Core conditions.

Question 1

RF for asthma.

Answer 1

Atopic history.
Smoking at home.
Prematurity.
Dust.

Question 2

Asthma investigations.

Answer 2

PEFR.
CXR.
Spirometry.
Inhaler technique.

Question 3

<5 yo asthma chronic Mx.

Answer 3

SABA.
Inhaled corticosteroid.
Leukotrine receptor antagonist (montelukast).
Refer to paediatric specialist.

Question 4

> 5 yo asthma chronic Mx.

Answer 4

SABA.
Inhaled corticosteroid.
LABA.
Increase steroid.
Daily steroid tablet.
Refer.

Question 5

Acute asthma Mx.

Answer 5

O2.
Nebulised bronchodilators.
Steroids –IV hydrocortisone or PO prednisolone.
IV Aminophylline.
IV Magnesium Sulphate.
IV salbutamol.

Question 6

Pathogen most commonly causing bronchiolitis.

Answer 6

RSV.

Question 7

Ix in bronchiolitis.

Answer 7

Blood gas.
NPA.
CXR.
Fluid assessment.

Question 8

RF for bronchiolitis.

Answer 8

Prematurity.
SCBU.
Hx of admissions.
Heart disease.
Immunodeficiency.
Developmental delay.

Question 9

Mx bronchiolitis.

Answer 9

Supportive – O2, NG feed/IV, suctioning.

Question 10

Signs of bronchiolitis on Ex.

Answer 10

Increased respiratory effort.
Accessory muscles + recessions.
Grunting.
Hyperinflation.
Nasal flaring.

Question 11

When do you admit a child with bronchiolitis?

Answer 11

RR >60
50-75% normal fluid intake.
Dehydration.
Respiratory distress.
Apnoea.
O2% <92.
Carer anxiety.

Question 12

Criteria for discharging child with bronchiolitis.

Answer 12

Adequate intake.
Sats >92% off oxygen including 4 hours of sleep.
Clinically stable.
Safety netting.

Question 13

What is VIW?

Answer 13

Recurrent episodes of wheezing in an <3 yo thought to be linked to a viral trigger. May develop into asthma.

Question 14

Red flags for VIW.

Answer 14

Present from birth.
Persistent productive cough.
Weight faltering.
Focal neuro signs.

Question 15

Mx VIW.

Answer 15

Oxygen.
Bronchodilators.
Smoking cessation advice.
Safety netting.

Question 16

Criteria for admission with VIW.

Answer 16

Tachypnoeic.
Can't feed.
Floppy/unresponsive.
Accessory muscle use.
Cyanosis.

Question 17

What is croup?

Answer 17

(acute laryngotracheobronchitis)

URTI caused by viral infection.

Question 18

Pathogens causing croup.

Answer 18

Parainfluenzae 1, 2, 3.

RSV.

Question 19

Signs of croup.

Answer 19

Barking cough.
Stridor.
Drooling.
Hoarseness.

Question 20

DDx croup.

Answer 20

Epiglottitis.
Bronchiolitis.
Bacterial tracheitis.

Question 21

Distinguishing features separating pneumonia from bronchiolitis.

Answer 21

Pneumonia causes a higher fever and lower sats.

Question 22

Pneumonia Mx.

Answer 22

IV/PO amoxicillin (oral as effective if tolerated).
Fluids.
Oxygen.

Question 23

What should you not do if you suspect epiglottitis?

Answer 23

Look in child’s mouth or lie them flat.

Question 24

Pathogen causing epiglottitis.

Answer 24

Haemophilus Influenzae B.

Question 25

Mx epiglottitis.

Answer 25

Call for senior help.
IV cefotaxime.
Consider need for intubation.

Question 26

Signs of epiglottitis.

Answer 26

Excessive drooling.
No cough.
High fever.
Soft stridor.