Pediatric Pulmonary ppt:

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Questions and Answers

What is the primary cause of Infant Respiratory Distress Syndrome (RDS)?

Intrauterine infection

Vascular insufficiency

Airway obstruction

Surfactant deficiency (correct)

Which factor is least likely to increase the frequency of RDS in neonates?

Single gestation pregnancies (correct)

C-section deliveries

Infants of diabetic mothers

Multifetal pregnancies

Which component is NOT part of the surfactant mixture associated with lung development?

Hemoglobin (correct)

Phosphatidylglycerol

Proteins

Cholesterol

What is a characteristic sign observed within minutes of birth in infants with RDS?

Tachypnea Signup and view all the answers

What does the ground-glass appearance on a chest X-ray indicate in the context of RDS?

Diffuse microatelectasis Signup and view all the answers

Which of the following is a preventative treatment for RDS administered to pregnant women at risk of preterm delivery?

Betamethasone Signup and view all the answers

What is commonly seen in the physical examination of a neonate suffering from RDS?

Diminished breath sounds Signup and view all the answers

Which of the following is NOT a differential diagnosis for Infant Respiratory Distress Syndrome?

Asthma Signup and view all the answers

What is the primary aim of antimicrobial treatment for pertussis?

To limit the severity of coughing and spread Signup and view all the answers

Which patient group is NOT recommended for hospitalization due to pertussis?

Adults with underlying health conditions Signup and view all the answers

Which sign is specifically associated with epiglottitis?

Thumbprint sign Signup and view all the answers

What common test has findings consistent with obstructive airway disease in cystic fibrosis?

Pulmonary function tests Signup and view all the answers

What is the mortality rate associated with pertussis in infants under 2 months of age?

1% Signup and view all the answers

What is the primary purpose of antenatal corticosteroid therapy in the context of neonatal care?

To enhance fetal lung development and surfactant production Signup and view all the answers

Which of the following is NOT a recommended treatment for bronchiolitis in infants?

Inhaled bronchodilators Signup and view all the answers

What indicates the need for rescue surfactant therapy in newborns?

Hypoxic respiratory failure due to secondary surfactant deficiency Signup and view all the answers

What is the typical recovery time for infants with bronchiolitis?

3-5 days Signup and view all the answers

Which of the following groups of infants should be evaluated for sepsis when presenting with fever?

Infants less than 60 days of age Signup and view all the answers

In the management of infant respiratory distress syndrome (RDS), when should surfactant be administered?

After initial stabilization if intubation is needed Signup and view all the answers

What is the most common lower respiratory tract infection in infants and children?

Bronchiolitis Signup and view all the answers

What percentage of children who experience bronchiolitis will continue to wheeze after the age of 5?

40% Signup and view all the answers

What is the primary reason RSV infections are of particular concern in infants born prematurely?

Severe complications associated with congenital heart disease Signup and view all the answers

What percentage of adults visiting their primary care doctor during winter for respiratory illness are likely to test positive for RSV?

10 – 20% Signup and view all the answers

Which of the following is NOT a recommended prevention method for RSV infection?

Annual flu vaccination Signup and view all the answers

Which method is recommended for the diagnosis of asthma?

Demonstration of reversible airflow obstruction via spirometry Signup and view all the answers

What is a common clinical manifestation of pediatric asthma?

Expiratory wheezing during exercise Signup and view all the answers

What environmental factor is least likely to contribute to the worsening of asthma symptoms?

High humidity Signup and view all the answers

Which factor is associated with a higher incidence of asthma in the population?

Lower socioeconomic status Signup and view all the answers

What is the role of Nirsevimab in relation to RSV?

It is a monoclonal antibody that provides immunity for five months Signup and view all the answers

Which of the following describes a crucial aspect of asthma management?

Regular assessment and monitoring of symptoms Signup and view all the answers

Which symptom is typically NOT associated with asthma in children?

Chronic fever Signup and view all the answers

What is the primary method for managing acute croup in a pediatric patient?

Encouraging adequate fluid intake and using cool mist Signup and view all the answers

Which statement describes the clinical manifestation of croup?

Barky cough, hoarseness, and inspiratory stridor Signup and view all the answers

What distinguishes acute epiglottitis from croup?

Presence of a high-grade fever and drooling Signup and view all the answers

What is a hallmark laboratory finding in a patient with pertussis?

Leukocytosis with absolute lymphocytosis Signup and view all the answers

Which group is most affected by croup?

Children aged 3 months to 5 years Signup and view all the answers

What condition must be ruled out in cases of suspected acute epiglottitis?

Retropharyngeal or peritonsillar abscess Signup and view all the answers

Which antibiotic is commonly used for suspected acute epiglottitis pending culture results?

Ceftriaxone Signup and view all the answers

What characterizes the paroxysmal stage of pertussis?

Dry cough evolving into prolonged coughing fits Signup and view all the answers

Which of the following is NOT a component of asthma patient education?

