Upper Respiratory Tract Disorders Quiz

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Questions and Answers

What is a common cause of obstructive sleep apnea syndrome (OSAS) in children?

  • Viral infection
  • Adenotonsillar hypertrophy (correct)
  • Pulmonary edema
  • Asthma exacerbation

Which condition is most commonly caused by respiratory syncytial virus (RSV) in infants?

  • Lobar pneumonia
  • Asthma
  • Bronchiolitis (correct)
  • Chronic obstructive pulmonary disease

Which statement accurately describes angioedema?

  • It is a mast cell-mediated allergy to certain foods. (correct)
  • It is an autoimmune response to infections.
  • It primarily affects the lower airways.
  • It is often mistaken for bronchitis.

What is a consequence of surfactant deficiency in newborns?

<p>Respiratory distress syndrome (RDS) (C)</p> Signup and view all the answers

What characterizes bronchopulmonary dysplasia (BPD)?

<p>It arises from acute respiratory disease in premature infants. (D)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with obstructive sleep apnea syndrome (OSAS)?

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

What is defined as lung inflammation caused by the entry of foreign substances?

<p>Aspiration pneumonitis (D)</p> Signup and view all the answers

Which of the following conditions may lead to chronic upper airway obstruction in infants?

<p>Vascular rings (D)</p> Signup and view all the answers

What is the primary cause of bronchiolitis obliterans?

<p>Severe respiratory viral infection (C)</p> Signup and view all the answers

Which of the following is most closely associated with the development of asthma?

<p>Inflammation due to environmental triggers (C)</p> Signup and view all the answers

What condition is characterized by acute life-threatening hypoxemia and requires high-level ventilatory support?

<p>Acute Respiratory Distress Syndrome (ARDS) (C)</p> Signup and view all the answers

What is the genetic basis of cystic fibrosis (CF)?

<p>Autosomal recessive disease due to CFTR mutation (C)</p> Signup and view all the answers

What is a known risk factor for Sudden Infant Death Syndrome (SIDS)?

<p>Prone sleeping position (A)</p> Signup and view all the answers

What is a major manifestation of cystic fibrosis aside from respiratory complications?

<p>Digestive and nutritional problems due to pancreatic insufficiency (A)</p> Signup and view all the answers

Which of the following statements accurately describes ARDS?

<p>It can be triggered by direct injury to the lungs or systemic insults like sepsis. (D)</p> Signup and view all the answers

Which factor is NOT associated with decreased incidence of SIDS?

<p>Exposure to tobacco smoke (B)</p> Signup and view all the answers

What structural feature makes infants and children more prone to airway obstruction compared to adults?

<p>Narrower airways (A)</p> Signup and view all the answers

At what gestational week is surfactant secreted into the airways, marking developmental maturity of the fetal lung?

<p>30 weeks (C)</p> Signup and view all the answers

Which infection is the most common cause of acute upper airway inflammatory obstruction in children aged 6 months to 5 years?

<p>Viral croup (C)</p> Signup and view all the answers

What consequence does neonatal exposure to air pollution have on respiratory health?

<p>Increased risk for respiratory disease (C)</p> Signup and view all the answers

What is a common complication of tonsillar infections in children?

<p>Tonsillar abscess (A)</p> Signup and view all the answers

What is the primary causative organism of acute epiglottitis that vaccination has reduced?

<p>Haemophilus influenzae (D)</p> Signup and view all the answers

What condition might present with sudden onset stridor, coughing, and wheezing in young children?

<p>Aspiration of a foreign body (B)</p> Signup and view all the answers

What is a crucial first step in managing upper airway obstruction due to infection?

<p>Recognition and rapid evaluation (C)</p> Signup and view all the answers

Flashcards

Airway Obstruction in Children

Infants and children have narrower airways than adults, making them more susceptible to obstruction.

Alveoli Formation in Children

Infants and young children continue to form new alveoli for several years after birth.

Surfactant Production

Surfactant production, crucial for lung function, is secreted into the airways by 30 weeks' gestation.

Chest Wall Compliance in Infants

The immature chest wall of infants is soft and compliant, affecting breathing efficiency.

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Oxygen Consumption in Children

Children have a higher oxygen consumption per unit of body weight compared to adults.

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Immature Immune System in Infants

Infants' immune systems are not fully developed at birth, making them vulnerable to infections.

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Blunted Ventilatory Response in Newborns

Newborns have a less pronounced ventilatory response to low oxygen levels compared to older children and adults, increasing their risk for breathing pauses and low blood oxygen levels.

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Air Pollution and Respiratory Health in Infants

Exposure to air pollution during infancy increases the risk of developing respiratory diseases later in life.

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Sudden Infant Death Syndrome (SIDS)

A diagnosis of exclusion after thorough investigation and autopsy following the sudden death of an infant younger than 1 year of age; usually occurs during nighttime sleep.

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Asthma

A chronic inflammatory disease characterized by bronchial hyperreactivity and reversible airflow obstruction, usually occurring in response to an allergen, with episodes of acute respiratory symptoms (cough, wheeze, dyspnea) and intermittent or chronic subacute symptoms. It is the most common chronic condition in children, resulting from genetic susceptibility and environmental factors with varying phenotypes.

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Bronchiolitis Obliterans

Fibrotic obstruction of the respiratory bronchioles and alveolar ducts, usually secondary to severe respiratory viral infection or graft-versus-host disease after allograft transplantation. It is rare in children.

