Brainscape's Knowledge GenomeTM

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


See full index

Phase 3A > Paediatric - Respiratory > Flashcards

Paediatric - Respiratory Flashcards

1
Q

AIR SOUNDS

What is a wheeze

A

Polyphonic expiratory noise originating from lower airways

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

AIR SOUNDS

What conditions present with a wheeze

A 
VIW 
Asthma 
CF 
Bronchiolitis 
Pneumonia 
Foreign body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

AIR SOUNDS

What is stridor

A

high pitched monophonic inspiratory noise

originates from turbulent flow through partially obstructed airway

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

AIR SOUNDS

what conditions present with stridor

A 
foreign body 
croup 
acute epiglottitis 
laryngomalacia 
bacterial tracheitis 
anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

BRONCHIOLITIS

What is bronchiolitis

A

Infection and inflammation of bronchioles

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

BRONCHIOLITIS

When does bronchiolitis commonly present

A

Winter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BRONCHIOLITIS

What age is bronchiolitis common in

A

< 1 year

Peak at 6m

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

BRONCHIOLITIS

Name 3 causes of bronchiolitis

A

RSV
Parainfluenza
adenovirus

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

BRONCHIOLITIS

Name 4 risk factors for bronchiolitis infection

A 
passive smoking 
prematurity 
low birth weight 
Immunocompromised - CF
Chronic lung or hear disease 
Downs syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

BRONCHIOLITIS

How does bronchiolitis present - sx

A 
Coryzal symptoms 
- rhinorrhoea 
- sneezing 
- dry cough 
- mild fever 
wheeze 
dyspnoea 
poor feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

BRONCHIOLITIS

What are the signs of bronchiolitis

A 
signs of respiratory distress 
fine end inspiratory crackles
- Widespread  
Hyperinflation 
wheeze 
cough 
cyanosis 
pallor 
tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

BRONCHIOLITIS

What are the Ix for bronchiolitis

A

1st line - Pulse oximetry
2nd line - PCR analysis of nasal secretions
3rd line - CXR

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

BRONCHIOLITIS

What is the management of bronchiolitis

A

Feeding support - NG tubes
Supportive
- Humidified O2
- Fluids

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

BRONCHIOLITIS

What presentations warrant admission for bronchiolitis

A 
< 3m 
Pre-existing conditions 
feeding < 50%
hx of apnoea 
signs of resp distress 
cyanosis 
Sats < 94%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

BRONCHIOLITIS

What is the prevention for bronchiolitis and what group of people are eligible for it

A

Palivizumab - MAB that targets RSV

Monthly vaccinations for:

  • CF
  • Premature
  • Chronic lung disease
  • Immunocompromised
  • CHD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PNEUMONIA

Name 4 causes of pneumonia

A

Bacterial - older children

  • Strep pneumonia
  • Group B strep
  • S.aureus
  • Mycoplasma pneumonia
  • Pneumococcus

Viruses - < 2 years old

  • RSV
  • H.Influnzae
  • Influenzae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PNEUMONIA

Which pathogen commonly causes pneumonia in neonates

A

Group B strep

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

PNEUMONIA

What does S.aureus specifically present with

A

CXR - Pneumatoceles and consolidation in multiple lobes

Pneumatoceles - round air filled cavities

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

PNEUMONIA

What does Mycoplasma pneumonia specifically present with

A

Erythema multiforme - red circular rash

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

PNEUMONIA

Describe the presentation of pneumonia - symptoms

A 
cough 
High fever - > 38.5 
poor feeding 
chest recessions 
lethargy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PNEUMONIA

Describe the presentation of pneumonia - signs

A 
tachycardia 
tachypnoea 
Respiratory distress 
hypoxia 
Pleuritic chest pain 
auscultation 
- bronchial breath sounds 
- focal end inspiratory crackles 
Percussion 
- dullness to percussion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

PNEUMONIA

What investigations are used for a patient with suspected pneumonia

A

Sputum cultures / throat swabs for bacterial culture and PCR
- Establish organisms and guide treatment

Capillary blood gas analysis

  • metabolic acidosis
  • blood lactate

Blood cultures - Sepsis

CXR

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

PNEUMONIA

What is the management of pneumonia

A

Supportive

  • O2
  • Analgesia
  • IV fluids
Antibiotics 
Neonates - broad spectrum Abx 
Children 
1st line - Oral amoxicillin 
2nd line - Erythromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