Lifetime medication subscription Signup and view all the answers

What environmental factor is crucial to control for minimizing asthma severity?

Eliminating exposure to tobacco smoke and dust Signup and view all the answers

Which of the following is a risk factor for acute epiglottitis?

Being unimmunized or under immunized Signup and view all the answers

What treatment is commonly used for managing acute stridor associated with croup?

Nebulized racemic epinephrine Signup and view all the answers

In managing asthma, how is control assessed?

Through the degree to which symptoms and functional impairments are minimized Signup and view all the answers

Study Notes

Infant Respiratory Distress Syndrome (RDS) / Hyaline Membrane Disease

Hyaline membrane disease is a severe lung injury in neonates linked to surfactant deficiency due to prematurity.
Most prevalent in infants born before 28 weeks of gestation, reflecting insufficient lung development.
Occurs primarily in premature infants but also in those born to diabetic mothers, multifetal pregnancies, via C-section, or with a family history of RDS.
Key pathophysiology involves:
- Surfactant - a mix of phospholipids and proteins critical for reducing alveolar surface tension to prevent collapse.
- Increased surfactant production correlates with advancing gestational age.
Clinical signs appear within minutes after birth, including:
- Tachypnea, grunting, intercostal/subcostal retractions, nasal flaring, and dusky skin tone.
Physical examination may reveal diminished breath sounds, fine rales, falling blood pressure, pallor, progressing to apnea and acidosis.
Diagnosis involves clinical evaluation, chest X-ray showing "ground glass" appearances, and arterial blood gas analysis.

Differential Diagnosis of RDS

Important considerations include:
- Early-onset sepsis, pneumonia, cyanotic heart defects, persistent pulmonary hypertension, transient tachypnea of the newborn.

Prevention and Treatment of RDS

Administration of betamethasone to mothers at risk of preterm delivery promotes surfactant production.
Treatment strategies include:
- Close monitoring and warm humidified oxygen.
- Surfactant therapy post-intubation if needed.
- Minimally invasive surfactant therapy (MIST) aims to reduce complications from traditional intubation.

Bronchiolitis

An inflammation of the bronchioles primarily caused by viral infections, especially in infants under two years.
Management focuses on hydration, oxygenation, and symptomatic treatment:
- Routine use of bronchodilators and corticosteroids is discouraged.
- Ribavirin reserved for severe cases.
Prognosis is generally good, with many recovering within 3-5 days, although 40% may experience recurrent wheezing by age five.

Respiratory Syncytial Virus (RSV)

Known as the leading cause of bronchiolitis and a significant contributor to infant mortality from viral infections.
Most children are infected by age two, with severe cases seen in premature infants or those with underlying health conditions.
Diagnosis is often made via rapid antigen tests.
Complications such as otitis media (10-20%) and pneumonia (0.5-1%) can arise.

Pediatric Asthma

A chronic inflammatory condition with episodic airway obstruction.
Risk factors include environmental exposures and genetic predispositions, with a higher prevalence in males and lower socioeconomic groups.
Symptoms include recurrent wheezing and coughing, often triggered by viral infections or allergens.
Diagnosis is confirmed by spirometry showing variable airflow limitation and response to bronchodilators.

Croup (Laryngotracheobronchitis)

Primarily caused by parainfluenza viruses, most common in children aged 3 months to 5 years.
Characterized by a "barky" cough, hoarseness, and inspiratory stridor, often worsening at night.
Diagnosis is clinical but can be confirmed with a "steeple sign" observed in x-rays.
Management usually includes supportive care, cool mist, and corticosteroids for moderate to severe cases.

Acute Epiglottitis

A rare but serious form of airway obstruction that presents suddenly with a high fever, sore throat, and drooling.
Traditionally linked to Haemophilus influenzae type b; currently, most cases are due to other bacteria like Streptococcus species.
Diagnosis requires careful visualization of the epiglottis in a controlled setting, avoiding agitation of the child.
Immediate management includes ensuring airway patency, often requiring intubation and administering antibiotics.

Whooping Cough (Pertussis)

Caused by Bordetella pertussis and prevented by vaccination; incidence has risen despite widespread immunization.
Characterized by a paroxysmal cough, with infants often lacking the characteristic "whoop" due to their developmental stage.
Diagnosis involves identifying leukocytosis with lymphocytosis and is confirmed with PCR testing.
Treatment includes antibiotics to limit disease spread and hospital management for at-risk infants.

Cystic Fibrosis

The most common autosomal recessive condition in Northern European populations, occurring in about 1 in 2000 to 3000 live births.
Symptoms include chronic pulmonary infections, pancreatic insufficiency, and high sweat chloride levels.
Diagnosis rests on genetic testing or demonstrating CFTR gene functionality.

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Description

This quiz explores the epidemiology of Respiratory Syncytial Virus (RSV), including its prevalence, high-risk populations, and impact on infants and adults. Learn about the significance of RSV as a leading cause of bronchiolitis and the statistics surrounding its infection rates. Test your knowledge on this crucial public health topic.