LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Neumología Pediátrica. Anexos ❚ 169 f. Prognosis 1. Natural history 2. Prognosis with therapy a. Know that chronic bronchitis and decreased airflow rates frequently develop in patients with agammaglobulinemia despite immunoglobulin replacement therapy P. Control of breathing disorders 1. Obstructive sleep apnea syndrome a. Epidemiology 1. Know the incidence of habitual snoring in children 2. Know the relationship between snoring and obstructive sleep apnea syndrome 3. Know that in children, the prevalence of obstructive sleep apnea syndrome is equal in prepubertal males and females b. Etiology/genetics 1. Know that hypertrophy of tonsils and adenoids is the most common factor predisposing children to obstructive sleep apnea syndrome 2. Know that the incidence of obstructive sleep apnea syndrome is increased in craniofacial syndromes associated with micrognathia and mid-face hypoplasia 3. Know that morbid obesity is associated with obstructive sleep apnea syndrome, especially in adolescence c. Pathophysiology 1. Pathology a. Know that closure of the upper airway is greater with a small upper airway; decreased upper airway skeletal muscle tone; and increased inspiratory force 2. Path mechanisms and consequences a. Know that the hypopharynx is a frequent site of obstruction in obstructive sleep apnea syndrome b. Know that nasal congestion can increase upper airway resistance c. Know that children with marked hypoxemia and hypercapnia may have normal gas exchange while awake d. Know the impact of sleep on respiratory function and gas exchange in normal children with lung disease e. Know that both adenoidal and tonsillar hypertrophy can contribute to obstructive sleep apnea syndrome d. Diagnosis and clinical manifestations 1. History a. Understand the difference between primary snoring and obstructive sleep apnea syndrome b. Recognize the clinical signs and symptoms of obstructive sleep apnea syndrome in children during sleep as well as during wakefulness c. Know the significance of a history of snoring d. Know that there is no correlation between the intensity (loudness) of snoring and the severity of obstructive sleep apnea syndrome in children e. Know that snoring in children is often continuous without evidence of apnea f. Know the importance of a history of poor school performance or behavioral problems in children with snoring