Respiratory Disease in Childhood Flashcards
What does a lack of surfactant result in?
Atelectasis and impairment of gas exchange
What is the production of surfactant stimulated by?
Steroids
Respiratory distress syndrome is predominantly in preterm, what relationship does it have with gestation?
Inverse
What is there an increased incidence with IPPV, CPAP and ventilation?
Pneumothorax
What is the condition named where oxygen requirement is beyond 36 weeks corrected gestation plus evidence of pulmonary parenchymal disease onCXR?
Chronic lung disease
What does chronic lung disease generally follow?
RDS
What does a diaphragmatic hernia have associated with it=?
Pulmonary hypoplasia
Where are the two most common diaphragmatic hernias located?
Posterolateral (Bochdalek), left-sided
A 1 year old child presents with a prolonged history of cough, loose stools and failure to thrive - diagnosis?
CF
Anewborn infant with a raised immuno-reactive trypsin level on neonatal screening who is also found to be homozygous for the F508 deletion - diagnosis?
CF
Name a respiratory disease in childhood and adulthood that is autosomal recessive?
CF
What is the carrier incidence like for CF?
1 in 24 people
In CF what gene are the mutations found in?
CFTR gene
Is CF a multisystem disorder?
Yes
Give 4 differential diagnosises for CF?
- Immune deficiency
- Ciliary dyskinesia
- Asthma
- Kartagener’s immotile cilia syndrome - rare
A 7-year child presents with 3-month history of cough worse at night or during active play - diagnosis?
Asth,a
What are the 4 clinical features that increase the probability of a child having asthma (SIGN guidline)?
- One or more: wheeze, cough, chest tightness, difficulty breathing
- Atopy (personal or family history)
- Widespread wheeze on auscultation
- Response to Rx
What are the 4 stages of asthma management in children?
- Treat with inhaled beta-agonist when needed
- Treat with regular inhaled steroids
- Regular inhaled steroids + long acting beta agonists
- Stage 3 + leukotriene antagonists
What 2 features can passive smoking cause on a baby?
Teratogenic: airways, cleft lip/palate
Glue ear
7 steps of treatment for acute asthma in children.
- Oxygen
- Nebulised bronchodilator
- Oral prednisolone
- IV salbutamol
- IV aminophylline
- IV magnesium
- Ventilatory support
6 week old presented with increased work of breathing and possible apnoes, URTI symptoms over last 2 days - diagnosis?
Bronchiolitis
What are the three common viral infections that cause bronchiolitis in children?
- RSV
- HMPV
- Adenovirus
Three clinical features of bronchiolitis in children?
Tachypnoea
Poor feeding
Irritating cough
10 year old girl with cough, high fever and sputum production. Previously very well. Clinical examination: dullness on percussion, increased vocal fremitus and resonance, bronchial breathing - diagnosis?
Pneumonia
4 causes of pneumonia in neonates?
GBS
E.coli
Klebsiella
Staph aureus
2 causes of pneumonia in infants?
Strep pneumoniae
Chlamydia
What child age do these cause pneumonia commonly in - Strep pneumoniae, Staph aureus, Gr A strep, Bordetella, Mycoplasma, Legionella?
School age children
Give 5 differential diagnosis for: 2 year old child presenting with barking cough and difficulty in breathing of sudden onset.
Inhaled foreign body Laryngomalacia Epiglottitis and bacterial tracheitis Allergy Croup
What does a classic steeple sign with narrowing of the tracheal air column at the larynx and distension of the hypopharynx suggest?
Croup
What condition is caused by viral laryngotracheobronchitis?
Croup
What two clinical features are seen with croup?
Barking cough and stridor
What is the treatment for croup?
Oral steroid to reduce inflamamtion
9 month old infant from developing country with irratability, neck rigitity and afebrile - diagnosis?
Pulmonary TB
5 common respiratory problems in children - beginning with “C”?
CLD Congenital diaphragmatic hernia CF Childhood pneumonias Croup
What condition relates to relative surfactant deficiency?
Respiratory distress syndrome
