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Final Pediatre > Asthma > Flashcards

Asthma Flashcards

1
Q

Recurrent resp infections always represent a serious underlying pathology

A

F
The child may have :
-a simply managed cause for their symptom (viral resp infection)
-or there is evidence of a more serious underlying pathology (immune dysfunction)

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2
Q

hx is enough To assess the severity and dg the cause of the sympt

A

F
Hx
PE
Appropriate investigation

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3
Q

To diagnose asthma at least one of the following criteria has to be present:

A

*RECURRENT** episodes of
Wheezing
Shortness of breath
Coughing
Chest tightness

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4
Q

Asthma symptoms get better at night

A

F
They worsen at night and in response to exercise and cold weather (september to April) (automn and winter)

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5
Q

Asthma is the most common chronic dz in children

A

T
It is a common and non communicable dz of the lungs affecting both children and adults

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6
Q

Asthma is characterized by chronic airway infection of large airways

A

F
Of small airways

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7
Q

When is the usual onset of asthma (childhood or adulthood)

A

Childhood

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8
Q

Genetic is the main cause of asthma

A

F
Environmental factors are the main cause of asthma

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9
Q

How is the incidence of asthma changing

A

It is increasing due to increase in exposure to environmental allergens and irritants

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10
Q

RF for developing asthma

A

-genetic
-allergy or atopy
-urbanization is associated with increased risk of asthma
-GI reflux dz
-events in early life that affect development of lungs (low birth wt, premature)
-obesity

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11
Q

Environmental factors ( indoor and outdoor air pollution, house dust mites, chemicals, pets and danders) are the only cause of asthma

A

F
Also genetics

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12
Q

1) Recurrent viral colds

A
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13
Q

The common cold is caused by viruses that infect the nose, throat and sinuses
And it is more common in fall and winter

A

T

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14
Q

Young children can get as many as 3 colds each year

A

F
8 to 10

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15
Q

How much is the duration of symps in common cold

A

8 days ( 1 week)
But may extend beyond 2 weeks

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16
Q

What are the symps of common cold

A

-fever
-sore throat
-cough
-rhinorrhea
-nasal congestion

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17
Q

Isolated viral colds always do require further evaluation

A

F
They require further evaluation in case of :
-frequency is >15 times per year
-duration is >15d per episode

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18
Q

2) chronic rhinitis

A
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19
Q

Define chronic rhinitis

A

Chronic inflammation of the nasal mucosa that results in symptoms:
-congestion
-nasal discharge
-sneezing
For at least 30mins daily for 2 or more months

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20
Q

The cause of chronic rhinitis is always allergic

A

F
Allergic or non allergic

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21
Q

The pathophysiology of asthma involves both:
-airway inflammation of the bronchi and bronchioles
-intermittent airway obstruction due to contraction of smooth muscle—> bronchial hyper responsiveness

A

T

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22
Q

What are the signs of asthma

A

-breathlessness (dyspnea) (shortness of breath)
-wheezing when exhaled
-chest tightness or pain
-cough that worsen at night
Productive or dry cough (usually chronic)

23
Q

Wheezing upon exhalation is not a common sign of asthma in children

A

F
It is a common sign of asthma

24
Q

Pts have stable asthma for weeks or months and suddenly develop an episode of acute asthma
Often the symptoms are triggered by certian factors, list them:

A

Triggering factors are:
-viral upper resp infection: URTI
-Exercise
-cold
-tobacco exposure
-psychological stress: alters the IS and inc in airway inflammatory response to allergens
-Emotional upset
-home factors :dust, animals, dander, chemical, perfumes, Pets, Aero allergin

25
Q

Personal or family hx of other atopic condition is present in asthmatic person

A

T

26
Q

Asthmatics respond well to
-Betta blockers (propranolol)
-ACE inh
-Aspirin
-NSAIDS

A

F
These makes asthma worse !!
They respond well to bronchodilators

27
Q

Conditions occur more frequently with asthma

A

-GERD
-atopic dermatitis (eczema; urticaria)
-obstructive sleep apnea
-rhino sinusitis

