adrenaline
Respiratory support (CPAP etc.)

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9
Q

Physiotherapy management of Croup

A
  • Contraindicated in the non-intubated child

* May be required should the child be intubated for secondary complications e.g. sputum retention

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10
Q

Define Epiglottitis

A

Very dangerous condition occurring in 1-7years
Caused by Haemophilus Influenzae
Rare since the introduction of ‘Hib’ vaccine

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11
Q

Clinical presentation of epiglottitis

A

Sudden onset of severe sore throat & high temperature. Rapid development of stridor & dysphagia with the child being unable to swallow saliva & drools. Acute & possibly fatal obstruction of airway can develop

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12
Q

general management of epiglottitis

A

Child should not be disturbed in any way or their throat assessed as it could lead to acute life threatening obstruction
Nasal intubation or occasionally a tracheostomy

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13
Q

Physiotherapy management of epiglottitis

A

Contraindicated in the non-intubated child

May be required should the child be intubated for secondary complications e.g. sputum retention

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14
Q

Causes of Pneumonia

A

Different causes – Staphylococcus aureus (neonates), RSV (infant) & Mycoplasma, Streptococcus pneumoniae or Haemophilus influenzae (child)

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15
Q

Clinical presentation of pneumonia

A

• Present with pyrexia (fever), dry cough, ↑RR, & recession of ribs & sternum
CXR – consolidation

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16
Q

General management of pneumonia

A
  • Fluids
  • Humidified O2
  • Broad spectrum antibiotics
17
Q

Physiotherapy management of pneumonia

A
  • Careful & regular assessment

* Appropriate airway clearance techniques

18
Q

Causes of Whooping cough (pertussis)

A

Caused by Bordetella pertussis

Last epidemic in UK in 2012

19
Q

Clinical presentation of whooping cough

A
  • Cough becomes paroxysmal, worse at night. Spasms of coughing may cause hypoxia (ow oxygen levels at tissue level) & apnoea (Absence of breathing for more than 15 seconds)
  • At the end of coughing there is inspiratory stridor.
  • Often bouts of coughing lead to vomiting & expectoration of sputum
  • Coughing phase can last 6-8 weeks
20
Q

General management of whooping cough

A
  • Most managed at home
  • Treatment is supportive
  • Minimal handling to reduce disturbance which may precipitate coughing spasms
21
Q

Physiotherapy management of whooping cough

A
  • Contraindicated during the early stages as may induce coughing
  • May be required should the child be intubated for secondary complications e.g. sputum retention
22
Q

Define CF

A

Most common inherited recessive condition in Caucasians & affects 1 in 2500 births
Chromosome 7, which encodes for the CF transmembrane conductance regulator (CFTR), is defective. This leads to a problem in ion transport which results in low or abnormal salt concentration → increased mucus viscosity

23
Q

Clinical presentation of CF

A

Impaired mucociliary clearance → recurrent chest infections with gradual lung destruction. Primary areas affected are respiratory tract & digestive tracts but it is a multisystem disorder

24
Q

General management of CF

A
  • MDT approach (dietician, CF nurse, PT, Drs, Psychologists)
  • Drug therapy
  • Organ transplant in later life
25
Q

Physiotherapy management of CF

A
  • At point of diagnosis chest clearance techniques are introduced & taught to parents/carers
  • Education of self management as child grows up
26
Q

Define primary ciliary dyskinesia

A

Rare genetic disorder (1 in 15-30,000)
Leads to either abnormal structure of the cilia; normal structure of the cilia, but abnormal function; absence of cilia
Results in recurrent infections of ears, nose, sinuses & lungs, & fertility issues

27
Q

General management of PCD

A
  • Drug therapy
  • Monitoring of hearing +/- hearing aids
  • Assisted conception may be needed in adulthood
28
Q

Physiotherapy management of PCD

A

At point of diagnosis chest clearance techniques are introduced & taught to parents/carers
Education of self-management as child grows up

29
Q

Define Asthma

A

Increased responsiveness of smooth muscles in bronchial walls to various stimuli causing constriction & airway inflammation
Hypertrophy of mucous glands may lead to mucous plugging, airway obstruction, which may become chronic & severe

30
Q

Risk factors for asthma

A

• Children are more likely to develop it if parents or close relatives are asthmatic or atopic
Other links are those from low socioeconomic background, outdoor pollution, dietary factors & passive smoking

31
Q

General management for asthma

A

Drug therapy

32
Q

Physiotherapy management for asthma

A
  • Education of child & parents about condition
  • Advise on exercise/exercise programmes
  • Chest clearance techniques if there is sputum

Patho 2 (30 decks)

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