Why do infants wheeze Flashcards

1
Q

When is lung fully functional

A

36-38 weeks

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2
Q

Define wheeze

A

Musical lung sound

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3
Q

What is a wheeze produced from

A

Oscillation in narrowed airways

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4
Q

How can wheezes be characterised

A

Inspiratory or expiraratory

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5
Q

What pressure change happens when you inhale

A

Negative pressure generated in chest and transferred to small airway

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6
Q

What happens to small airways as you breathe in

A

Expand/ pulled apart by negative pressure

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7
Q

What happens if small airways narrow

A

Initially velocity increases, but as narrows further is decreases
Initally pressure decreases but narrows further giving increase
Alternation of these pressure/ velocity changes gives fluttery breaths

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8
Q

What % of children will wheeze before age of 3, and what triggers this most

A

35

Viral colds

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9
Q

Why is smoking in pregnancy a risk factor for preschool wheeze

A

Maternal smoking alters airway structure, making it floppier

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10
Q

Apart from smoking what is another risk factor for preschool wheeze

A

Air pollution

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11
Q

During what age are transient early wheezers most prevalent

A

0-3

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12
Q

During what age are non-atopic wheezers most prevalent

A

3-6

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13
Q

During what age is IgE associated wheeze more prevalent

A

6+

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14
Q

Define transient early wheeze

A

Wheeze only during first 3 years of life

Born with low lung function and tendency to develop twitchy airway with colds

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15
Q

By what age do transient early wheezers have normal lung function

A

Age 11

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16
Q

How do non atopic wheezers start wheezing

A

Symptomatic lower respiratory tract viral infection in early life

17
Q

What is the difference between non-atopic wheeze and atopic wheeze

A

There is no inflammation between wheezes in non-atopic

In atopic there is persistent inflammation throughout central and peripheral airways

18
Q

What 3 histological changes can be seen in atopic asthma

A

Goblet cell hyperplasia
Thick sub basement membrane
Lymphocyte and eosinophil infiltration

19
Q

How should preschool wheeze be treated (step 1)

A

Inhaled, short acting beta 2 agonist

20
Q

Step 2 of treating preschool wheeze

A

Inhaled corticosteroids

21
Q

How does large cystic abnormality present

A

Early with resp distress or later with infection

22
Q

What makes up a bronchogenic cyst

A

Thin walled with ciliated columnar lining
May contain cartilage, smooth muscle
Some have gastro-oesophageal mucosa
Air or fluid filled

23
Q

What are congenital lobar emphysema

A

Over distention of lobe
Partial bronchial obstruction
Ball valve effect