Respiratory diseases in childhood

Question 1

define neonatology

Answer 1

hospital-based subspeciality of paediatrics for pre-term babies up to a month old

Question 2

a pre-term baby is a baby born at or before __ weeks

Answer 2

37

Question 3

a baby born at term is born at __ to __ weeks gestation

Answer 3

37 to 42

Question 4

a late baby is born after __ weeks

Answer 4

42

Question 5

many premature babies have respiratory distress syndrome. This is due to a deficiency of what?

Answer 5

surfactant

Their lungs may collapse - atelectasis, and there is also impaired gas exchange so baby may be hypoxic

Question 6

what is CPAP (continuous positive airway pressure)?

Answer 6

a treatment that uses a mild air pressure to keep the airways open.

Question 7

What is IPPV (intermittent positive pressure ventilation)?

Answer 7

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

Question 8

Treatment for baby with RDS?

Answer 8

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).

Question 9

antenatal steroids are to…

Answer 9

mature the lungs

Question 10

what percentage of babies have a pneumothorax?

Answer 10

about 1%

most will be fine, but a tension pneumothorax requires treatment

Question 11

risk factors for pneumothorax in newborn baby

Answer 11

• increased incidence with IPPV, CPAP, and ventilation
• RDS (stiff lungs)
• spontaneous (1% vaginal deliveries, 1.5% caesarean sections)

Question 12

barotrauma

Answer 12

injury caused by a change in air pressure, affecting typically the ear or the lung

Question 13

volume trauma (pulmonary volutrauma)

Answer 13

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

Question 14

chronic lung disease (CLD)

Answer 14

specifically a paediatric problem

It’s a general term for long-term respiratory problems in premature babies

Question 15

dextrocardia

Answer 15

rare congenital defect in which the apex of the heart is located on the right side of the body

Question 16

congenital diaphragmatic hernia

Answer 16

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

Question 17

Pulmonary hypoplasia

Answer 17

incomplete development of the lungs, resulting in abnormally low number or size of bronchopulmonary segments or alveoli.

Question 18

Transient tachypnea of the newborn

Answer 18

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).

Question 19

ciliary dyskinesia

Answer 19

defects in the action of the cilia

Question 20

Kartagener’s syndrome

Answer 20

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.

Question 21

effects of passive smoking on children

Answer 21

• reduces birthweight by 250g
• 30% increase perinatal mortality
• teratogenic (airways, cleft lip/ palate)
• glue ear
• carcinogenic
• increased likelihood of asthma attack

Question 22

teratogenic

Answer 22

any agent that can disturb the development of an embryo or foetus

Question 23

bronchiolitis

Answer 23

• 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

Question 24

laryngomalacia

Answer 24

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

Question 25

croup (viral laryngotracheobronchitis)

Answer 25

It’s a viral UTRI which causes varying degrees of airway obstruction
Causes stridor, barking cough. Treatment is oral steroid to reduce inflammation