Dyspnée - détresse respi chez l'enfant

Question 1

[…] causes central cyanosis that presents with bluish lips and tongue on exercise or activity. Boot shaped heart on XRay is sign most commonly in pt with […].

Answer 1

Tétralogie de Fallot

Question 2

Dx?
pulmonary valve stenosis
ventricular septal defect
overriding aorta
right ventricular hypertrophy

Answer 2

Tétraogie de Fallot

*sétnose v. pulmonaire: souffle systolique at the upper left sternal edge

Question 3

most common cyanotic congenital heart dz?

Answer 3

Tétralogie de Fallot

Question 4

Dx?
continuous (systo + diasto) machinery murmur that is loudest at the left upper sternal border and a wide pulse pressure.
hyperactivité précordiale
hépatomégalie
apnée-brady multiples

Answer 4

Patent ductus arteriosus

Question 5

Vrai ou faux:

Cyanotic congenital heart dz can appear at the time of ductus closure.

Answer 5

vrai

Question 6

test permettant de confirmer une mx cardiaque congénitale?

Answer 6

échec à la correction de l’hypoxémie avec 100% O2

dx for abnormal mixing of blood from the right and left circulations

Question 7

[…] is a rare form of congenital heart dz which presents with moderate cyanosis at birth due to the fact that there is complete mixing of systemic and pulmonary venous blood.

Answer 7

Truncus arteriosus

Question 8

Vrai ou faux

Coarctation of the aorta is not typically a cyanotic lesion

Answer 8

vrai

Question 9

vrai ou faux

VSD is the most common congenital heart dz

Answer 9

vrai

Question 10

Acute management of respiratory distress?

Answer 10

airway

breathing
*o2

Circulation
*monit, iv

HMA ‘‘SAMPLE’’

CALL FOR HELP

Question 11

âge bronchiolite?
agent infectieux en cause?
prédispose à ?

Answer 11

1 mois à 2 ans
VRS
asthme

Question 12

A normal or increasing carbon dioxide level in the context of tachypnea and respiratory distress is ..?

Answer 12

an indicator of fatigue and impending respiratory failure!

Question 13

investigation détresse respi kid?

Answer 13

FSC
ions
créat
uré
glycémie
ammoniaque
gaz

RX thorax (non indiqué si bronchiolite ou asthme), ou cou (abcès, épiglottite), expi forcée ou dévubitus (CE)
ECG, échocoeur

Question 14

management bronchiolite?

Answer 14

tx support, toilette nasale (succion des sécrétions)
O2 pour sat > 90%
pas de bronchodilatateur
*sauf si possibilité asthme sous-jacent
si hypoxémie, si hydratation impossible ou FDR rendant comorbide…: Hospit
si pt à aut risque: prophylaxie VRS (palivizumab)

Question 15

management asthme aigu?

Answer 15

Support
O2 >94%
BD courte action: salbutamol (+/- ipratropium bromide +/- cortico p.o.)
*ventolin 2 atrovent 1! x3 q 30 min
si sévère: soluté iv avec K (ventolin entraine shift intracell de K)
si pas mieux: sulfate de mg
si persistance infusion salbutamol et H USI
ad intubation

Question 16

DDX stridor?

Answer 16

croup (laryngotrachéobronchite) ‘‘toux aboyante’’

épiglottite *vaccination (thmub print sign RX cou)

CE –> bronchoscopie