PNEUMONIA

What investigation should be performed for a child with pneumonia who gets unwell after a period of improvement

A

CXR - Check for empyema

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

PNEUMONIA

What investigations should be performed for a child with recurrent LRTI and what are they looking for

A 
FBC - WCC levels 
CXR - Structural abnormality 
Serum IgG - Antibody levels 
IgG - Test immunoglobulin G to previous vaccines 
Sweat test - CF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

VIW

What is a VIW and what does it increase the risk of

A

Acute wheezy illness caused by viral infection

Children have a higher risk of asthma development later in life

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

VIW

What are the risk factors

A

maternal smoking
prematurity
Family hx of wheezing

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

VIW

What is the presentation of VIW

A 
Evidence of viral illness 
- fever 
- cough 
- coryzal sx for 1 - 2 days 
S.O.B
Signs of respiratory distress 
Expiratory wheeze throughout chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

VIW

What is the pathophysiology of VIW

A

children have small airways

virus - RSV or rhinovirus causes inflammation and oedema reducing airway size

smooth muscle constriction occurs due to swelling

air flow through restricted airways causes a wheeze

restricted ventilation causes resp distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

VIW

Name 3 typical features of VIW that differentiates it from asthma

A
  • presenting before 3 years of age
  • no atopic history
  • only occurs during viral infections
  • no interval sx
  • typically resolves by 5 years old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ASTHMA

Name 4 asthma triggers

A 
cold weather 
strong emotions 
viruses 
bacterial infections 
exercise 
dust 
Drugs - NSAIDs / Beta blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

ASTHMA

What is the definition of asthma

A

Chronic inflammation of airways that causes episodic exacerbations of bronchoconstriction due to hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

ASTHMA

Name 3 risk factors for asthma development

A 
Hx of atopy 
Allergens - dust / grass / pollen 
- hayfever 
family hx 
smoking exposure 
obesity 
pollution 
URTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ASTHMA

What is the atopic triad

A

asthma
allergic rhinitis
eczema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

ASTHMA

What is the pathophysiology of asthma

A

Bronchial inflammation

  • oedema
  • mucus hypersecretion

Airway hyper-responsiveness

  • Mass histamine release
  • Hypersensitivity

Reversible airflow limitation

  • Airway obstruction due to inflammation
  • Bronchospasm and chronic bronchoconstriction

symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

ASTHMA

What are the distinguishing features of asthma

A

diurnal variation
sx have non viral triggers
interval sx between exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

ASTHMA

What are the sx and signs of asthma

A

sx

  • wheeze
  • dry cough
  • S.O.B
  • Disturbed sleep

signs

  • exercise tolerance
  • bilateral polyphonic wheeze
  • typical triggers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

ASTHMA

What are the investigations for asthma

A
  • hx and investigations
  • skin prick for common allergens
  • Serial PEFR if > 5 years old
    readings at morning and at night
  • FeNO > 35ppb
  • Spirometry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

ASTHMA

What are the spirometry readings for an asthmatic patient

A

FEV1:FVC < 70%

FEV1 improves by 15% after bronchodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

ASTHMA - drugs
What is used a preventer therapy
- what is the MOA
- What are the A/E

A

ICS

Decreases airway inflammation to decrease sx

A/E

  • Impaired growth
  • adrenal suppression
  • altered bone metabolism / osteoporosis
  • pepti ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

ASTHMA - drugs

What is adrenal suppression due to ICS usage caused by

A

decreased cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

ASTHMA - drugs

What is used as a reliver therapy

A

Bronchodilators

Anticholinergics - Ipratropium bromide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

ASTHMA - drugs

What techniques are used to minimise the adverse effects of ICS

A

Lowest possible dose

spacer usage

rinsing mouth after medication delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

ASTHMA

What is the management of asthma in < 5 years old

A

SABA

SABA + low dose ICS
- If uncontrolled on low dose ICS

SABA + ICS + LTRA

45
Q

ASTHMA

What is the management of asthma in > 5 years old

A

SABA

SABA + ICS

  • Recheck adherence
  • inhaler technique
  • elimination of triggers

SABA + ICS + LABA

  • good response –> continue
  • poor response to LABA (1)
  • If no response to LABA (2)
  1. SABA + Titrate ICS dose + LABA
  2. Stop LABA and add LTRA
    - Refer to specialist
    - Oral LTRA OR Oral theophylline
46
Q

