DISORDERS OF RESPIRATORY SYSTEM
1. BRONCHIECTASIS
• A condition characterized by chronic
permanent dilatation and destruction of
bronchi due to
... [Show More] destructive changes in
the elastic and muscular layers of
bronchial walls.
Congenital
a. Cystic Fibrosis (most common cause)
b. Primary hypogammaglobinemia leading to
a recurrent infection
c. Ciliary dysfunction syndrome
-Acquired (in children)
-Secondary to pneumonia which occurs
often as complication of whooping cough
and measles.
-Aftermath of aspiration of foreign body
unremoved
o The most common thread in the
pathogenesis of bronchiectasis consists of
difficulty cleaning secretions and recurrent
infections with a “vicious circle” of infection
and inflammation resulting in airway injury
and remodeling.
CLINICAL FEATURES:
• COUGH:
-Chronic productive cough usually
worse in the morning and often
brought on by change in posture.
-Cough occurs due to accumulationof
pus in dilated bronchi
• SPUTUM: copious & purulent
• FEVER
• HEMOPTYSIS
• ANOREXIA AND POOR WEIGHT
GAIN may occur as time passes.
• CRAKLES localized to the affected
area
• WHEEZING STRIDOR
NSG 101 DISORDERS OF THE RESPIRATORY SYSTEM NOTES
2021GKGG
• CHRONIC LUNG DISEASE
SYMPTOMS (digital clubbing,
easyfatigability)
DIAGNOSIS:
• Thin section HRCT scanning- is the gold
standard, because it has excellent
sensitivityand specificity
• CT- provides further information on
diseaselocation, presence of mediastinal
lesions, and the extent of segmental
involvement.
• Chest x-ray- increase in size and loss of
lungvolume.
Severe case: Honeycombing
• SPUTUM
CULTURETREATMENT:
o Aims at decreasing airway obstruction
andcontrolling infection
o Postural drainage and control infection
o 2 to 4 weeks of parenteral antibiotics
isoften necessary to manage acute
exacerbations adequately.
o Amoxicillin/Clavulanic acid (22.5
mg/kg/dose twice daily) has been
successfultreating the exacerbations.
o Long term prophylactic oral (macrolide)
ornebulized antibiotics (e.g. tobramycin,
colistin, aztreonam) may be beneficial.
o Airway hydration (inhaled hypertonic
saline or mannitol) also improves quality
of life in adults with bronchiectasis.
o Any underlying disorder
(immunodeficiencyrespirations) that may
be contributing mustbe addresses.
2. PNEUMONIA
• An acute infection of the
pulmonaryparenchyma
• Infection and inflammation of aleveoli
TYPES:
A. HOSPITAL ACQUIREDGKGG
B. COMMUMITY ACQUIRED
Most common pulmonary cause of death in infants
younger than 48 hours of age.
More prone in NB born 24 hrs. after rupture of
membrane and those who aspirated amniotic fluid
or meconium (SEPTIC WORKUP & PROPHYLACTIC
ANTIBIOTIC)
BASIC PATHOPHYSIOLOGY
➢ Most cases of pneumonia are caused by the
aspiration of infective particles into the
lower respiratory tract.
➢ Organisms that colonize child’s upper
airway can cause pneumonia.
➢ Pneumonia can be caused by person to
person transmission via airborne droplets.
I. PNEUMOCOCCAL PNEUMONIA
• Abrupt following an URTI
• Infants; bronchopneumonia with
poor consolidation
• Older children; localized in single
lobe and full consolidation= blood
tinge sputum
II. VIRAL PNEUMONIA
• Virus from URTI (RSV’S,
myxoviruses, adenoviruses)
• Chest x-rays shows diffuse
infiltrated areas
• Antibiotic therapy is not effective
• Rest, antipyretic and IVF
III. CHLAMYDIAL PNEUMONIA
• Often seen in NB up to 12 weeks of
age
• Contracted from the mother’s vagina
during birth
• Elevated IgG and IgM antibodies,
peripheral eosinophilia and specific
antibody of causative agent
• Macrolide antibiotic (erythromycin)
IV. MYCOPLASMAL PNEUMONIA
• Similar but larger than viruses
• Occurs more frequently in over 5 years’
old
• Persistent rhinitis
• Erythromycin- younger than 8
years’ old
• Tetracycline- stains teeth brown
and stunts long bone growth
V. LIPID PNEUMONI
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