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Flashcards in Respiratory Problems in Children Deck (59)
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1

What is the neonatal period?

First 28 days of life

2

What classes can respiratory problems in children be split into?

* Neonatal and older children
* Acute and chronic

3

In what ways are infants different from adults?

* Babies respiratory rate is 60 breaths/min
* They can have periodic breathing (really fast then really slow)

4

What are signs of respiratory distress in newborns?

* Sternal in-drawing
* Tracheal tug (head bobs)
* Grunt when struggling to breathe - essentially giving themselves CPAP

5

What is respiratory distress syndrome in newborns?

Relative surfactant deficiency

6

What newborns are affected with respiratory distress syndrome?

* Predominately affects pre-term babies
* 1% of all births

7

What is the relationship between RDS and gestational age?

As gestational age increases, incidence of RDS decreases

8

What are components of surfactant?

* Phospholipid
* Apoproteins

9

What does lack of surfactant result in?

Atelectasis and impairment of gas exchange

10

How is production of surfactant stimulated in premature infants?

* If suspected pre-mature birth, mother given steroids to promote surfactant production by infant
* Following birth, synthetic surfactant can be delivered down intubation tube into the lungs

11

What can ventilation lead to in young infants?

Pneumothorax

12

What are signs of a pneumothorax caused by ventilation of an infant?

* Sudden deterioration requiring increased oxygen
* No breath sounds on one side of chest
* CXR showing black space in lung

13

What is pneumothorax?

Air in pleural space

14

What can increase the incidence of pneumothorax in young infants?

* IPPV, CPAP and ventilation
* RDS (stiff lungs)

15

What percentage of pneumothorax cases are spontaneous?

* Occurs in around 1% vaginal deliveries
* 1.5% caesarean sections

16

When would intervention be needed for pneumothorax in children?

Tension pneumothorax - a chest drain in required

17

What is chronic lung disease in children?

* Oxygen requirement beyond 36 weeks corrected gestation
* Evidence of pulmonary parenchymal disease (ILD) on CXR
* Generally follows RDS

18

What can cause chronic lung disease in infants?

Damage caused by ventilation
* Barotrauma (pressure trauma)
* Volume trauma
* High inspired oxygen

19

What are the effects of chronic lung disease in infants?

* Often wheezy
* Healing stage associated with continued lung growth over 2-3 years

20

What is dextrocardia?

Heart points toward right side of chest instead of left side

21

What condition can mimic dextocardia in children?

Diaphragmatic hernia - guts in baby's chest can push heart to right side

22

What are diaphragmatic hernias assorted with?

Pulmonary hypoplasia - lung hasn't had enough space to develop

23

What are the commonest types of diaphragmatic hernia?

* Posterolateral (Bochdalek), left-sided

24

Why should a bag-mask be avoided as treatment for diaphragmatic hernia?

Avoid bag mask as can travel down the oesophagus into bowel causing more problems

25

What is the treatment for diaphragmatic hernia?

* respiratory support - intubation (not bag mask)
* Surgical intervention

26

What is the most likely diagnosis of a term baby who was delivered by LUSCS and is grunting shortly after delivery?

Transient Tachypnoea of the Newborn (TTN)

27

What is Transient tachypnoea of the Newborn?

Lung fluid present in babies
* Occurs in babies delivered through caesarean section as in the womb, lungs are filled with amniotic fluid but the stress of labour pushes fluid out of the lungs

28

What is the most likely respiratory diagnosis of a 1-year-old child who has a prolonged history of cough, loose stools and failure to thrive?

Cystic fibrosis

29

What is the most likely diagnosis of a newborn infant with a raised immune-reactive trypsin level on neonatal screening and is also found to be homozygous for the delta-F508 deletion?

Cystic fibrosis

30

Why is everyone in Scotland screened for CF?

Most common life-limiting illness in caucasians