ACUTE ASTHMA

What are the features of moderate acute asthma

A

peak flow > 50%

normal speech

47
Q

ACUTE ASTHMA

What are the features of severe asthma

A

peak flow < 33%

sats < 92%

unable to complete sentences in one breath

signs of resp distress

48
Q

ACUTE ASTHMA

What are the features of life-threatening asthma

A

33 / 92 / CHEST

peak flow < 33%

sats < 92%

cyanosis

hypotension

exhaustion and poor effort

silent chest

tachycardia

49
Q

ACUTE ASTHMA

What are the side effects of salbutamol

A

tachycardia
hypokalaemia
tremor

50
Q

ACUTE ASTHMA

What is required when giving IV Salbutamol

A

cardiac monitoring

51
Q

ACUTE ASTHMA

What is the management of acute asthma

A

OSHIT ME

O - High flow O2

S - Nebulised salbutamol

  • every 15 mins
  • 1 puff every 30-60s up to 10 puffs

H - IV Hydrocortisone / oral prednisolone

I - Ipratropium bromide

T - IV Theophylline

M - IV magnesium sulphate

E - Escalate

52
Q

ACUTE ASTHMA

When can a patient be discharged following an acute asthma attack

A

PEFR > 75% constantly

asthma action plan

safety net information

1 week GP follow up

53
Q

ACUTE ASTHMA

What are 4 common reasons response to asthma management is not occurring

A 
adherence 
bad disease 
choice of drugs / devices 
diagnosis 
environment
54
Q

ASTHMA

What is the presentation of chronic asthma

A

barrel chest
hyperinflation
- increased resonance on percussion
Harrison’s sulci

55
Q

ASTHMA

What are the adverse effects of oral steroids

A 
HTN 
Hyperglycaemia 
Adrenal suppression 
weight gain 
poor growth
56
Q

ASTHMA

What are the adverse effects of Montelukast

A

nightmares
coryzal sx
diarrhoea
fever

57
Q

CYSTIC FIBROSIS

What is CF

A

AR disorder due to mutation in CFTR gene on chromosome 7

58
Q

CYSTIC FIBROSIS

What is the pathophysiology of CF

A

Decreased Cl- secretion
Increased Na+ absorption

leads to increased H20 absorption into cells with thickened secretions

Mucous stasis and dehydrated airway surface liquid predisposes to infection

59
Q

CYSTIC FIBROSIS

What is the carrier rate for CF

A

1 in 25

60
Q 
CYSTIC FIBROSIS 
What is the presentation of CF for each of these systems:
- Resp 
- GI 
- GU
A 
Resp 
- chronic cough with thick sputum 
- sinusitis 
- nasal polyps 
- bronchiectasis 
Due to recurrent infection 
- breathlessness 
- haemoptysis 
- recurrent chest infections

GI

  • Cholesterol gallstones
  • meconium ileus
  • steatorrhea
  • Pancreatitis
  • failure to thrive

GU

  • pubertal delay
  • Secondary amenorrhoea
  • Infertility
61
Q

CYSTIC FIBROSIS

How does meconium ileus present

A

abdominal distension
vomiting

meconium is

  • thick
  • sticky
62
Q

CYSTIC FIBROSIS

How does CF present in infancy

A 
faltering growth 
malabsorption 
steatorrhea 
prolonged neonatal jaundice 
recurrent infections 
- pseudomonas
63
Q

CYSTIC FIBROSIS

How does CF present in young child

A

bronchiectasis
rectal prolapse
nasal polyps
sinusitis

64
Q

CYSTIC FIBROSIS

How does CF present in adolescents

A 
diabetes 
cirrhosis 
portal HTN 
Infertility 
distal intestinal obstruction
65
Q

CYSTIC FIBROSIS

What ix are required for CF

A

1st line - Guthrie card
2nd line - Sweat test
DIAGNOSTIC
3rd line - Genetic testing

other:

