Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Paeds > Lower resp > Flashcards

Lower resp Flashcards

1
Q

what are common lower resp conditions in children?

A 
asthma 
bronchitis 
bronchiolitis 
bronchiectasis 
cystic fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are common upper resp conditions in children?

A

croup
whooping cough

epiglottitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what cells mediate allergic asthma?

A

Th2 T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what cells do activate Th2 T cells when allergens bind to them?

A

dendritic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what cytokine is involved in the inflammatory process of asthma?

A

leukotriene C4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what environmental factors are involved with asthma?

A 
low birth weight 
prematurity 
parental smoking 
atopy 
cold air and exercise 
atmospheric pollution 
NSAIDs 
B blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what viruses most commonly cause viral chest infections in children?

A

rhinovirus

respiratory syncytial virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

state two clinical patterns of wheeze?

A

episodic viral wheeze

multiple trigger wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what resp conditions could finger clubbing suggest?

A

CF and bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what signs on examination may be present for asthma?

A

wheeze

use of accessory muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what investigations can be done for asthma?

A

spirometry (FEV1:FVC <70% if poor control)

peak expiratory flow rate 
bronchial provocation tests 
exercise testing 
skin prick testing 
exhaled nitric oxide (NO production in bronchial epithelial cells is increased with Th2 driven eosinophilic inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what investigation can be done to diagnosis CF?

A

chloride sweat test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what investigation can be done to rule out GORD?

A

oesophageal pH testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what investigation can be done to exclude bronchiectasis ?

A

high resolution CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what gene is associated with asthma?

A

ADAM33

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the aims of good control of asthma?

A 
full school attendance 
no sleep disturbance 
<2/week daytime symptoms no limitations of daily living 
no exacerbations 
using salbutamol <2/week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

if asthma is suspected what treatment should be started?

A

inhaled corticosteroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the 5 step wise management of asthma ?

A

as required SABA (short acting b-2 agonist - salbutamol)

regular inhaled corticosteroid

add on therapy

  • LABA (salmeterol/formeterol)
  • increase ICS dose
  • stop LABA and start leukotriene receptor antagonist

increase ICS dose

regular oral steroids and refer to paediatrician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

state the name of a leukotriene receptor antagonist

A

montelukast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if no treatment works for asthma was specialist medication can be used?

A

Omalizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the action of Omalizumab for asthma?

A

reduces free IgE in the blood. This reduces IgE mediated inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what should LABA be prescribed with?

A

ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what ICS is used in children?

A

beclometasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what should all children diagnosed with asthma have?

A

written asthma management plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the signs of life threatening asthma exacerbation ?

A 
O2 sats <92% 
PEFR <33% predicted 
silent chest 
altered GCS 
confusion 
exhaustion 
cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the immediate management of asthma exacerbation ?

A

oxygen

bronchodilators (inhaled SABA - if severe nebulised)

ipatropium bromide (anti-muscuranic)

corticosteroids (prednisolone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the second line treatment for asthma exacerbation?

A

IV salbutamol

magnesium sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what condition is exhaled nitric oxide raised in?

A

hay fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is bronchiolitis commonly caused by?

A

respiratory syncytial virus

30
Q

what pathophysiology occurs during bronchiolitis

A

proliferation of goblet cells causing excess mucus
IgE mediated type 1 allergic reaction causing inflammation
bronchiolar constriction
infiltration of lymphocytes causing submucosal oedema
infiltration of cytokines and chemokines

31
Q

what would be seen on examination of bronchiolitis ?

A 
tachypnoea 
grunting 
intercostal, subcostal recessions 
inspiratory crackles 
expiratory wheeze
hyper inflated chest 
cyanosis
32
Q

what are DD for bronchiolitis ?

A 
pneumonia 
croup 
CF
heart failure 
bronchitis
33
Q

what should the management of bronchiolitis be in hospital ?

A

oxygen if sats <92%
give fluids via NG tube
consider CPAP if resp failure
perform upper airway suctioning

34
Q

should antibiotics be used for bronchiolitis ?

A

no

- caused by parainfluenza virus

35
Q

what are some complications of bronchiolitis ?

A 
hypoxia 
dehydration 
fatigue 
persistent cough/wheeze
bronchiolitis obliterans
36
Q

how long does bronchiolitis usually last?

A

7-10days

37
Q

what LRTI organisms can lead to bronchial damage and bronchiectasis ?

A 
strep pneumonia 
staph aureus 
adenovirus 
measles 
influenza 
Bordetella pertussis
Mycobacterium tuberculosis
38
Q

what is the hereditary of primary ciliary dyskinesia ?

A

autosomal recessive

39
Q

what is young syndrome ?

A

A rare condition associated with bronchiectasis, reduced fertility and rhinosinusitis.

