Respiratory disease in children

Question 1

Name the stages of lung development

Answer 1

Embryonic period- 1 month to 7 weeks
Pseudoglandular- 5-17 weeks
Canalicular- 16-25 weeks
Saccular- 24 weeks till after birth
Aveolar- late fetal to 8 years old

Question 2

What stage lung development would a baby be at born at 27 weeks?

Answer 2

Saccular

Question 3

Describe the breathing of a neonate born at 27 weeks

Answer 3

Laboured, in drawing, nostril flaring, increased work of breathing, thickened diffusion distance- less gas exchange increased respiration required, low surfactant levels requires greater effort to ventilate. Condition called respiratory distress syndrome

Question 4

Treatment for RDS

Answer 4

Intubation, postive pressure ventilation, high pressure, 100% oxygen

Question 5

Name the condition that can result from treatment of RDS and define it.

Answer 5

Chronic lung disease of prematurity (also known as bronchopulmonary dysplasia).
Definition: Persistant increased work of breathing (indrawing and increased resp rate),abnormal CXR changes, for babies born at

Question 6

Pathology of CLD, early and late changes

Answer 6

Early changes: areas of atelectasis, emphysema. Hyperplasia of airway epithelium, interstitial oedema.
Late changes: intersitial fibrosis, hypertrophy of airway smooth muscle, pulmonary arteriolar musculature

Question 7

Aetiology of CLD

Answer 7

Lung immaturity- increased susceptibility to damage from oxygen, barotrauma, and volutrauma. Surfactant deficiency, immature antioxidant response.
Pulmonary oedema- patent ductus arteriosus, IV fluids.

Question 8

Describe paroxysmal cough

Answer 8

Whooping cough; violent (paroxysmal) cough, well in between coughing fits, may last up to 3-4 months.

Question 9

8 months- cough, in drawing, increased respiratory rate (50 breaths per minute), no wheezing. Diagnosis?

Answer 9

Pneumonia.

Question 10

Describe bronchiolitis

Answer 10

Inflammation of the bronchioles. Common in babies.

Question 11

What would be used to treat meres asthma

Answer 11

Inhaled corticosteroids and a bronchodilator

Question 12

Aged 10-12 years repeated bouts of wet productive cough, crackles heard. What could be the possible causes?

Answer 12

Bronchiectasis, cystic fibrosis, retained foreign body, TB

Question 13

Describe bronchiectasis

Answer 13

Abnormal enlargement if the bronchi causing increased mucous production and increased risk of infection.

Question 14

What pattern would you see on spirometry with bronchiectasis

Answer 14

Obstructive, reduced FEV and FEV1, FEV1 more so.

Question 15

Treatment of bronchiectasis

Answer 15

Antibiotics and sputum clearance techniques (physio)