David king tips Flashcards
What is persistent pulmonary hypertension of the newborn associated with
Meconium aspiration
Birth asphyxia
Septicaemia
Respiratory distress syndrome
Explain the pathology of PPHN
High pulmonary resistance which causes a right to left shunt at the aterial and ductal levels
Baby becomes cyanotic very soon after birth
Treatment of PPHN
Mechanical ventilation
Circulatory support (Iontropes)
Inhaled nitric oxide
? sildenafil
More severe
Oscillatory ventilation
Extracorpeal membrane oxygenation
Management of asthma ( not acute management)
1. B2 agonist 2+ inhaled corticosteriod 3. <5yrs add montelukast / >5yrs salmeterol 4. Increased corticosteroid 5. Add prednisolone
Assessment of control in an asthmatic child
No of oral course of steroids (> 4 in 6mnths) Hospital admission Been to ICU Number of blue inhalers Time off school Check technique
Symptoms of bronchiolitis
Coryza Cough Fever Tachypnoea Wheeze Inspiratory crackles Intercostal recession Cyanosis
Reasons to admit
Inadequate feeding
Respiratory distress
Hypoxia
Treatment of bronchiolitis
O2
Nasogastric feeds
Confirm the diagnosis of the bronchiolitis
Nasopharyngeal aspirate
Symptoms of Kawasaki disease
Fever 5/7 days Bilateral non purulent conjunctivitis Mucous membrane changes (strawberry tongue, red dry cracked lips) Cervical lymphadenopathy Rash (polymorphous) Oedematous and desquamation of the fingers and the toes Reactivation of the BBG site Coronary aneurysums
Treatment of Kawasakis disease
IV IgG
Aspirin
Echo and a f/up echo in 4-6 weeks
Tests/ Investigations in Kawasakis disease
ESR/CRP WCC Bilirubin AST Alpha 1 antitrypsin Platelets
Clinical presentation of ALL
Malaise Anorexia Anaemia Neutropenia Thrombocytopenia HSM Lymphadenopathy
Investiagations
FBC BM aspirate ( blast cells)
Treatment of ALL
Induction Consolidation Interim maintenance Delayed intensification Continued maintenance