Pediatric Cough and Allergy Quiz
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Questions and Answers

What phase involves a characteristic inspiratory whoop following spasmodic coughing?

  • Catarrhal phase
  • Chronic phase
  • Paroxysmal phase (correct)
  • Convalescent phase
  • Which symptom is NOT commonly associated with the paroxysmal phase of coughing?

  • Cyanotic attacks
  • Rapid recovery (correct)
  • Inspiratory whoop
  • Epistaxis
  • What complication is considered uncommon in severe cases of the disease?

  • Severe dehydration (correct)
  • Bronchiectasis
  • Pneumonia
  • Seizures
  • What is the primary treatment method to reduce symptoms when initiated in the early phase?

    <p>Macrolide antibiotics (A)</p> Signup and view all the answers

    Which group should receive macrolide prophylaxis to prevent further transmission?

    <p>Close contacts of an infected person (C)</p> Signup and view all the answers

    What is the appropriate measure for infants with severe coughing spasms or cyanotic attacks?

    <p>Admission to hospital (C)</p> Signup and view all the answers

    In which age group are most pertussis cases now observed?

    <p>Young adults over 15 years (D)</p> Signup and view all the answers

    Which laboratory test is most sensitive for identifying the organism early in the disease?

    <p>PCR (polymerase chain reaction) (D)</p> Signup and view all the answers

    Which factor can significantly impact the growth of children with allergies?

    <p>Nutritional deficiencies from dietary restrictions (D)</p> Signup and view all the answers

    What is the primary purpose of skin prick testing?

    <p>Identify the presence of wheals as an indicator of allergy (A)</p> Signup and view all the answers

    What does a raised total IgE in a child typically indicate?

    <p>Presence of atopy (C)</p> Signup and view all the answers

    Which statement about allergen challenges is true?

    <p>They should be conducted under close medical supervision. (C)</p> Signup and view all the answers

    When should IgE blood tests specifically for food allergens be avoided?

    <p>When the child is not consuming the food (C)</p> Signup and view all the answers

    At what age do allergic rhinitis, conjunctivitis, and asthma most commonly develop?

    <p>In preschool and primary school years (A)</p> Signup and view all the answers

    What is a possible outcome of a negative skin prick test after proper preparation?

    <p>Allergy is unlikely (C)</p> Signup and view all the answers

    What should be considered before interpreting IgE blood test results?

    <p>Detailed medical history (B)</p> Signup and view all the answers

    What primarily causes respiratory distress syndrome (RDS) in infants?

    <p>Surfactant deficiency (A)</p> Signup and view all the answers

    Which clinical sign is most indicative of respiratory distress in an infant suffering from RDS?

    <p>Cyanosis (B)</p> Signup and view all the answers

    How does surfactant deficiency affect the alveoli in infants with RDS?

    <p>It increases surface tension, causing alveolar collapse. (A)</p> Signup and view all the answers

    What is a common management approach for infants diagnosed with RDS?

    <p>Antenatal glucocorticoids therapy (A)</p> Signup and view all the answers

    Which of the following factors increases the likelihood of developing RDS?

    <p>Genetic mutations in surfactant genes (A), Maternal diabetes (B)</p> Signup and view all the answers

    During a clinical evaluation of an infant with RDS, which diagnostic tool is primarily used?

    <p>Chest X-ray (D)</p> Signup and view all the answers

    What mechanism do infants utilize to create positive airway pressure during expiration in RDS?

    <p>Expiratory grunting (C)</p> Signup and view all the answers

    In cases of respiratory failure associated with reduced oxygen saturation, what additional clinical sign may indicate worsening condition?

    <p>Increased pCO2 on blood gas (A)</p> Signup and view all the answers

    What is the average blood volume in healthy term infants?

    <p>80 ml/kg (C)</p> Signup and view all the answers

    Which nutrient stores are lower and depleted more quickly in preterm infants compared to term infants?

    <p>Iron and folic acid (B)</p> Signup and view all the answers

    What is considered anemia in a neonate based on hemoglobin levels?

    <p>Less than 140 g/L (C)</p> Signup and view all the answers

    What is one of the mechanisms that can lead to anemia?

    <p>Increased red cell destruction (B)</p> Signup and view all the answers

    How does iron deficiency typically occur in infants?

