high yield- paediatric resp Flashcards
stridor on inspiration suggests?
partial upper airway obstruction
stridor on expiration suggests?
obstruction below level of larynx
causes of acute stridor?
- croup infection
- epiglottitis infection
- inhaled foreign object
causes chronic stridor?
- laryngomalacia (most common)
- haemangioma (congenital)
- vocal cord paralysis (congenital)
cause of croup?
-parainfluenza virus
cause of epiglottitis?
H. influenzae
stridor red flags! (admit to hospital)
- sternal retractions
- constant stridor
- cyanosis
- lethargy
presentation of epiglottitis?
- acute
- soft, constant stridor
- drooling
- unable to swallow
presentation of croup?
- prodrome
- barking cough
- harsh, intermittent stridor
- able to swallow and no drooling
treatment for croup?
-oral dexamethasone
if severe give nebulised adrenaline
trestment for epiglottitis?
- immediate senior ENT help
- IV ceftriaxone + oxygen
DO NOT EXAMINE THROAT
what sign is seen on Xray of epiglottitis?
thumb print sign
what sign is seen on xray of croup?
narrow trachea
-steeple sign
what causes CF?
Autosomal recessive mutation
-CFTR gene mutation on chromosome 7
CYSTIC F= 7 letters= chromosome 7
why does CF affect mucous glands?
due to loss of chloride channels
why do patients with CF have a lack of digestive enzymes (e.g. lipase)?
due to thick pancreas + biliary secretions causing ducts to block
why do CF patients have increased bacterial colonisation and infections?
-due to their low volume thick airway secretions and reduced airways clearance
why do male CF patients experience infertility?
congenital bilateral absence of vas deferens in males
early sign of CF in neonates?
not passing meconium within 24 hrs birth
presentation CF?
- male infertility
- lack of digestive enzymes (e.g. lipase)
- recurrent resp infections
- malabsorption
- pancreatitis
- steatorrhea (fatty stool)
- failure to thrive
neonates: do not pass meconium within 24 hrs of birth
test for CF?
GOLD STANDARD= sweat test
will show high chloride concentration due to loss of chloride channels
most common cause bronchiolitis?
respiratory synovial virus (RSV)
most commonly affected by brocnhiolitis?
<12 months (90%)
bronchiolitis presentation?
- poor feeding
- wheeze
- increase work of breathing (tracheal tug and intercostal/subcostal recession)
bronchiolitis treatment?
- supportive
- NG tube
- Oxygen (<92% O2)
cause of whooping cough?
bordetella pertussis
presentation whooping cough?
- acute cough (>14 days)
- coryzal symptoms
- inspiratory whoop
- vomit post cough
- worse at night
Whoop:
- worse at night
- whitey
- feeling unWell
investigation whooping cough?
nasal swab
treatment whooping cough?
Oral macrolide:
-erythromycin, azithromycin or clarithromycin
most common cause of pneumonia in children?
strep. pneumonia
treatment for pneumonia in children?
amoxicillin
