Respiratory disease in childhood Flashcards
What is respiratory distress syndrome of the newborn?
Relative surfactant deficiency in a neonate. Occurs in premature babies because the type 2 alveolar cells don’t start to produce surfactant until about 32 weeks.
Lack of surfactant results in atelectasis (lung collapse) and impaired gas exchange.
What is given to mothers before birth of a premature child and why?
Steroids because they stimulate production of surfactant.
What can cause chronic lung disease in infants?
Generally follows respiratory distress syndrome.
Can be caused by barotrauma, volume trauma or high inspired oxygen.
a) What is a diaphragmatic hernia?
b) How might the baby’s abdomen appear?
a) Abdominal contents in the thoracic cavity. The abdominal contents have prevented the lung from developing normally and there is associated pulmonary hypoplasia.
b) As a scaphoid abdomen because the contents have moved into the thoracic cavity.
How is CF inherited?
It is autosomal recessive. There are mutations on the CFTR gene which is on chromosome 7.
What is the carrier incidence of CF?
Approx. 1 in 25 people.
What are possible differential diagnoses for children with CF?
Immune deficiency
Ciliary dyskinesia (when the cilia beat in the wrong direction, or point in the wrong direction, or may be out of order)
Asthma
Kartagener’s/immotile cilia syndrome (rare)
Why can children with CF not be exposed to each other?
In case they share their pathogens with each other.
What is the diagnosis of a seven year old child who present with a history of a 3 month cough which is worse at night or during active play?
Asthma
Describe the different stages of management for a child with asthma.
Stage 1: Inhaled beta-agonist when needed
Stage 2: Treat with regular inhaled steroids
Stage 3a: Regular inhaled steroids + LABA
Stage 3b: Stage 3A + Leukotriene antagonists
Why have their recently been concerns about the use of inhaled steroids in children?
There are thoughts that it might impair growth and the child will end up shorter than otherwise.
What reduces birthweight by 250g, causes 4500 pregnancy losses p.a and a 30% increase in perinatal mortality, is carcinogenic and increases the likelihood of the child having asthma attacks?
Passive smoking
What are the signs of acute asthma ?
Cough and wheeze worsening over hours or days
Is RSV the only cause of bronchiolitis in infants?
No but it is the cause of most cases.
What is croup?
Viral laryngotracheobronchitis- inflammation and swelling of upper airway.
