Respiratory Childhood Diseases. Flashcards
What increases the incidence of pneumothorax in children?
IPPV, CPAP and ventilation.
RDS
What can cause chronic lung disease in children?
General follows RDS
Barotrauma, volume trauma, high inspired oxygen.
How do we examine older children for respiratory conditions?
Weight, height and length all plotted. Look for clubbing, chest shape and do auscultation.
What kind of genetic abnormality is cystic fibrosis and what number of people are carriers of the disease?
Autosomal recessive mutation in the CFTR gene.
Carried by roughly 1 in 25 people.
What is the differential diagnosis of CF?
Immune deficiency
Ciliary dyskinesia
Asthma
Kartageners syndrome - rare involves immobile cilia.
What clinical signs and symptoms point to a child having asthma?
Wheeze, cough, chest tightness, difficulty breathing. Atopy. Response to drugs.
What are the stages of treatment for childhood asthma?
1 - inhaled shirt acting beta agonists.
2 - regular inhaled steroids.
3a - regular inhaled steroids plus LABA
3b - stage 3a plus leukotrine antagonists.
What can passive smoking cause in children?
Reduces birthweight.
Increased likelihood of asthma attack.
Glue ear
Cleft lip
What are the signs of acute asthma?
Cough and wheeze worsening over hours or days.
What causes bronchiolitis?
Viral infection commonly caused by RSV but also HMPV and adenovirus.
What children normally get bronchiolitis?
Under 18 months.
More severe in younger babies, ex Prem and
family smokers.
What are the complications of bronchiolitis?
Respiratory and cardiac failure.
What organisms cause pneumonia in neonates?
GBS, e.coli, klebsiella and staph aureus.
What organisms cause pneumonia in infants?
Strep pneumoniae and chlamydia.
What organisms cause pneumonia in school age children?
Strep pneumoniae, staph aureus, GR A strep, bordetella, mycoplasma and legionella.
What is croup? What are the symptoms and treatments?
Viral laryngealtracheobronchiolitis.
Stridor and a barking cough.
Given oral steroids to reduce inflammation or humidification in mild cases.
What is the presentation of measles?
Pyrexia, runny nose, red eyes, malaise and a dry cough.
Get kopliks spots and a maculopoular rash which begins behind the ears and descends over 3 days.
What are the complications of measles?
Bacterial bronchopneumonia, bacterial otitis media and encephalitis.
What jab prevents TB?
BCG
What jab prevents measles?
MMR.
What is the vermillion border?
The junction between the lip and the skin.
What do kopliks spots look like?
Coarse grains of sea salt on the inside of the mouth.
What is a macropopular rash?
Smooth red raised areas.
What 3 types of encephalitis can we get following measles?
At the time, post infectious and subacute sclerosing panencephalitis (occurs 7 years later and can be fatal).
When are complications from measles more common?
In the immunocompromised and the malnourished.
What do children with bronchiolitis present with?
Fever, corzya, irritating cough, wheeze and Tachypnoea.
poor feeding and apnoea in small babies.
What do severe cases of bronchiolitis present with?
Grunting, decreased PaO2 and intercostal or sternal indrawing.
How do we confirm bronchiolitis?
PCR from throat or nasal swab.
What is the therapy for bronchiolitis?
Supportive measures.
When does bronchiolitis happen and how common is it?
Every winter and it is very common.
What other virus is second to RSV in causing bronchiolitis and what are the symptoms?
Metapneumovirus.
Similar symptoms to RSV in both children and adults.
Range of severity goes from mild to requiring ventilation.
How do we generally test for a viral infection?
PCR from throat or nasal swabs.
Bronchial lavage or endotracheal aspirate.
What STI can cause infantile pneumonia and how do we test for it?
Chlamydia trachomatis.
Diagnosed by PCR of mothers urine or throat and nasal swabs of child.
What does acute epiglottisis cause and what can this lead to?
Causes severe croup in children.
can progress to obstruction and death.
What do children suffering from acute epiglottisis look like?
What do they usually have a history of?
Very unwell.
have a history of RTI illness and infections.
Why must we be careful when examining children with acute epiglotitis?
When depressing the tongue, the epiglottis thinks we are swallowing and flips down. As it is enlarged it may get stuck and cause obstruction.
What causes respiratory distress syndrome of the newborn?
How do we treat it?
Surfactant deficiency due to preterm birth.
Surfactant isn’t made until 32 weeks.
Results in impaired gas exchange and actelectasis.
Production stimulated by steroids.
What is a respiratory complication in the new baby in around 1% of vaginal births?
Pneumothorax.
slightly higher incidence in C sections.
