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Respiratory > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

what is the neonatal period

A

first 28 days

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2
Q

when is full term

A

37-42 weeks

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3
Q

when is due date

A

40 weeks

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4
Q

is a resp rate of 60 normal for neonates

A

yes

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5
Q

what is periodic breathing in neonates and is it normal

A

fast then slow, yes

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6
Q

what are signs of a baby in severe respiratory distress

A

sternal intercostal recession and grunting

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7
Q

how is sternal in drawing feasible

A

due to flexibility of the ribs

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8
Q

what is CPAP

A

continuous positive airway pressure, self induced, forced air against closed glottis to maintain breathing and pressure

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9
Q

what is a way to access the circulatory system in neonates that is not possible in adults

A

via the umbilicus

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10
Q

what causes respiratory distress syndrome

A

relative surfactant deficiency

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11
Q

how does the prevelance of resp distress syndrome change with gestation

A

decrease as baby matures, mainly affect pre term babys

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12
Q

at what age is surfactant secreted

A

30-32/40 weeks

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13
Q

what does a lack of surfactant result in

A

atelectasis (collapse) and impairment of gas exchange

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14
Q

how is production of surfactant stimulated

A

steroids

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15
Q

how is respiratory distress syndrome treated

A

mums in premature labour given steroids, can also give surfactant prophylactically via intubation

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16
Q

what is a pneumothorax

A

air in pleural space

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17
Q

when is there increased incidence of pneumothorax

A

pre term, CPAP and ventilated babys

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18
Q

what is the extra risk of a pneumothorax in ventilated babies

A

tension pneumothorax, chest drain- tube into chest cavity

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19
Q

what is chronic lung disease

A

when lung tissue is damaged and traps air or collapses and fills with fluid

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20
Q

what does chronic lung disease often follow

A

respiratory distress syndrome

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21
Q

what are the clinical signs of chronic lung disease

A

oxygen requirement beyond 36 weeks corrected gestation, evidence of pulmonary parenchymal disease on CXR

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22
Q

describe the healing stage of chronic lung disease in babies

A

associated with continual lung growth over 2-3 years often wheezy

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23
Q

what is dextrocardia

A

heart sounds are on wrong side

24
Q

describe a diaphragmatic hernia in babies

A

small bowl goes through hole in the diaphragm

25
Q

what is a diaphragmatic hernia associated with

A

pulmonary hypoplasia

26
Q

what is pulmonary hypoplasia

A

incomplete development of the lungs

27
Q

why does pulmonary hypoplasia affect lung development

A

as it exerts pressure on lung bud

28
Q

what should be avoided in a diaphragmatic hernia

A

avoid bag mask- IPPV as don’t want to blow air into gut

29
Q

how is a diaphragmatic hernia treated

A

surgery and resp support

30
Q

describe transient tachypnoea of a newborn

A

short lasting increased breathing rate

31
Q

how is fluid in the lungs removed during labour

A

stress causes re-absorption of fluid

32
Q

why is infection a worry in neonates

A

as not many ways so showing deterioration- grunting can have many causes

33
Q

why is hard to test children breathing abilities

A

find it hard to do tests and values change with age

34
Q

what are chronic respiratory problems associated with older children

A

cystic fibrosis and asthma

35
Q

what are some differential diagnosis of CF

A

immune deficiency, ciliary dyskinesia (cilia not moving right), asthma, kartagener’s/immotile cilia syndrome (cilia beat the wrong way)

36
Q

what can be seen on a CXR of cystic fibrosis

A

consolidation, patchy infiltrates/ nodules

37
Q

why does a CF patient need a dietitian

A

pancreas doesn’t break down food, cant get calories to grow

38
Q

what clinical features increase the probability of an asthma diagnosis

A

wheeze, cough, chest tightness, difficulty breathing, atopy (personal or family history), WIDESPREAD WHEEZE ON AUSCULTATION, response to Rx

39
Q

what is a wheeze

A

an expiratory noise

40
Q

what happens if diagnosis of asthma unsure

A

watchful waiting, spirometry, Rx and evaluate

41
Q

in flow volume rates what does flow show

A

how fast your breathing

42
Q

describe the shape of an obstruction and restriction loop

A

obstruction- hard to breath out fast due to airway obstruction
restriction- low volume of air exhaled

43
Q

what are acute respiratory problems seen in older children

A

acute asthma, croup, childhood pneumonia, bronchiolitis,

44
Q

describe acute asthma

A

cough and wheeze worsening over hours and days

45
Q

how is acute asthma treated

A

oxygen, nebulised bronchodilator, oral prednisolone steroid,, IV salbutamol (bronchodilator), IV aminophylline (bronchodilator), IV magnesium ( smooth muscle relaxation), ventilatory support

46
Q

what is an apnoea

A

pause in breathing up to 20 seconds

47
Q

what is a bronchiolitis

A

viral infection, usually respiratory syncytial virus (RSV)

48
Q

what are the symptoms of bronchiolitis

A

tachypnoea, poor feeding, irritating cough, apnoea in small babies

49
Q

what organisms cause pneumonia in neonates

A

GBS (group B streptococcal), E.coli, klebsiella, staph aureus

50
Q

what organisms cause pneumonia in infants

A

strep. pneumoniae, chlamydia

51
Q

what organisms cause pneumonia in school age children

A

strep. pneumoniae, staph. aureus, Gr A strep, bordetella, mycoplasma, legionella

52
Q

what are the differential diagnosis of pneumonia

A

inhaled foreign body, laryngomalacia, epiglottitis and bacteria tracheitis, allergy, croup

53
Q

what is croup

A

viral laryngotracheobronchitis (resp. infection)

54
Q

what are the symptoms of croup

A

stridor, barking cough

55
Q

how is croup treated

A

oral steroid to reduce inflammation

Respiratory (26 decks)

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