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Acute Respiratory Distress Syndrome (ARDS)

An acute life-threatening condition characterized by severe hypoxemia, poor lung compliance, atelectasis, and diffuse densities on chest radiographs. It can be triggered by direct acute lung injury (ALI), such as pneumonia, aspiration, near drowning, or smoke inhalation; or from a systemic insult, such as sepsis or multiple trauma. High-level ventilatory support is required, and mortality is significant.

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Cystic Fibrosis (CF)

An autosomal recessive disease caused by the cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation. Defective chloride secretion and excess sodium absorption cause production of thick, tenacious mucus, plugging of airways, chronic pulmonary infection, and bronchiectasis related to airway epithelial chloride and sodium transport. The other major manifestations are digestive and nutritional, related to pancreatic insufficiency.

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Oropharyngeal Aspiration

Aspiration of oropharyngeal bacteria can occur because of loss of protective reflexes in neurologically impaired children, or during induction of anesthesia.

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Angioedema

A condition where swelling occurs in the mucous membranes or subcutaneous layers of the skin due to an allergic reaction, often to certain foods. It can cause swelling in the airways, leading to breathing difficulties.

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Chronic Upper Airway Obstruction (UAO)

A chronic condition that affects infants and young children, causing symptoms like stridor (noisy breathing), wheezing, and difficulty breathing. It can be caused by various factors, including narrowed airways and vocal cord paralysis.

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Obstructive Sleep Apnea Syndrome (OSAS)

A sleep disorder that occurs when the airway repeatedly collapses during sleep, leading to pauses in breathing. It is characterized by snoring, gasping, and restless sleep. Common causes include enlarged tonsils and adenoids, obesity, and craniofacial anomalies.

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Surfactant Deficiency Disorder (RDS) or Hyaline Membrane Disease (HMD)

A condition affecting premature infants, usually occurring before their lungs are fully developed. It is characterized by underdeveloped alveoli and insufficient surfactant production, leading to collapsed lungs and breathing difficulties.

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Bronchopulmonary Dysplasia (BPD)

A chronic lung disease that develops in premature infants as a consequence of acute respiratory distress requiring oxygen and mechanical ventilation. It is caused by damage to the lungs and underdeveloped lung structures.

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Bronchiolitis

A common respiratory infection among infants and toddlers, usually occurring during the winter and early spring months. It's mainly caused by RSV (respiratory syncytial virus) and leads to inflammation and swelling in the bronchioles, causing breathing difficulties and wheezing.

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Childhood Pneumonia

An infection and inflammation of the lungs, mainly caused by bacteria, viruses, or Mycoplasma. It affects the terminal airways and alveoli, resulting in coughing, fever, and difficulty breathing. Lobar pneumonia involves the entire lobe of a lung.

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Aspiration Pneumonitis

Lung inflammation caused by the inhalation of foreign substances, such as food, liquids, or chemicals. It can lead to coughing, fever, and difficulty breathing.

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Study Notes

Upper Respiratory Tract Disorders

  • Infants' and children's airways are narrower than adults', making them more prone to obstruction
  • Surfactant production, a marker of fetal lung maturity, occurs by 30 weeks gestation
  • Infants' chest walls are soft and compliant, affecting breathing efficiency
  • Children have higher oxygen consumption per body weight
  • Infants have immature immune systems, increasing infection risk
  • Newborns have a weaker ventilatory response to low oxygen levels, raising apnea risk
  • Neonatal exposure to air pollution increases respiratory disease risk

Acute Epiglottitis

  • Rare due to H. influenzae vaccination
  • Current cases often involve vaccine failure or other bacteria (e.g., group A streptococci)
  • A life-threatening emergency

Tonsillar Infections

  • Can cause upper airway obstruction (UAO)
  • May necessitate antibiotics and corticosteroids
  • Complications include tonsillar abscesses

Bacterial Tracheitis

  • Causes airway swelling and purulent secretions, leading to UAO
  • Requires antibiotics and airway maintenance

Retropharyngeal Abscess

  • Associated with nasopharyngeal infection or penetrating injury
  • Requires immediate antibiotic treatment

Foreign Body Aspiration

  • Consider in cases of sudden stridor, coughing, wheezing, or hoarseness, particularly in 1-3 year olds
  • Misdiagnosis is possible, often mistaken for asthma, bronchitis, or pneumonia
  • Can cause airway obstruction

Angioedema

  • Mast cell-mediated allergic reaction, often to food
  • Causes mucosal and subcutaneous swelling, potential airway obstruction

Chronic Upper Airway Obstruction

  • Presents with stridor, abnormal cry, wheezing, or dyspnea
  • Several causes in infants: laryngomalacia, tracheomalacia, subglottic stenosis, laryngeal atresias, tracheal stenosis, vocal cord paralysis, vascular rings

Obstructive Sleep Apnea Syndrome (OSAS)

  • Primarily affects older children, not infants
  • Symptoms include snoring, gasping, restless sleep due to airway narrowing

Viral Croup (Laryngotracheobronchitis)

  • Most common cause of acute upper airway inflammation in 6-month to 5-year-olds
  • Subglottic edema can range from mild to severe
  • Parainfluenza is the most common causative virus

Upper Airway Infections

  • Inflammation and obstruction can lead to serious issues like bacterial tracheitis, retropharyngeal abscesses, and peritonsillar infections
  • Prompt diagnosis and rapid evaluation are essential

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