    <p>Inadequate intake or malabsorption (A)</p> Signup and view all the answers

    What are the typical platelet counts at birth?

    <p>150-400 x 10^9/L (A)</p> Signup and view all the answers

    What is the primary component that hemoglobin is made of?

    <p>Heme and globin (A)</p> Signup and view all the answers

    How much iron does a 1-year-old infant require compared to an adult male?

    <p>About the same amount (A)</p> Signup and view all the answers

    What is the primary source of iron with the highest absorption in infants?

    <p>Infant formula (D)</p> Signup and view all the answers

    Which of the following factors inhibits iron absorption?

    <p>Tannin in tea (A)</p> Signup and view all the answers

    What clinical feature indicates the onset of significant iron deficiency anemia in children?

    <p>Microcytic, hypochromic anemia (B)</p> Signup and view all the answers

    Delayed cord clamping at birth increases which of the following in infants?

    <p>Iron stores (D)</p> Signup and view all the answers

    Which of the following foods is likely to enhance iron absorption when consumed together?

    <p>Citrus fruits (C)</p> Signup and view all the answers

    Which diagnostic clue is associated with iron deficiency anemia?

    <p>Low MCV and MCH (D)</p> Signup and view all the answers

    What dietary change can help manage iron deficiency anemia in children?

    <p>Increased consumption of iron-rich foods (A)</p> Signup and view all the answers

    What is a common behavior associated with iron deficiency in children?

    <p>Pica (B)</p> Signup and view all the answers

    What is a common reason children are labeled as having a drug allergy?

    <p>They develop a skin rash after receiving antibiotics during a viral illness. (B)</p> Signup and view all the answers

    What is a potential indicator of a severe drug allergy?

    <p>Widespread skin involvement and mucous membrane involvement. (A)</p> Signup and view all the answers

    What is the typical hemoglobin concentration (Hb) at birth in both term and preterm infants?

    <p>140g/L to 215g/L (C)</p> Signup and view all the answers

    What is the nadir hemoglobin level that infants typically reach by the age of 2 months?

    <p>100g/L (C)</p> Signup and view all the answers

    What is the main type of hemoglobin present at birth in healthy infants?

    <p>HbF (fetal hemoglobin) (C)</p> Signup and view all the answers

    What effect does HbF have compared to HbA?

    <p>HbF is more effective in holding onto oxygen due to its higher affinity. (D)</p> Signup and view all the answers

    What typically happens to the levels of HbF and HbA over the first year of life?

    <p>HbF decreases while HbA increases. (B)</p> Signup and view all the answers

    What is a significant impact of delaying the clamping of the umbilical cord at birth?

    <p>It increases blood volume at birth. (D)</p> Signup and view all the answers

    Flashcards

    Impending Respiratory Failure

    A serious condition where the lungs cannot deliver enough oxygen to the blood, causing a drop in oxygen saturation despite oxygen therapy, rising carbon dioxide levels, and signs of exhaustion, confusion, and reduced consciousness.

    Respiratory Distress Syndrome (RDS)

    A lung condition primarily affecting premature babies, caused by a deficiency in surfactant, a substance that reduces surface tension in the lungs allowing them to inflate properly. This deficiency leads to widespread collapse of air sacs in the lungs, resulting in inadequate gas exchange.

    Surfactant

    A substance produced by cells that lines the air sacs of the lungs, reducing surface tension and allowing for proper inflation and deflation of the lungs during breathing.

    Cyanosis

    A condition where the skin appears bluish due to low oxygen in the blood.

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    Expiratory Grunting

    A noisy breathing sound made during exhalation, often associated with respiratory distress where the airways are partially blocked.

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    Continuous Positive Airway Pressure (CPAP)

    A respiratory support method that uses a mask or nasal prongs to deliver continuous positive pressure to the airways, helping to keep the lungs open and improve breathing.

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    High-Flow Nasal Cannula Therapy

    A type of respiratory support that delivers high flow oxygen through nasal cannulae, assisting with oxygenation and airway patency.

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    Surfactant Therapy

    A medical procedure where surfactant is introduced directly into the lungs of a baby with respiratory distress syndrome using a tube or catheter.

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    Pertussis (Whooping Cough)

    A severe respiratory infection caused by the bacterium Bordetella pertussis. Characterized by a distinctive whooping sound during inhalation after a coughing fit.

