Paeds chronic airway disease (CED/HDU) Flashcards
What problems come under long-term upper airway disease?
Snoring
Mouth breathing
Recurrent ear infections
Recurrent croup
What problems come under long-term lower airway disease?
Recurrent wheeze
Asthma
Cystic fibrosis
Non-CF bronchiectasis
What are the common presentations of long-term respiratory disease in children?
- Cough
- Wheeze
- Nasal obstruction (snoring, nasal blockage, mouth breathing)
- Reduced ability to participate in active sports
- Difficulty in breathing
- Chronic production of sputum – white, green, blood-stained
- Chest wall deformity
- Clubbing
How does Cystic fibrosis affect different parts of the body?
- Sinusitis
- Lungs: thick, sticky mucus build up, bacterial infections, and widened airways
- Skin: sweat glands produce salty sweat
- Blocked pancreatic duct
- Cannot fully absorb nutrients
- Complications to reproductive organs
What is the screening programme for cystic fibrosis?
In the heal prick test
What is meconium ileus?
A bowel obstruction that occurs when the meconium in the child’s intestine is even thicker and stickier than normal meconium
What are some history findings in children for cystic fibrosis?
Cough, wheeze, shortness of breath, fatty stools, poor weight gain, sputum production, haemoptysis
How is the sweat test used to diagnose cystic fibrosis?
It measures the amount of chloride in sweat
Kids with cystic fibrosis can have 2-5 times the normal amount of chloride in their sweat
What are the childhood problems caused by cystic fibrosis?
- Infancy
Meconium ileus, prolonged neonatal jaundice, hypoproteinaemia - Childhood
Recurrent lower respiratory infections, failure to thrive, rectal prolapse, nasal polyps and sinusitis - Adolescence
Diabetes mellitus, cirrhosis, distal intestinal obstruction, pneumothorax, haemoptysis, allergic bronchopulmonary aspergillosis, arthropathy, male infertility, psychological issues
What is included in management of CF?
GI: managing bowel obstructions
Pulmonary: physiotherapy, anti-microbial therapy, nebulised DNAse, hypertonic saline, inhaled bronchodilators, fluv accination, oral azithromycin
Nutritional management – pancreatic supplements, high calorie diet, salt supplements, fat-soluble vitamin supplements
Psychology / social work / family support through difficult times
What is chronic lung disease of prematurity?
Causes breathing difficulty, cough, mucus (sputum) production and wheezing
What is congenital cystic adenomatoid malformation?
When lobes of the lung form as a fluid-filled sac (cyst) and doesn’t function as normal lung tissue
What is Congenital pulmonary sequestration?
When a segment or lobe of dysplastic lung tissue exists with no communication with the rest of the tracheobronchial tree and receives an anomalous systemic vascular supply, separate from the rest of the lung
It is, therefore, a non-functional tissue
What is Congenital lobar emphysema?
When the air can enter the lungs but cannot escape, causing hyperinflation of the lobes of the lung
Sometimes it doesn’t become apparent till adulthood
What is Pierre-Robin sequence?
A birth defect causing an underdeveloped jaw, backward displacement of the tongue and upper airway obstruction
Cleft palate is also commonly present beside it