  • CXR
  • Faecal elastase
  • Lung function
66
Q

CYSTIC FIBROSIS

What is the Guthrie screening test looking for

A

Immunoreactive trypsinogen test

conducted between days 5 - 9

67
Q

CYSTIC FIBROSIS

What does the sweat test measure

A

measures chloride ions

> 60 mmol/L - diagnostic

68
Q

CYSTIC FIBROSIS

What is the general management of CF

A

Stop smoking

vaccinations

69
Q

CYSTIC FIBROSIS

What is the management of pulmonary disease in CF

A

Airway clearance techniques to reduce incidence of infections

chest physiotherapy

mucoactive agents

  • dornase alpha
  • hypertonic NaCl

amiloride

lung transplant
- FCV < 30%

70
Q

CYSTIC FIBROSIS

What is the MOA of amiloride

A

Inhibits Na transport

71
Q

CYSTIC FIBROSIS

How are infections managed in CF

A

Prophylactic flucloxacillin
- reduced risk of bacterial infection (s.aureus)

vaccinations

  • pneumococcal
  • flu
  • varicella
72
Q 
CYSTIC FIBROSIS 
What is the extrapulmonary management of CF 
- Nutrition 
- fertility 
- hepatobiliary
A 
Nutritional assesment 
- increase portion size 
- high calorie diet 
- supplements 
- PERT 
CREON tablets help patients with pancreatic insufficiency to digest fats (replace lipase)

testicular sperm extraction

liver transplant

73
Q

CYSTIC FIBROSIS

What microbial colonisers are common for CF in childhood

A

staph aureus
Haemophilus influenza
Pseudomonas aeruginosa

74
Q

CYSTIC FIBROSIS

How is pseudomonas aeruginosa managed

A

avoid contact with other CF patients

  • hard to clear once colonised
  • resistant to multiple Abx

Nebulised Abx - Tobramycin
Oral ciprofloxacin

75
Q

CYSTIC FIBROSIS
What is the main differential for CF?
How does it present

A

Primary ciliary dyskinesia

Presentations - 
URTI and LRTI 
bronchiectasis 
productive cough 
nasal discharge 
chronic ear infections 
dextrocardia
76
Q

HYPERSENSITIVITY

What is type 1 hypersensitivity reaction and give an example

A

Allergic - IgE mediated

bee sting
medications

77
Q

HYPERSENSITIVITY

What is type 2 hypersensitivity reaction and give an example

A

Cytotoxic - Antibody mediated

haemolytic reactions
good pastures syndrome

78
Q

HYPERSENSITIVITY

What is type 3 hypersensitivity reaction and give an example

A

Immune complex

hypersensitivity pneumonitis
SLE
serum sickness

79
Q

HYPERSENSITIVITY

What is type 4 hypersensitivity reaction and give an example

A

Delayed - T cell mediated

SJS

80
Q

HYPERSENSITIVITY

How does anaphylaxis present

A 
urticaria 
itching 
angio-oedema 
S.O.B
wheeze 
stridor 
tachycardia 
collapse
81
Q

HYPERSENSITIVITY

What is the management of anaphylaxis

A

ABCDE

IM Adrenaline

repeat after 5 mins

other:
Fluid challenge and O2

Antihistamines

  • Chlorphenamine
  • Cetirizine

steroids
- IV Hydrocortisone

82
Q

HYPERSENSITIVITY

What is the follow on management of anaphylaxis

A

observation for 6 - 12 hours
- Biphasic reactions

education for family

83
Q

HYPERSENSITIVITY

What investigation can be used to determine if a true anaphylactic attack occurred

A

Serum mast cell tryptase

- elevated for 12hrs following event

84
Q

CROUP

What is the other name for croup

A

Laryngotracheobronchitis

85
Q

CROUP

When does croup commonly present

A

autumn and spring

86
Q

CROUP

What are the causes of croup

A

Parainfluenza 1 and 3

adenovirus

RSV

87
Q

CROUP

What is the presentation of croup

A

Preceeding

  • low grade fever
  • coryzal sx

At time:

  • barking cough - worse at night
  • Coughing in clusters
  • hoarse voice
  • stridor
  • breathlessness
  • poor feeding
88
Q