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    Catarrhal Phase of Pertussis

    The first stage of pertussis, marked by cold-like symptoms such as runny nose, sneezing, and mild cough. This phase can last up to a week.

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    Paroxysmal Phase of Pertussis

    The most characteristic stage of pertussis, defined by intense coughing fits followed by a high-pitched 'whoop' during inhalation.

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    Convalescent Phase of Pertussis

    The final stage of pertussis, marked by a gradual decline in symptoms. However, coughing can persist for months.

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    Asthma

    A condition characterized by inflammation of the airways in the lungs, leading to recurring symptoms like wheezing, shortness of breath, and chest tightness.

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    PCR (Polymerase Chain Reaction) for Pertussis

    A diagnostic test used to identify the presence of Bordetella pertussis, the bacteria causing pertussis.

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    Pertussis Antibody

    A type of antibody that is specifically produced by the body to fight off pertussis.

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    Pertussis Immunization

    A medical intervention aimed at preventing the occurrence of pertussis. It typically involves administering a vaccine to protect against this specific infection.

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    Skin prick test

    A test where a small amount of allergen is placed on the skin and pricked with a lancet to check for allergic reactions. A raised wheal indicates a positive reaction.

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    IgE blood test

    A blood test that measures the level of IgE antibodies in the blood. Raised IgE levels indicate an allergic tendency.

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    Allergen challenge

    A test that involves gradually increasing the amount of a suspected allergen that is given to a patient to observe for allergic reactions. It's performed under strict supervision and with emergency equipment readily available.

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    Spirometry and other lung function tests

    Tests that assess lung function, such as airflow and lung capacity, used to diagnose and monitor conditions like asthma or lung inflammation.

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    Drug allergy in children

    A skin reaction that occurs when a child is taking antibiotics, often due to a viral infection, rather than a true allergy to the medication.

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    Stevens-Johnson Syndrome

    A serious drug reaction that involves widespread skin and mucous membrane involvement, often accompanied by systemic symptoms.

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    Hemoglobin concentration at birth

    The amount of hemoglobin in a newborn's blood is higher than in adults to compensate for the lower oxygen levels in the womb.

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    Hemoglobin decline in newborns

    The hemoglobin level naturally decreases in the first weeks of life as the baby's red blood cell production adjusts to the new environment.

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    Hemoglobin decline in preterm babies

    Premature infants have a faster and more significant drop in hemoglobin levels due to their underdeveloped red blood cell production.

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    Fetal hemoglobin (HbF)

    The main type of hemoglobin in newborns, both full-term and premature, is fetal hemoglobin (HbF), which has a higher affinity for oxygen compared to adult hemoglobin (HbA).

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    Blood volume at birth

    The normal blood volume at birth varies depending on gestational age, and it is increased when the umbilical cord is clamped later.

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    Drug challenge

    A test used to confirm or rule out a drug allergy, where a small dose of the suspected drug is given to the patient under careful monitoring.

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    Iron absorption in breast milk

    Iron from breast milk is absorbed at a higher rate (50%) compared to iron from other sources.

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    Iron in cow's milk

    Cow's milk, while not a good iron source, offers low iron along with poor bioavailability, making it a poor choice for iron supplementation.

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    Absorption of iron from cereals

    Cereals often contain added iron, but only a small portion (about 1%) is absorbed by infants.

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    Benefits of delayed cord clamping

    Delayed cord clamping at birth allows increased placental blood transfusion, improving iron stores in newborns.

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    Causes of iron deficiency in infants

    Iron deficiency can arise when infants are transitioned to mixed feeding later than six months, or their diet lacks iron-rich foods.

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    Factors affecting iron absorption

    Vitamin C boosts iron absorption, while tannins in tea hinder it.

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    Symptoms of iron deficiency

    Children with iron deficiency may be asymptomatic until their hemoglobin levels drop significantly.

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    Blood picture in iron deficiency

    Microcytic hypochromic anemia is a characteristic of iron deficiency, manifested by smaller and paler red blood cells.

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    Hematopoiesis

    The process of forming blood cells, originating from pluripotent stem cells, occurring both in fetal life within the yolk sac, liver, spleen, and bone marrow, and after birth in the bone marrow.

