11 topics with brief reviews: definitions, key facts, and class questions.
Respiratory diseases are the absolute leader in the structure of pediatric morbidity. The section begins with the fundamentals: the development and anatomical and physiological features of the respiratory system. Without this, it is impossible to understand why a commonplace infection in an infant instantly causes severe obstruction.
We will consistently analyze pathologies of the upper and lower respiratory tract. The first part covers routine yet insidious acute rhinosinusitis, adenoiditis, otitis media, and tonsillopharyngitis. The second part covers lower respiratory tract lesions: acute and chronic bronchitis, acute bronchiolitis, and pneumonia. A separate block is dedicated to severe genetic and chronic pathologies: cystic fibrosis and bronchiectasis.
What is most frequently asked during seminars? Instructors will definitely demand that you perform a differential diagnosis between acute bronchitis and bronchiolitis in an infant, name the strict indications for antibiotic therapy in tonsillopharyngitis and otitis media, and describe the pathogenesis and intestinal manifestations of cystic fibrosis. Learn the "red flags" and diagnostic criteria—this will save you both at the exam and during a night shift.
Can vasoconstrictor drops be used for a long time?
No, topical decongestants are used strictly for a short duration. Use for longer than 5–7 days leads to the development of atrophic or medicamentosa rhinitis (rebound phenomenon).
What is "adenoid facies" and why does it occur?
This is a characteristic alteration of the facial skeleton due to forced mouth breathing. It manifests as a semi-open mouth, elongation of the lower jaw, and the formation of malocclusion (progenia).
Why does ear pain worsen when swallowing?
Swallowing movements contract the muscles that open the pharyngeal opening of the auditory tube. This causes movement of the inflamed tissues and a sharp change in pressure within the tympanic cavity, which triggers the pain syndrome.
When are antibiotics prescribed for a sore throat?
Antibacterial therapy is indicated only for confirmed (or highly probable according to the McIsaac score ≥ 4 points) streptococcal etiology (group A Streptococcus).
Are antibiotics always necessary in acute bronchitis?
No, about 90% of cases are viral in nature, for which antibacterial therapy is ineffective and not indicated. Antibiotics are prescribed only for a proven bacterial etiology.
Why do infants in the first months of life primarily get acute bronchiolitis?
Infants have anatomically very narrow airways. Because of this, even minimal thickening of the bronchiole wall against the background of inflammation leads to severe airflow obstruction and hypoxia.
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