Lecture 13 Paediatric Respiratory

Question 1

What is the aetiology of Asthma

Answer 1

ADAM33, ORMDL3

Epigenetics

Question 2

How is Asthma diagnosed

Answer 2

Spirometry
Bronchiodilator Response
FeNO
Peak Flow

Question 3

What are the clinical features of asthma

Answer 3

Wheeze
SOB at rest
Cough (nocturnal, exertion)
Parent Hx
History of atopy

Question 4

What are the classes of medication used to treat asthma

Answer 4

• Short acting beta agonists
• Inhaled corticosteroids (ICS)
• Long acting beta agonists*
• Leukotriene receptor antagonists*
• Theophyllines*
• Oral steroids

Question 5

What are the adverse effects of ICS

Answer 5

Height suppression
Oral candidiasis
Adrenocortical suppression

Question 6

Name an example of a Leukotriene receptor antagonost

Answer 6

Montelukast

Question 7

What is the treatment for a mild acute asthma attack

Answer 7

SABA via spacer

SABA via spacer + pred

Question 8

What is the treatment for a moderate acute asthma attack

Answer 8

SABA via neb + pred

SABA + ipra via neb + pred

Question 9

What is the treatment for a severe acute asthma attack

Answer 9

IV salbutamol
IV aminophylline
IV magnesium (neb)
IV hydrocortisone
Intubate and Ventilate

Question 10

Rhinitis is prodrome to what other illnesses

Answer 10

Pneumonia
Bronchiolitis
Meningitis
Septicaemia

Question 11

What is the treatment for Rhinitis

Answer 11

Self limiting

Question 12

What are the symptoms of otitis media

Answer 12

Erythema
Bulging drum
Pink

Question 13

What is the treatment for otitis media

Answer 13

Common
Self limiting
Antibiotics doesn’t help

Question 14

What are the complications of otitis media

Answer 14

Rupture of drum

Question 15

When do you treat otitis media

Answer 15

Severe pain >6 months

Non severe bilateral 6-23 months

Question 16

If Tonsillitis/Pharyngitis are caused by bacteria what are the treatment options

Answer 16

Nothing

10 days penicillin

Question 17

If Tonsillitis/Pharyngitis are caused by a virus what are the treatment options

Answer 17

Nothing

Question 18

What should you not give to a person with Tonsillitis/Pharyngitis

Answer 18

Amoxycillin

Question 19

What is the causative organism of croup

Answer 19

Para influenza

Question 20

What is the treatment for Croup

Answer 20

Oral dexamethasone

Question 21

What are the symptoms of Croup

Answer 21

Coryza
Stridor
Hoarse voice
Barking cough

Question 22

What is the causative organism for Epiglottitis

Answer 22

H Influenzae Type B

Question 23

What are the symptoms of Epiglottitis

Answer 23

Drooling

Stridor

Question 24

What is the treatment for epiglottitis

Answer 24

Intubation and antibiotics

Question 25

Name common bacterial agents of LRTI

Answer 25

``` Strep pneumoniae Haemophilus influenzae Moraxella catarrhalis Mycoplasma pneumoniae Chlamydia pneumonia ```

Question 26

Name common viral agents of LRTI

Answer 26

Respiratory Syncital Virus Parainfluenza III Influenza A and B Adenovirus

Question 27

What is Tracheitis

Answer 27

Croup which does not get better Fever Staph or Stre[ invasive infection

Question 28

What is the treatment for Tracheitis

Answer 28

Augmentin

Question 29

What are the symptoms of Bronchitis

Answer 29

Loose rattly cough Post-tussive vomit - “glut” Chest free of wheeze/creps

Question 30

What are the common causative organisms of bronchitis

Answer 30

Haemophilus/Pneumococcus

Question 31

What is the treatment of bronchitis

Answer 31

Mostly self limiting

Question 32

What are the symptoms of Bronchiolitis

Answer 32

LRTI in infants • Nasal stuffiness, tachypnoea, poor feeding • Crackles +/- wheeze

Question 33

What is the common causative organisms of bronchiolitis

Answer 33

RSV | Paraflu III, HMPV

Question 34

Wheeze indicates bacterial or viral causes of illness

Answer 34

Viral

Question 35

What are the symptoms of Pertussis

Answer 35

Coughing fits >2 weeks | Vomiting and colour change

Question 36

What is Empyema

Answer 36

Pus in pleural space | Complication of pneumonia

Question 37

What are the symptoms of Empyema

Answer 37

Chest pain | Very unwell

Question 38

What is the treatment f Empyema

Answer 38

Drainage | IV Antibiotics

Question 39

What is the first line treatment for pneumonia/LRTI

Answer 39

``` Oral amoxycillin Oral macrolide (2nd) ```