Respiratory Disease in Childhood

Question 1

What does a lack of surfactant result in?

Answer 1

Atelectasis and impairment of gas exchange

Question 2

What is the production of surfactant stimulated by?

Answer 2

Steroids

Question 3

Respiratory distress syndrome is predominantly in preterm, what relationship does it have with gestation?

Answer 3

Inverse

Question 4

What is there an increased incidence with IPPV, CPAP and ventilation?

Answer 4

Pneumothorax

Question 5

What is the condition named where oxygen requirement is beyond 36 weeks corrected gestation plus evidence of pulmonary parenchymal disease onCXR?

Answer 5

Chronic lung disease

Question 6

What does chronic lung disease generally follow?

Answer 6

RDS

Question 7

What does a diaphragmatic hernia have associated with it=?

Answer 7

Pulmonary hypoplasia

Question 8

Where are the two most common diaphragmatic hernias located?

Answer 8

Posterolateral (Bochdalek), left-sided

Question 9

A 1 year old child presents with a prolonged history of cough, loose stools and failure to thrive - diagnosis?

Answer 9

CF

Question 10

Anewborn infant with a raised immuno-reactive trypsin level on neonatal screening who is also found to be homozygous for the F508 deletion - diagnosis?

Answer 10

CF

Question 11

Name a respiratory disease in childhood and adulthood that is autosomal recessive?

Answer 11

CF

Question 12

What is the carrier incidence like for CF?

Answer 12

1 in 24 people

Question 13

In CF what gene are the mutations found in?

Answer 13

CFTR gene

Question 14

Is CF a multisystem disorder?

Answer 14

Yes

Question 15

Give 4 differential diagnosises for CF?

Answer 15

1. Immune deficiency
2. Ciliary dyskinesia
3. Asthma
4. Kartagener’s immotile cilia syndrome - rare

Question 16

A 7-year child presents with 3-month history of cough worse at night or during active play - diagnosis?

Answer 16

Asth,a

Question 17

What are the 4 clinical features that increase the probability of a child having asthma (SIGN guidline)?

Answer 17

1. One or more: wheeze, cough, chest tightness, difficulty breathing
2. Atopy (personal or family history)
3. Widespread wheeze on auscultation
4. Response to Rx

Question 18

What are the 4 stages of asthma management in children?

Answer 18

1. Treat with inhaled beta-agonist when needed
2. Treat with regular inhaled steroids
3. Regular inhaled steroids + long acting beta agonists
4. Stage 3 + leukotriene antagonists

Question 19

What 2 features can passive smoking cause on a baby?

Answer 19

Teratogenic: airways, cleft lip/palate

Glue ear

Question 20

7 steps of treatment for acute asthma in children.

Answer 20

1. Oxygen
2. Nebulised bronchodilator
3. Oral prednisolone
4. IV salbutamol
5. IV aminophylline
6. IV magnesium
7. Ventilatory support

Question 21

6 week old presented with increased work of breathing and possible apnoes, URTI symptoms over last 2 days - diagnosis?

Answer 21

Bronchiolitis

Question 22

What are the three common viral infections that cause bronchiolitis in children?

Answer 22

1. RSV
2. HMPV
3. Adenovirus

Question 23

Three clinical features of bronchiolitis in children?

Answer 23

Tachypnoea
Poor feeding
Irritating cough

Question 24

10 year old girl with cough, high fever and sputum production. Previously very well. Clinical examination: dullness on percussion, increased vocal fremitus and resonance, bronchial breathing - diagnosis?

Answer 24

Pneumonia

Question 25

4 causes of pneumonia in neonates?

Answer 25

GBS E.coli Klebsiella Staph aureus

Question 26

2 causes of pneumonia in infants?

Answer 26

Strep pneumoniae | Chlamydia

Question 27

What child age do these cause pneumonia commonly in - Strep pneumoniae, Staph aureus, Gr A strep, Bordetella, Mycoplasma, Legionella?

Answer 27

School age children

Question 28

Give 5 differential diagnosis for: 2 year old child presenting with barking cough and difficulty in breathing of sudden onset.

Answer 28

``` Inhaled foreign body Laryngomalacia Epiglottitis and bacterial tracheitis Allergy Croup ```

Question 29

What does a classic steeple sign with narrowing of the tracheal air column at the larynx and distension of the hypopharynx suggest?

Answer 29

Croup

Question 30

What condition is caused by viral laryngotracheobronchitis?

Answer 30

Croup

Question 31

What two clinical features are seen with croup?

Answer 31

Barking cough and stridor

Question 32

What is the treatment for croup?

Answer 32

Oral steroid to reduce inflamamtion

Question 33

9 month old infant from developing country with irratability, neck rigitity and afebrile - diagnosis?

Answer 33

Pulmonary TB

Question 34

5 common respiratory problems in children - beginning with "C"?

Answer 34

``` CLD Congenital diaphragmatic hernia CF Childhood pneumonias Croup ```

Question 35

What condition relates to relative surfactant deficiency?

Answer 35

Respiratory distress syndrome