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    Anemia

    A condition where the blood has a lower than normal concentration of hemoglobin, the protein responsible for carrying oxygen in red blood cells. It can be caused by reduced red blood cell production, increased red blood cell destruction, or blood loss.

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    Iron Deficiency Anemia

    The most common cause of anemia in children, resulting from inadequate iron intake, malabsorption, or blood loss. It can be caused by insufficient dietary intake, poor absorption, or chronic blood loss.

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    Iron Needs in Infants

    The iron requirement for infants is higher than for adults due to the rapid growth and increase in blood volume. This means that infants need more iron to support their growing bodies.

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    Extramedullary Hematopoiesis

    The production of blood cells outside the bone marrow, often in the spleen or liver. This is a compensatory mechanism for anemia, where the body tries to make blood in other locations to compensate for the insufficient production in the bone marrow.

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    Expansion of Bone Marrow

    The expansion of the bone marrow cavity due to increased blood cell production leading to thinning of the bone cortex. This can cause bone changes and sometimes pathological fractures.

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    Hyperdynamic Circulation

    An increased heart rate and blood flow as the body compensates for the decreased oxygen-carrying capacity in anemia. This can lead to a faster heartbeat, murmurs in the heart, and difficulty breathing.

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    Red Blood Cell Aplasia

    A condition where the blood contains an abnormally low number of red blood cells. This can occur due to various causes, including reduced production, increased destruction, or blood loss.

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    Study Notes

    Respiratory System

    • Pediatric inflammatory multisystem syndrome (PIMS-TS) is a severe systemic inflammatory response associated with COVID-19 infection. It shares features with Kawasaki disease, staphylococcal, and streptococcal toxic shock syndromes, bacterial sepsis and macrophage activation syndromes.
    • Cardiac involvement, such as shock, typically occurs 3-4 weeks post-COVID-19 infection.
    • Echocardiography may reveal severe cardiac dysfunction or coronary artery aneurysms.

    Respiratory System Zones

    • Conducting zone does not involve gas exchange.
    • Respiratory zone is where gas exchange occurs.
    • Alveoli are surrounded by capillaries.
    • Alveolar walls consist of type 1 and type 2 pneumocytes.
    • Type 1 pneumocytes, 97% of the total, are thin for gas exchange.
    • Type 2 pneumocytes produce surfactant reducing surface tension to prevent lung collapse.
    • Surfactant production begins at 24 weeks and lungs are fully mature by 34 weeks.

    Respiratory System Respiration Types

    • Quiet respiration

    Abnormal Respiration Sounds

    • Stridor is an inspiratory sound occurring from upper airway obstruction
    • Wheezes are expiratory sounds resulting from lower airway obstruction
    • Biphasic sounds occur with both upper and lower airway obstruction.

    Risk Factors for Respiratory Diseases in Children

    • Parental genetic predisposition
    • Maternal smoking during pregnancy
    • Prematurity or low birthweight
    • Bronchopulmonary dysplasia
    • Congenital heart disease
    • Weakened immune responses
    • Incomplete immunizations
    • Exposure to cigarette smoke or vaping
    • Exposure to environmental allergens and air pollution
    • Low socio-economic status

    Respiratory Tract Disorders in Children

    • Upper respiratory tract symptoms (Coryza, sore throat, earache, sinusitis, cough, or stridor)
    • Lower respiratory tract symptoms (tachypnea, reduced oxygen saturation, chest recession, noisy breathing.)

    Respiratory Distress Syndrome

    • Also called hyaline membrane disease (RDS)
    • Lack of surfactant in the lungs, a decreased surface tension leading to reduced lung elasticity and difficulty in breathing

    Pediatric Respiratory System - Additional Topics

    • Infants born before 28 weeks' gestation are more likely to develop severe respiratory distress syndrome.
    • Surfactant deficiency can result in widespread alveolar collapse and poor gas exchange.
    • Signs and symptoms of respiratory disorders include increased or decreased rate of breathing, noises of different types, and chest pain.
    • Clinical signs/symptoms suggest possible respiratory failure
    • Clinical signs include cyanosis, grunting, and reduced oxygen saturation despite oxygen therapy.

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    Description

    Test your knowledge on pediatric cough, specifically focusing on pertussis and common allergic reactions in children. This quiz covers phases of coughing, treatments, laboratory tests, and allergies. Enhance your understanding of pediatric respiratory conditions and allergic responses.

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