Respiratory Disease in Childhood

Question 1

describe respiratory distress syndrome

Answer 1

relative surfactant deficiency
1% of all births
predominantly in preterm - inverse relationship with gestation (the more premature, the more likely neonatal to have respiratory distress syndrome)

lack of surfactant results in atelectasis and impairment of gas exchange - stiff lung
production can be stimulated by steroids
sudden deterioration requires increased oxygen

Question 2

describe tension pneumothorax in babies

Answer 2

common
caused by ventilation and putting pressure on the lungs
requires chest drain
risk of respiratory distress syndrome

Question 3

describe chronic lung disease

Answer 3

oxygen requirement beyond 36 weeks corrected gestation plus evidence of pulmonary parenchymal disease on CXR
generally follows respiratory distress
high risk of respiratory infections
abnormal airways
growth and development issues
barotrauma, volume trauma, high inspired oxygen
healing stage associated with continued lung growth over 2-3 years - wheezy
common in premature babies

Question 4

describe grunting in new borns

Answer 4

attempt at getting air past epiglottis

Question 5

describe bronchiolitis

Answer 5

viral infection - RSV
babies under 18 months old
more severe in younger babies, ex premature and family of smokers
tachypnoea, poor feeding, irritating cough
apnoea in small babies
treatment is supportive
increased incidence of wheezing episodes in next 10 years

Question 6

describe pneumonia in neonates

Answer 6

GBS, E.Coli, Klebsiella, staph aureus

Question 7

describe pneumonia in infants

Answer 7

strep pneumonia, chlamydia

Question 8

describe pneumonia in school age children

Answer 8

strep pneumonia, staph aureus, Gr A strep, bordetella, mycoplasma , legionella

Question 9

describe croup

Answer 9

viral laryngotracheobronchitis
stridor
barking cough
treatment - oral steroid to reduce inflammation

Question 10

describe croup

Answer 10

viral laryngotracheobronchitis
stridor
barking cough
treatment - oral steroid to reduce inflammation

Question 11

describe anatomy and physiology in children

Answer 11

high anterior larynx
neonates breath through their nose
airways narrower
compliant chest, horizontal ribs and diaphragm
babies tend to increase respiratory rate as there is less scope for increasing tidal volume. larger physiological dead space
fewer alveoli as they develop in adulthood
high oxygen requirement per kg