CROUP

What are the investigations for croup

A

Bedside - O2 stats / HR / RR

CXR
- Steeple sign

Minimal examination required

89
Q

CROUP

What is contraindicated in a child presenting with croup

A

Throat examination - leads to laryngospasms

90
Q

CROUP

what is the management of croup

A

Acronym - ODA

Self-limiting

Supportive

  • fluids
  • rest
  • oxygen

Oral dexamethasone / prednisolone

  • 1 dose –> 150mcg/kg
  • Can be repeated 12hrs later

Nebulised adrenaline
- If severe: signs of resp distress

91
Q

ACUTE EPIGLOTTITIS

What is acute epiglottitis

A

Life threatening emergency
inflammation and swelling of epiglottis due to infection

common in aged 2 - 7

92
Q

ACUTE EPIGLOTTITIS

Why is acute epiglottitis rare

A

Due to child immunisation

suspect in an unvaccinated infant

93
Q

ACUTE EPIGLOTTITIS

What is the cause of acute epiglottitis

A

Haemophilius influenza B

94
Q

ACUTE EPIGLOTTITIS

What is the presentation of acute epiglottitis

A 
4 D'S 
Dysphagia 
Drooling - difficulty swallowing 
Distress 
Dysphonia

HIGH FEVER
Septic looking child

95
Q

ACUTE EPIGLOTTITIS

What signs are present in a child with acute epiglottitis

A 
stridor - soft inspiratory 
tripod position 
- sitting upright and leaning forward 
muffled voice 
septic looking 
absent cough
96
Q

ACUTE EPIGLOTTITIS

What investigations are required for a child with acute epiglottitis

A

Direct visualisation - Laryngoscopy
- Beefy red oedematous epiglottis

X-Ray
- thumb sign

97
Q

ACUTE EPIGLOTTITIS

What is the management of acute epiglottitis

A

Keep child calm
do not examine throat

1st line - Secure airway
2nd line - cultures

98
Q

ACUTE EPIGLOTTITIS

what is the pharmacological management of acute epiglottitis

A

IV Abx - Ceftriaxine

steroids - Dexamethasona

99
Q

ACUTE EPIGLOTTITIS

what should be given to unvaccinated close contacts

A

Rifampicin

100
Q

ACUTE EPIGLOTTITIS

How do you differentiate croup from acute epiglottitis

A

AE

  • faster onset
  • no coryzal sx
  • no cough
  • can’t drink
  • drooling
  • toxic appearance
  • HIGH FEVER
  • Whispering stridor
  • fullfed voice

croup

  • slow onset
  • coryzal sx
  • barking cough
  • low grade fever
  • hoarse voice
  • harsh stridor only when upset
101
Q

BACTERIAL TRACHEITIS

What is bacterial tracheitis and what causes it

A

uncommon condition similar to severe epiglottitis

occurs 6m to 14 years old

causes

  • S.aureus
  • strep A
102
Q

WHOOPING COUGH

what is whooping cough

A

Pertussis - NOTIFIABLE DISEASE

URTI occurring before babies first vaccinations (<4m)

100 day cough

103
Q

WHOOPING COUGH

What infection commonly co-exists with whooping cough

A

Bronchiolitis

104
Q

WHOOPING COUGH

What causes whooping cough

A

Pertussius bordatella

Gram -ve cocobacilli

105
Q

WHOOPING COUGH

How does whooping cough present

A

1st

  • mild coryzal sx
  • low grade fever
  • dry cough
  • conjunctivitis
  • nasal discharge
  • sore throat

2nd - coughing fits

  • Proxysmal cough (3-6wks)
  • dry hacking cough
  • child can turn blue
  • worse at night or feeds
  • loud inspiratory woop

Apnoea in infants

106
Q

WHOOPING COUGH

What can occur due to coughing fits in whooping cough

A 
sunconjunctival haemorrhage 
syncope of seizures 
fainting 
vomiting 
pneumothorax 
nose bleed
107
Q

WHOOPING COUGH

What investigations are required in a child presenting with whooping cough

A

within 2-3 weeks
Nasopharyngeal swabs
- PCR testing
- bacterial culture

cough > 2 weeks

  • Anti-pertussis toxin IgG
  • Looked for in oral fluid or blood
108
Q

WHOOPING COUGH

What is the management of whooping cough

A

supportive care

Abx - reduce infectivity period and useful if given within first 3 weeks

Infants < 1m –> Azithromycin / Clarithromycin

infants > 1m –> Macrolides / Trimethoprim

Pregnant (20-32wks) –> Erythromycin

109
Q

WHOOPING COUGH

What prophylaxis is given to close contacts

A

Erythromycin

Phase 3A (12 decks)

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