Peds Lung Diseases Flashcards
Pediatric pulmonary disease accounts for almost 50% of deaths in children younger than _____.
1 year
______ accounts for almost 50% of deaths in children younger than 1 year.
Pediatric pulmonary disease
An infant’s larynx and trachea are significantly _____ than an adult.
smaller
The narrowest part of the pediatric airway is ______.
just below the vocal cords at the level of the cricoid cartilage
The narrowest part of the adult airway is _____.
the vocal cords
Extrathoracic airway obstruction usually causes _____.
stridor or a barking cough
What are the 4 D’s of airway obstruction?
- Dyspnea
- Drooling
- Dysphagia
- Distress
What is Laryngomalacia?
a benign congenital disorder in which the cartilaginous support for the supraglottic structures is underdeveloped
When does Laryngomalacia present?
within the first few months of life
This is a benign congenital disorder in which the cartilaginous support for the supraglottic structures is underdeveloped.
Laryngomalacia
This is the most common cause of persistent stridor in infants and usually is seen in the first 6 weeks of life.
Laryngomalacia
What are the s/s of croup?
upper respiratory tract symptoms is followed by a barking cough and stridor but no (or only low grade) fever
How do xrays look in croup?
subglottic narrowing-steeple sign
What is the steeple sign on xray indicative of?
croup
What is the tx for croup w/o stridor at rest?
supportive care, maybe inhaled mist
What is the tx for croup w/ stridor at rest?
- Nebulized epinephrine
- glucocorticoids
What usually causes epiglottis?
Haemophilus influenzae type B
Why is epiglottitis a medical emergency?
it can rapidly lead to life-threatening upper airway obstruction
What are the s/s of epiglottis?
- sudden onset of high fever
- dysphagia
- drooling
- muffled voice
- inspiratory retractions
- cyanosis
- soft stridor
- often sit in the sniffing dog position
How is epiglottitis definitively diagnosed?
visualization of the airway
What is the first step in treating epiglottitis?
endotrach intubation
What is bacterial tracheitis?
a severe, life-threatening form of laryngotracheo-bronchitis
This is a severe, life-threatening form of laryngotracheo-bronchitis.
Bacterial tracheitis
What is the most common cause of bacterial tracheitis?
Staphylococcus aureus
What are the s/s of bacterial tracheitis?
starts similar to viral croup, but patients develop higher fever, toxicity, and progressive or intermittent severe upper airway obstruction that is unresponsive to standard croup therapy
This dz starts similar to viral croup, but patients develop higher fever, toxicity, and progressive or intermittent severe upper airway obstruction that is unresponsive to standard croup therapy.
bacterial tracheitis
Pediatric airways are _____ and the cross sectional area is _____.
smaller; lower
How are infant chest walls different than that of an adult?
- Weak intercostal muscles
- Ribs are horizontal–>infants rely mostly on their diaphragm
- Diaphragm is flat limiting the change in tidal volume and fatigues easily
Intrathoracic airway obstruction usually causes _____.
expiratory wheezing
Name 3 congenital disorders of intrathoracic airway obstruction.
- Tracheomalacia and bronchomalacia
- Tracheoesophageal fistula
- Vascular Rings, Pulmonary slings, and other vascular anomalies that can cause airway compression
What is the most common acquired cause of intrathoracic airway obstruction?
infection
What is bronchiolitis?
- acute onset tachypnea, labored breathing, and/or hypoxia
- Irritability, poor feeding
- Wheezing and crackles
Dx?
- acute onset tachypnea, labored breathing, and/or hypoxia
- Irritability, poor feeding
- Wheezing and crackles
bronhiolitis
_____ is the most common serious acute respiratory illness in infants and young children.
Bronchiolitis
Respiratory syncytial virus (RSV) is by far the most common viral cause of _____.
acute bronchiolitis
_____ is by far the most common viral cause of acute bronchiolitis.
Respiratory syncytial virus (RSV)
Pts with bronchiolitis can potentially develop ____.
asthma
Dx:
- Recurrent symptoms of airway obstruction (cough, SOB, chest tightness)
- At least partial reversal of bronchospasm and symptom relief with a bronchodilator (e.g. a beta agonist such as albuterol)
- All other diagnoses ruled out
asthma
What is the chronic tx of choice in asthma?
corticosteroids
What is parenchymal lung disease in children?
any disorders that affect the alveoli, associated structures, and the airways
What is the most common acquired cause of parenchymal lung disease in children?
Viral or bacterial pneumonia
What is bronchopulmonary dysplasia?
- Acute respiratory distress in the first week of life
- Required oxygen therapy or mechanical ventilation, with persistent oxygen requirement at 36 weeks gestational age or 28 days of life
- Persistent respiratory abnormalities, including physical signs and radiographic findings
Dx?
- Acute respiratory distress in the first week of life
- Required oxygen therapy or mechanical ventilation, with persistent oxygen requirement at 36 weeks gestational age or 28 days of life
- Persistent respiratory abnormalities, including physical signs and radiographic findings
bronchopulmonary dysplasia
______ is a developmental disorder characterized by decreased surface area for gas exchange, reduced inflammation, and dysmorphic vascular structure.
bronchopulmonary dysplasia (BPD)
The cause of _____ is a defect in a single gene on chromosome 7 that encodes an epithelial chloride channel.
CF
The cause of CF is a defect in a single gene on chromosome ___ that encodes an epithelial chloride channel.
7
The cause of CF is a defect in a single gene on chromosome 7 that encodes an epithelial _____ channel.
chloride
The most common CF mutation is ______.
ΔF508
What is meconium ileus? What disease is it assoc. with?
a severe intestinal obstruction resulting from inspissation of tenacious meconium in the terminal ileum; CF
What is the dominant lung pathogen in CF patients?
Pseudomonas aeruginosa
CF pts should also take daily multivitamins that contain vitamins ______.
A, D, E, and K
