paediatric resp

Question 1

stridor on inspiration suggests?

Answer 1

partial upper airway obstruction

Question 2

stridor on expiration suggests?

Answer 2

obstruction below level of larynx

Question 3

causes of acute stridor?

Answer 3

• croup infection
• epiglottitis infection
• inhaled foreign object

Question 4

causes chronic stridor?

Answer 4

• laryngomalacia (most common)
• haemangioma (congenital)
• vocal cord paralysis (congenital)

Question 5

cause of croup?

Answer 5

-parainfluenza virus

Question 6

cause of epiglottitis?

Answer 6

H. influenzae

Question 7

stridor red flags! (admit to hospital)

Answer 7

• sternal retractions
• constant stridor
• cyanosis
• lethargy

Question 8

presentation of epiglottitis?

Answer 8

• acute
• soft, constant stridor
• drooling
• unable to swallow

Question 9

presentation of croup?

Answer 9

• prodrome
• barking cough
• harsh, intermittent stridor
• able to swallow and no drooling

Question 10

treatment for croup?

Answer 10

-oral dexamethasone

if severe give nebulised adrenaline

Question 11

treatment for epiglottitis?

Answer 11

• immediate senior ENT help
• IV ceftriaxone + oxygen

DO NOT EXAMINE THROAT (this could make symptoms worse)

Question 12

what sign is seen on Xray of epiglottitis?

Answer 12

thumb print sign

Question 13

what sign is seen on xray of croup?

Answer 13

narrow trachea

-steeple sign

Question 14

what causes CF?

Answer 14

Autosomal recessive mutation
-CFTR gene mutation on chromosome

7CYSTIC F= 7 letters= chromosome 7

Question 15

why does CF affect mucous glands?

Answer 15

due to loss of chloride channels

Question 16

why do patients with CF have a lack of digestive enzymes (e.g. lipase)?

Answer 16

due to thick pancreas + biliary secretions causing ducts to block

Question 17

why do CF patients have increased bacterial colonisation and infections?

Answer 17

-due to their low volume thick airway secretions and reduced airways clearance

Question 18

why do male CF patients experience infertility?

Answer 18

congenital bilateral absence of vas deferens in males

Question 19

early sign of CF in neonates?

Answer 19

not passing meconium within 24 hrs birth

Question 20

presentation CF?

Answer 20

• 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

Question 21

test for CF?

Answer 21

GOLD STANDARD= sweat test

will show high chloride concentration due to loss of chloride channels

Question 22

most common cause bronchiolitis?

Answer 22

respiratory synovial virus (RSV)

Question 23

most commonly affected by brocnhiolitis?

Answer 23

<12 months (90%)

Question 24

bronchiolitis presentation?

Answer 24

• poor feeding
• wheeze
• increase work of breathing (tracheal tug and intercostal/subcostal recession)

Question 25

bronchiolitis treatment?

Answer 25

• supportive
• NG tube
• Oxygen (<92% O2)

Question 26

cause of whooping cough?

Answer 26

bordetella pertussis

Question 27

presentation whooping cough?

Answer 27

• acute cough (>14 days)
• coryzal symptoms
• inspiratory whoop
• vomit post cough-worse at night
• worse at night

Whoop:
-worse at night-whitey-feeling unWell

Question 28

investigation whooping cough?

Answer 28

nasal swab

Question 29

treatment whooping cough?

Answer 29

Oral macrolide:

-erythromycin, azithromycin or clarithromycin

Question 30

most common cause of pneumonia in children?

Answer 30

strep. pneumonia

Question 31

treatment for pneumonia in children?

Answer 31

amoxicillin