Respiratory Disease In Childhood Flashcards
What is Infant respiratory Distress Syndrome?
A syndrome in premature infants caused by developmental insufficiency of pulmonary surfactant production and structural immaturity in the lungs.
Why does an insufficiency of surfactant cause a problem?
It causes the alveoli to collapse and therefore leads to hypoxia.
It causes atelectasis (complete of partial collapse of the lung or a lobe of the lung) and impairment of gas exchange
Describe surfactant?
Contains phospholipid and apoproteins
Usually secreted around 30-32/40 weeks
Any child born before 32 weeks must be given surfactant.
What is the production of surfactant stimulated by?
Steroids
Describe pneumothorax’s in infants?
Air in the pleural space
Increased incidence with IPPV, CPCP and ventilation
Other risk factors include RDS - stiff lungs
Describe diaphragmatic hernia?
Associated with pulmonary hypoplasia (incomplete development of the lungs, resulting in an abnormally low size or number of bronchopulmonary segments or alveoli)
Common is the left side to get them
Must avoid a bag mask as some of the air may go into the gut and worsen the baby
Just have to give them resp support and then surgical intervention
What does grunting in a neonate suggest?
Resp distress - means they are expiring against a closed epiglottis keeping their lungs open.
What gene is associated with cystic fibrosis and what the the mutation in CF?
F508 gene
Mutation in CFTR gene
What are the SIGN guidelines in asthma in children?
Clinical Features that increase probability
One or more : wheeze, cough, chest tightness, difficulty breathing
Atopy (personal or family history - tendency to develop allergic reactions)
Widespread wheeze on auscultation
Response to Rx
What is the management of asthma?
Stage 1: Treat with inhaled beta-agonists when needed (SABA)
Stage 2: Treat with regular inhaled steroids
Stage 3A: Regular inhaled steroids + Long acting beta agonists (LABA)
Stage 3B: Stage 3A + Leukotriene antagonists (CySLT/Theophylline)
(Stage 4 - oral corticosteroids + refer to asthma clinic)
What can passive smoking cause in terms of pregnancy etc?
Passive smoking can reduce birthweight by 250g
Can get a cleft lip/palate
Increased likelihood of an asthma attack
What would be some symptoms in acute asthma?
Cough and wheeze worsening over hours or days
How would you treat acute asthma?
Oxygen Nebulised bronchodilator Oral prednisolone IV salbutamol IV aminophylline IV magnesium Ventilatory support
What is bronchiolitis and what is it caused by?
Viral infection caused by RSV
What age group usually gets bronchiolitis?
Uder 18months usually
