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Paeds - C.U > Cardio and Resp > Flashcards

Cardio and Resp Flashcards

1
Q

how many live births have CHD

A

1%

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2
Q

two genetic conditions associated with heart defects

A

Trisomy 21 and Turners syndrome

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3
Q

Acyanotic HD with shunts

A

ASD
VSD
PDA

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4
Q

Acyanotic HD without shunts

A

Coarction of the aorta

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5
Q

Cyanotic HD with shunts

A

Tetralogy of fallot

Transposition of great arteries

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6
Q

Cyanotic HD without shunts

A

Severe pulmonary stenosi
Tricuspid / pulmonary atresia
Hypoplastic left heart

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7
Q

Symptoms of congenital HD

A 
Problems breast feeding 
Failure to thrive 
Shortness of breath 
Syncope 
Squatting in older children 
Symptoms of cardiac failure - cyanosis, oedema, sweating, poor feeding
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8
Q

Signs of congenital HD

A 
Murmur
Tachycardia 
Tachypnoea 
Cyanosis - especially during feeding 
Clubbing
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9
Q

Complications in cogentila HD

A

Infective endocarditis
Paradoxical embolism
Polycythaemia
Pulmonary hypertension

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10
Q

Sign of ASD on examination

A

Parasternal heave in right ventricle

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11
Q

Signs of VSD on examination

A

Pan-systolic heart murmur - heard best at left sternal edge

Can be a parasternal heave

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12
Q

Signs of PDA on examination

A

Continuous machinery murmur below the left clavicle
Thrill
Bounding pulse

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13
Q

What can be used to close a PDA

A

Prostaglandin inhibitor - indometacin

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14
Q

Symptoms of coactation of the aorta

A

Headache / nose bleeds / intermittent claudication and cold legs

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15
Q

Signs of coarctation of the aorta

A

hypertension in the UL
Weak distal leg pulses
Maybe a systolic murmur over the upper back

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16
Q

Signs of heart failure in older children

A 
difficulties in weight gain 
tired 
SOB 
Chest pain and palpitations 
recurrent chest infections
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17
Q

Signs of heart failure in younger children

A

takes longer to complete feeds but seems hungry
may look puffy and sweaty
increasing resp difficulties
sudden weight gain - fluid retention

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18
Q

Investigations for heart failure in children

A

Clinical diagnosis

confirmed by US, echo, ECG and Echo

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19
Q

Acute management of HF in children

A

ABC
Stable - give diuretic
ACE inhibitor
Increase calorific intake

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20
Q

Most common cause of bronchiolitis

A

RSV infection

other- adenovirus and rhinovirus

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21
Q

Signs of respiratory distress

A 
Tachypnoea 
Head bobbing 
Tracheal tug 
Subcostal / intercostal recession 
abdominal movements to aid ventilation
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22
Q

Ddx in respiratory distress in a child

A 
Bronchiolitis 
Pneumona 
GI reflux with aspiration 
HF 
Pneumothorax 
Collapsed lung
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23
Q

Management of bronchiolitis

A

minimal handling
o2 and ventilation
hydration support
inhaled therapies

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24
Q

Mild croup

A

Mild – seal-like barking cough but no stridor or sternal/intercostal recession at rest.

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25
Q

Moderate croup

A

Moderate – seal-like barking cough with stridor and sternal recession at rest; no agitation or lethargy.

26
Q

Severe croup

A

Severe – seal-like barking cough with stridor and sternal/intercostal recession associated with agitation or lethargy.

27
Q

When should a child with croup be admitted ?

A

Moderate, severe or impending respiratory failure

28
Q

Mild croup but should still be admitted

A

<3m old
inadequate fluid
immunocompromised
CHD significant

29
Q

treatment of mild croup

A

supportive treatment

30
Q

treatment of moderate croup

A

oral dex

31
Q

treatment of severe croup

A

may require adrenaline, O2, involve ENT and anesthetics

32
Q

incidence of CF

A

1,2000

33
Q

Clinical features of CF

A

recurrent infections
faltering growth
nasal obstruction / polyps
bowel obstruction

34
Q

test used in new borns to detect CF

A

immune reactive trypsinogen

35
Q

Gold standard test for CF

A

Sweat test

36
Q

Long term monitoring required in CF

A

Serial CXR
USS abdo
Bone scans
Monitor insulin function

37
Q

Long term therapy in CF

A

Regular physiotherapy
Monitor nutrition
Prophylactic AB
Nebulisers -help clear the lungs

38
Q

Nutritional support in CF

A

Creon - pancreatic enzyme supplements

Micronutrient supplements

39
Q

Complications of CF

A 
Exocrine function of pancreas 
Diabetes 
Liver disease 
Infertility 
Early mortality
40
Q

Ddx for asthma in <5 y/o

A

Viral induced wheeze

41
Q

Causes of acute asthma

A 
Viral URTI 
Change in enviro 
Allergen 
Exercise 
Strong emotional triggers
42
Q

3rd line in asthma management
<5 y/o
>5 y/o

A

Leukotriene receptor agonist

LABA

43
Q

Mild croup treatment

A

Single dose of dex

Resolves within 48hrs

44
Q

emergency croup treatment

A

oxygen and nebulised adrenaline

45
Q

Peak incidence of bronchiolitis

A

3-6m

46
Q

Most common cause of serious LRTI i < 1y

A

Bronchiolitis

47
Q

What makes a bronchiolitis infection more severe

A

bronchopulmonary dysplasia (e.g. Premature), congenital heart disease or cystic fibrosis

48
Q

Symptoms of bronchiolitis

A

coryzal symptoms (including mild fever) precede:

dry cough

increasing breathlessness

wheezing, fine inspiratory

crackles (not always present)

feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission

49
Q

Tetralogy of fallot is a combination of…

A

Ventricular septal defect (VSD)
Pulmonary stenosis (PS)
Right ventricular hypertrophy (RVH)
Overriding aorta

50
Q

Risk factors for cardiac congenital abnormalities

A 
Maternal diabetes 
Rubella infection 
Foetal alcohol syndrome 
Downs syndrome 
VACTERL
51
Q

Main cause of resp problems in neonates

A

Resp distress syndrome

52
Q

Main cause of resp problems in infants

A

Bronchiolitis
Pneumonia
Croup

53
Q

Main cause of resp problems in under 5

A

viral induced wheeze
croup
pneumonia

54
Q

Main cause of resp problems in >5

A

asthma

pneumonia

55
Q

Sings of resp distress

A 
head bobbing 
nasal flaring 
tracheal tug 
IC recession 
Abdo recession
56
Q

Length of typical bronchiolitis infection

A

9 days

57
Q

bronchiolitis vs pneumonia

A

pneumonia - focal signs on resp exam and higher grade fever

58
Q

Astham exacerbation in children - those with mild / moderate asthma

A

For children with mild to moderate acute asthma:

Bronchodilator therapy
give a beta-2 agonist via a spacer (for a child < 3 years use a close-fitting mask)
give 1 puff every 30-60 seconds up to a maximum of 10 puffs
if symptoms are not controlled repeat beta-2 agonist and refer to hospital

Steroid therapy
should be given to all children with an asthma exacerbation
treatment should be given for 3-5 days

2 - 5 years 20 mg od 1-2 mg/kg od (max 40mg)
> 5 years 30 - 40 mg od 1-2 mg/kg od (max 40mg)

59
Q

Complication of kawasaki disease

A

coronary artery aneurysms - therefore should echo

60
Q

Treatment of whooping cough

A

Azithromycin or clarithromycin within the 1st 21 days

Paeds - C.U (10 decks)

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