Clinic - Resp Flashcards
What is the inheritance pattern of CF?
What is the test for it?
Autosomal recessive - 1/25 carry it
Test for it in Guthrie test. Also via sweat test and INCREASE IN CHLORIDE
What is the pathyphysiology of CF?
Abnormal ion transport across epithelial cells leading to a reduction in surface liquid layer and imparied ciliary function and retained secretions
What are the common symptoms of CF?
- Poor growth, steatorrhea malabsorption due to blocked pancreatic ducts
- Recurrent chest infections and persistant loose cough due to increase sputum and reduced clearance
What would you see O/E of CF in resp exam?
Hyperinflation due to trapped air
Inspiratory crackles
Expiratory wheeze
What are some other symptoms of CF?
Nsal polyps
Rectal prolapse
Sinusitis
Bronchiectasis
Meconium ileus
What are some long term effects of CF?
DM
Male infertility
Cirrhosis
What commonly causes the following:
- Common cold
- Pharyngitis (sore throat)
- Tonsilitis
- Otitis media
- Sinusitis
- Common cold - rhinovirus
- Pharyngitis (sore throat) - viral
- Tonsilitis - Pharyngitis with exudate on tonsils - Strep/EBV
- Otitis media - strep/viral ALWAYS EXAMINE TYMPANIC MEMBRANES OF CHILD WITH FEVER
- Sinusitis - Viral - give decongestants
What are the indications for a tonsillectomy?
- sore throats are due to acute tonsillitis
- the episodes of sore throat are disabling and prevent normal functioning
- seven or more well documented, clinically significant, adequately treated sore throats in the preceding year or
- five or more such episodes in each of the preceding two years or
- three or more such episodes in each of the preceding three years.
- What is croup and who gets it?
- What are the symptoms?
- What is the management?
- Laryngotrachealbronchitis uusually caused by parainfluenza viruses. 6m - 6y
- NON ACUTE Barking cough, hoarsnesss and fever/coryza
- Steroids can reduce inflammatin but closely monitor for deterioration
NB - pseudomembranous croup from S.aureus
- What is epiglottitis and who gets it?
- What are the symptoms?
- What is the management?
1) Inflammation of epiglottis usually caused by H.influenzae
2) Unlike croup it is
- ACUTE
- No preceeding cough or cpryza
- Cant speak
- Drooling
- high fever
3)Transfer to ICU immediately
- What is whooping cough and who gets it?
- What are the symptoms?
- What is the management?
- What is bronchiolitis and who gets it?
- What are the symptoms?
- Signs?
- What is the management?
- Respiratory Synctitial virus (RSV) is the most common cause in infants up to a year.
- Dry cough and breathlessness. Dyspnoea and difficulty feeding.
- Signs are tachypnoea, signs of respiratory distress and hyperinflation of chest
- It is often a clinical diagnosis and supportive management is given - oxygen, IV fluids and usually recover within two weeks
What is the stepwise approach to asthma in kids under 5?
What is the stepwise approach to asthma in kids above 5?
What would lead you to suspect a diagnosis of asthma in a child?
Wheeze on more than one occasion
Worse at night and in the morning
Triggers
FH or atopy
What is the management of acute asthma?
How is asthma assessed?
oxygen
B2 agonist
Steroids
Nebulised ipatropum
IV magnesium sulphate/aminophylline
Assessed via PEFR
50-75 moderate
33-50 severe
<33 life threatening
