Katies crash course

Question 1

How old to diagnose asthma

Answer 1

5 years

Question 2

Moderate exacerbation PEFR

Answer 2

50-75%

Question 3

Severe PEFR

Answer 3

33-50%

Question 4

Life threatening PEFR

Answer 4

Under 30%

Question 5

What sats for life threatening asthma

Answer 5

Anything with sats under 92%

Question 6

Acute asthma management ladder

Answer 6

10 puffs of 100mics
Or nebs
2.5mg if under 5.

If no good add ipratropium. Can be given 4 hourly.

Steroids 3 days - PO/IV if poorly

Mag/ theophylline/ IV salbutamol

Tube

Question 7

When could you discharge a child with acute asthma

Answer 7

If you can go 4 hours without salbutamol

Question 8

What work up would you do for a ?asthma in community

Answer 8

Spiro - ratio less than 0.7. Always obstructive.
MUST also have improvement (reversibility) of 12%.

If no reversibility or normal Spiro then do FeNo

If this is above 35 -> diagnose.

Question 9

Stepwise asthma management

Answer 9

Blue inhaler.
If sx on more than 3 days a week, add low dose steroids.

if no good, try adding LKRA (montelukast).

If not working, STOP LKRA (causes night terrors, behavioural issues).
Add on a LABA (Symbicort - steroid and LABA).

If over 12 use SMART (single maintenance and reliever therapy).

If none of this has worked, increase steroid.

If above moderate steroid then refer.

Question 9

What age would transient synovitis affect?

Answer 9

Above 2.

Question 10

Perthes demographics

Answer 10

Boy between 4 and 10

Question 11

SUFE demographics

Answer 11

Fat boys.

Question 12

When would you refer a child who doesn’t have a social smile?

Answer 12

8 weeks.

Question 13

When would you refer a child who can’t sit with a straight back

Answer 13

9 months

Question 14

When would you refer a child who can’t stand
When would you refer a child who can’t walk

Answer 14

1 year for if can’t stand

Can’t walk 18 months.

Question 15

When would you want a child to be able to say 6 words by

Answer 15

18 months.