Respiratory Cases Flashcards
What is the threshold for a chronic cough?
Children: >4 weeks
Adults: >8 weeks
Why don’t young children cough out mucous?
They swallow it
What causes coughing after eating in children?
Airway fistula
Laryngeal dysfunction
What types of cough go away during the sleep?
Psychogenic
What pathology causes cough that is worse in the morning?
Bronchiectasis
What does being born premie predispose you too?
Bronchopulmonary dysplasia
Asthma like illness later in childhood
Where is the pathology in stridor?
Extra-thoracic aspect of the tract
Where is the pathology in wheeze?
Intra-thoracic
What is the highest risk family history factor for asthma?
Asthma in mother
What classically causes chronic cough with fevers?
TB
What age groups inhale foreign bodies?
Toddlers
Or younger if has siblings
What does Harrison’s sulci reflect?
Chronic increased work of breathing due to obstruction
What is the most common cause of chronic wet cough?
Protracted bacterial bronchitis
Which organisms cause protracted bacterial bronchitis?
Untypible haemophilus influenzae
Strep pneumonia
Moraxella catarrhalis
What is the pathophysiology of PBB?
Viral illness causing damaged to mucociliary elevator
Biofilm formation
How is PBB treated?
4-6 weeks of abx - augmentin, bactrim
How long do URTI coughs take to resolve?
1-2 weeks
How sensitive is CXR for detecting bronchiectasis?
Low in non-severe disease
What are the CXR features of bronchiectasis?
Tram tracking
Ring shadows
Hyperinflation
Patchy atelectasis
How do you investigate chronic lung disease?
Chest xray FBE Immunoglobulins Functional antibody response CF - sweat test
How do you interpret the sweat test result?
Greater 60 mmol/L of chloride is diagnostic
Less than 40mmol/L is normal
What is the definition of bronchiectasis?
Airway diameter greater than its accompanying artery
Radiological diagnosis
What are the causes of bronchiectasis in children?
CF Primary ciliary dyskinesia Immunodeficiency Previous severe pneumonia - focal Foreign body - focal TB
What are the clinical features of primary ciliary dyskinesia?
- Sinusitis
- Otitis media
- Chronic suppurative lung disease
- Rhinitis
- Male infertility
- Dextrocardia
What is primary ciliary dyskinesia?
- Is a rare,ciliopathic,autosomalrecessivegenetic disorderthat causes defects in the action ofcilialining therespiratory tract(lower and upper,sinuses,Eustachian tube,middle ear) andfallopian tube, as well as in theflagellaofspermcells.
How is PCD diagnosed?
Nasal NO Ciliary beat frequency Ciliary beat pattern Cilial ultrastructure Cell culture with regrowth of ciliary epithelium
How is PCD treated?
Airway clearance Abx Routine vaccination Hearing aids Grommets Functional endoscopic sinus surgery