28
Q

Suspect asthma in any child who has:
persistent productive cough and hx of episodes of wheezy chest

A

T
Associated with
-Fam hx
-Allergic hx
-Triggering factor
-psychological stress

29
Q

What is the tool used to dg asthma

A

Spirometry is the recommended test to confirm the dg of asthma

30
Q

In spirometry pt should take deep breath and exhale forcefully, where it measures the amount of airflow to breath in and out and the rate of flow

A

T

31
Q

Spirometry indicates only dg of asthma

A

F
It is used for dg and assessment of severity of asthma

32
Q

What is the gold standard method to dg asthma

A

Spirometry

33
Q

At what age is spirometry perfomed

A

From age 5 and above

34
Q

Spirometry is performed only before bronchodilators

A

F
Before and after in order to assess the reversibility
Bcs spirometry demonstrates reversible airflow obstruction

35
Q

List the values of FEV1( it represent the percentage of the lung capacity that one can expel in second)

A

FEV1 (>80%) N
FEV1 65-79% mild obstruction
FEV1 50- 65% moderate obstruction
FEV1 <50% severe obstruction

36
Q

How much should the FEV1 improve for dg of asthma

A

It should improve by > than 12% and increase by at least 200ml following administration of bronchodilators

37
Q

Caffeine is a bronchoconstrictor

A

F
It is a bronchodilator thus it intervenes with the result of spirometer

38
Q

In a child <5 y we cant do spirometer
How to dg the child

A

Dg steps are same as before
A trial of asthma med may help to establish dg—> reversal symps after administration of albuterol

39
Q

Differential diagnosis

A
40
Q

1) immuno deficiency disorder

A
41
Q

The resp system is the organ system most commonly involved in immunodeficiency disorder

A

T

42
Q

What are the clinical manifestations to suspect an immune defect

A

-unusual severity
-atypical presentation
-unresponsive to typical tx
-recurrent

43
Q

We should suspect immunodeficiency when we have:

A
  • > = 8 new ear infection within 1y
  • > = 2 serious sinus infection or pneumonia within one year
  • > = 2 sepsis or meningitis
  • > = 2months of Abx with little effect
  • need IV Abx or hospital to tx infection
  • FTT
  • Resistant superficial or oral candiasis
  • recurrent tissue or organ abcess
  • infection with opportunistic organisms
  • Fam hx
44
Q

Cellular immuno deficiencies are the most common

A

F
Defects in humoral immunity (50%)
Humoral and cellular (20-30%)
Phagocyte defect (18%)
Complement defect (<2%)

45
Q

2) chronic post infective cough
What is chronic cough

A

Cough that appeared with acute infection
Normally cough should subside within 2-6m

46
Q

Most common bacterias associated with chronic cough

A

Bordetella
M. Pneumonia

47
Q

The post infective cough results from bronchial hyper activity and impaired mucociliary clearance that follow and inflammation that occurs with these infections

A

T

48
Q

3) inhaled foreign body
It should be suspected in any child who develops persistent dry cough

A

F
persistent productive cough particularly after Hx of chocking

49
Q

What does the severe inflammation in the bronchial mucosa due to foreign body lead

A

Obstruction of airways followed by distal infection

50
Q

Airway damage is resolved after removal of FB

A

F
There may be persistent
-localised airway damage
-abnormal lung ft
-cough

51
Q

4) disorders of celia ft
Primary celiary dyskinesia is an auto dominant

A

F
Auto R dz (males and females are equally affected)

52
Q

Primary ciliary dyskinesia have abnormal mucociliary clearance

A

T

53
Q

Clinical manifestations of ciliary dysfunction in newbons

A

-nasal obstruction
-mucopurulent discharge
-pneumonia
-tachypnea

54
Q

Clinical manifestations of ciliary dysfunction in older children

A
  • PERSISTENT PRODUCTIVE COUGH
  • atypical asthma
  • severe GER
  • bronchiectasis
  • chronic purulent rhinitis
  • sinusitis
  • chronic secretory OM with effusion and deafness

Final Pediatre (5 decks)

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