40
Q

what is yellow nail syndrome ?

A

rare syndrome associated with pleural effusions, lymphoedema and dystrophic nails. Bronchiectasis occurs in around 40% of patients.

41
Q

what condition is suggested by Bilateral upper lobe bronchiectasis?

A

CF

42
Q

what condition is suggested by unilateral upper lobe bronchiectasis?

A

post TB infection

43
Q

what condition is suggested by Focal bronchiectasis (lower lobe) ?

A

foreign body inhalation

44
Q

what are some complications of bronchiectasis?

A 
Recurrent infection
Life-threatening haemoptysis
Lung abscess
Pneumothorax
Poor growth and development
45
Q

what is the key symptom of bronchiolitis ?

A

chronic productive cough

46
Q

what will a CXR of bronchiectasis

A

bronchial wall thickening and airway dilation

47
Q

which spirometry pattern does severe bronchiectasis have?

A

mixed obstructive/restrictive

48
Q

what gene is associated with CF?

A

CF transmembrane conductance regulator gene

49
Q

what GI complications does CF have?

A

bowel obstruction in utero can cause meconium ileus

CF related liver disease
- causes cholestasis and can result in neonatal jaundice

distal intestinal obstruction syndrome

50
Q

what reproductive complication does CF have?

A

98% of males are infertile due to the absence of vas deferens

51
Q

what are signs of CF in children?

A 
failure to thrive 
recurrent chest infections 
Rectal prolapse
Nasal polyps (N.B. strongly suspect CF in children presenting with nasal polyps)
Sinusitis
52
Q

what specific mutation is the most common for CF in the UK?

A

ΔF508

53
Q

what changes does CF cause to the pancreas?

A

the pancreatic duct is usually occluded in utero causing permanent damage to the exocrine pancreas

54
Q

what are signs of CF in infants?

A

meconium ileus
failure to thrive
prolonged neonatal jaundice

55
Q

how is CF screened in neonates?

A

part of the Guthrie test

56
Q

what are the two key aims of CF management?

A

early treatment of infection

optimisation of nutrition

57
Q

on examination what may be seen on the hands, face, chest and abdo?

A

Hands: finger clubbing

Face: nasal polyps

Chest: hyperinflated, crepitiations, portacath (indwelling vascular access device)

Abdomen: faecal mass (if constipated/DIOS), may have a scar from ileostomy (meconium ileus)

58
Q

what two things are required for a diagnosis of CF?

A

fitting clinical history

positive chloride sweat test

59
Q

what investigations can be done for CF?

A

CXR (hyperinflation, bronchial thickening)
Chloride sweat test
sputum sample

annually- 
glucose tolerance test 
liver function and coagulation 
bone profile 
lung function testing 
faecal elastase (pancreatic function)
Chest CT (for bronchiectasis)
genetic analysis
60
Q

how is a sweat sample collected for chloride testing?

A

pilocarpine iontophoresis

61
Q

what are signs of CF in a young adult?

A

Pancreatic insufficiency: diabetes mellitus
Chronic lung disease
DIOS, gallstones, liver cirrhosis

62
Q

is a single sweat test sufficient to diagnosis CF?

A

no

- require a second test or genetic testing

63
Q

what level of chloride is required for a sweat test?

A

> 60mmol/L

40-60 is borderline and should be repeated

64
Q

what MDT would be involved in the treatment of CF?

A

patient’s GP, a respiratory paediatrician, a specialist CF nurse, a dietician, physiotherapist, psychologist and social worker.

65
Q

state what the management of CF would be ?

A

patient and family education

twice daily physiotherapy
mucolytics and DNase (reduces viscosity)
hypertonic saline

pancreatic enzyme supplements
fat soluble vitamins (ADEK)
ensure for weight gain

prophylactic antibiotics
infections should be treated for 2 weeks
Regular azithromycin has been shown to reduce exacerbations and improve lung function even in those not chronically infected with Pseudomonas aeruginosa.

annual follow up

66
Q

what complications can occur in the resp tract for CF patients?

A 
allergic bronchopulmonary aspergillosis (ABPA)
bronchiectasis 
pulmonary HTN 
pneumothorax 
nasal polyps
67
Q

what complications can occur in the GI tract for CF patients?

A 
rectal prolapse (Tx = laxatives)
distal intestinal obstruction syndrome (DIOS)
68
Q

do CF patients have early or delayed puberty ?

A

delayed puberty

- delay of 2 years

69
Q

What bacteria’s chronic infection is associated with worsening lung function and must be treated aggressively in CF patients?

A

pseudomonas aeruginosa

70
Q

The CTFR gene encodes the CFTR protein, what channel ion does this form?

A

chloride channel

Y4 Paeds (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions