Respiratory diseases in childhood Flashcards
define neonatology
hospital-based subspeciality of paediatrics for pre-term babies up to a month old
a pre-term baby is a baby born at or before __ weeks
37
a baby born at term is born at __ to __ weeks gestation
37 to 42
a late baby is born after __ weeks
42
many premature babies have respiratory distress syndrome. This is due to a deficiency of what?
surfactant
Their lungs may collapse - atelectasis, and there is also impaired gas exchange so baby may be hypoxic
what is CPAP (continuous positive airway pressure)?
a treatment that uses a mild air pressure to keep the airways open.
What is IPPV (intermittent positive pressure ventilation)?
a form of mechanical ventilation in which air is delivered into a person’s lungs under pressure and in short bursts, to simulate intakes of breath
Treatment for baby with RDS?
baby tubed and given surfactant
Then they go onto CPAP (which is more gentle and less invasive - it keeps the lungs open, trying not to damage the lungs).
antenatal steroids are to…
mature the lungs
what percentage of babies have a pneumothorax?
about 1%
most will be fine, but a tension pneumothorax requires treatment
risk factors for pneumothorax in newborn baby
- increased incidence with IPPV, CPAP, and ventilation
- RDS (stiff lungs)
- spontaneous (1% vaginal deliveries, 1.5% caesarean sections)
barotrauma
injury caused by a change in air pressure, affecting typically the ear or the lung
volume trauma (pulmonary volutrauma)
condition in which the alveoli and bronchioles are damaged by excessive levels of air, thus overinflating the lungs and physically damaging the tissue. Often a result of incorrect use of a medical ventilator. Volutrauma is separate from barotrauma because the mechanism of injury is excessive volume, instead of excessive pressure
chronic lung disease (CLD)
specifically a paediatric problem
It’s a general term for long-term respiratory problems in premature babies
dextrocardia
rare congenital defect in which the apex of the heart is located on the right side of the body
congenital diaphragmatic hernia
birth defect of the diaphragm. Most common type is Bochdalek hernia. Diaphragm malformation allows abdominal organs to push up into the chest cavity, hindering proper lung function. CDH is life-threatening in infants and caused death by 2 complications: pulmonary hypoplasia and pulmonary hypertension. Also, newborns with CDH have RDS
Pulmonary hypoplasia
incomplete development of the lungs, resulting in abnormally low number or size of bronchopulmonary segments or alveoli.
Transient tachypnea of the newborn
Transient respiratory problem that can be seen in the newborn shortly after delivery. It consists of a period of rapid breathing and is likely due to retained lung fluid (most often in babies delivered by caesarean section).
ciliary dyskinesia
defects in the action of the cilia
Kartagener’s syndrome
rare, ciliopathic autosomal recessive disorder that causes defects in the action of the cilia lining the respiratory tract. In situs inversus, the cilia are a mirror image of normal and so beat the wrong way.
effects of passive smoking on children
- reduces birthweight by 250g
- 30% increase perinatal mortality
- teratogenic (airways, cleft lip/ palate)
- glue ear
- carcinogenic
- increased likelihood of asthma attack
teratogenic
any agent that can disturb the development of an embryo or foetus
bronchiolitis
- inflammation of the bronchioles (usually get it under 18months old)
- caused by RSV most commonly (also metapneumovirus and others…)
- tachypnoea, poor feeding, irritating cough
- treatment is supportive: some may need NG tube, oxygen, drips
laryngomalacia
most common cause of stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inwards during inhalation, causing airway obstruction. Common congenital disease in infancy
croup (viral laryngotracheobronchitis)
It’s a viral UTRI which causes varying degrees of airway obstruction
Causes stridor, barking cough. Treatment is oral steroid to reduce inflammation
