Week 5 Paediatrics + SIDS Flashcards
Anatomy
Paeds often have a large and heavy head in proportion to their body, At what age does the Fontanelles fuse together (skull gaps)?
A. 6 months
B. 12 months
C. 18 months
D. 24 months
D. 24 months
- Relatively large and heavy in proportion to the body
- Up to 19% surface area compared with 9% for adults = ↑ heat loss
- Fontanelles present (completely close usually by 2 years old
Source - Lecture Slides
Why do paediatrics lose a lot of body heat through their head?
- Up to 19% surface area compared with 9% for adults = ↑ heat loss
Paediatrics have weaker ligaments and muscles in the neck. At what site do we generally see injury?
A. C1 - C2
B. C5 - C6
C. SCIWORA
D. Both A and C
D. Both A and C
Weak ligaments and muscles
C1-C2 injuries more common
SCIWORA
According to the lecture slide 17 Peads Part 1,
What is a sign of child abuse when it comes fractured ribs?
3+ # ribs are considers child abuse. This is due to blunt trauma rarely causes #ribs in paediatrics.
Therefore, # ribs = severe injury
It also good to not that anatomically
- Paediatric ribs are horizontal in design
- Intercostal muscles are less developed = diaphragmatic breathers (belly breathers)
What is Sudden Infant Death Syndrome (SIDS)?
Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. SIDS is sometimes known as crib death because the infants often die in their cribs.
What is Obstructive Sleep Apnoea (OSA)?
OSA is a condition causing repetitive episodes of upper airway obstruction during sleep, leading to hypoxia and/or sleep disturbance.
It is important to note that muscle use for breathing still continues during the airway obstruction.
This is different to central sleep apnoea where the brain during an episode does not send signals to breath
What is the main cause for Obstructive Sleep Apnoea (OSA) in children?
A. Enlarged tonsils and adenoids
B. Obesity
C. Foreign Body
D. All of the above
A. Enlarged tonsils and adenoids
Obesity does increase the risk of OSA but is more common in adults
A foreign body is not a cause of OSA
Risk factors for Obstructive Sleep Apnoea (OSA)
Hint: F MOBCAP
F - Family Hx of OSA M - Male Gender O - Obesity B - Bronchopulmonary Dysplasia C - Craniofacial Anomalies A - Antenatal Smoking P - Premature Birth
Bronchopulmonary Dysplasia = Damage caused by mechanical ventilation and excessive oxygen use
What is not a sign and symptom of Obstructive Sleep Apnoea (OSA)
A. Loud Snoring B. Chokes, Gasps, Snorts in sleep C. Breathing through nasal passage only D. Profuse sweating during sleep E. Dysphagia
C. Breathing through nasal passage only
Babies prefer to nose breath and breathing through their mouth instead of their nose at night is a SxSx of OSA
Why are people with Down Syndrome likely to suffer from sleep disorders?
- Hypotonia
- Hypertrophy of adenoid and tonsils
- Poor coordination of airway movements
- Obesity
- Central apnoea
True or False
Prader Will Syndrome is associated with hypertonia and tall stature?
False
Prader Willi Syndrome. This is a rare (estimated prevalence for the Australian population 1in25 000) and complex genetic syndrome associated with developmental delay, hypotonia, short stature and failure to thrive in infancy
Which overgrowth syndrome is related to Obstructive Sleep Apnoea and an increase in the likelihood of cancer?
A. Disruptive Mood Dysregulation Disorder
B. Prader Willi Syndrome
C. Beckwith-Tiedmann Syndrome
D. Down Syndrome
C. Beckwith-Tiedmann Syndrome
This is an overgrowth syndrome.
- macrosomia and rapid growth during childhood,
- sometimes with asymmetry; omphalocele and macroglossia.
An increased risk of cancers,
- Wilm’s tumours,
- Hepatoblastoma
- Rhabdomyosarcomas.
Sleep-disordered breathing is common, it can in part be explained by upper airway narrowing but central apnoeas may also occur.
What is the difference between Obstructive Sleep Apnoea (OSA) and Central Sleep Apnoea (CSA)?
OSA - is airflow is diminished or absent in the presence of persistent chest and abdominal movements due to partial or complete blockage of upper airway
CSA - breathing stops and there is a pause before there is an effort to breathe again
What are the 4 genetic syndromes associated with Sleep Disorders of Infancy?
Down Syndrome
Prader Willi Syndrome
Hyperphagia
Beckwith-Tiedmann Syndrome (BWS)
How is Gastroesophageal Reflux Disease (GORD) associated with Sleep Apnoea?
Reflux may trigger apnoea via the laryngeal chemoreflex or GORD may induce laryngeal swelling.
Apnoea has been shown to improve after successful treatment of GORD in infants.
