Brainscape's Knowledge GenomeTM

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


See full index

Osha 3a > Paediatric respiratory > Flashcards

Paediatric respiratory Flashcards

1
Q

What is croup?

A
  • acute infective condition
  • upper resp tract infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the epidemiology of croup?

A
  • 6 months to 6 years, most common under 3 years
  • more prevalent autumn - winter
  • affects 1 in 6 children in their life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathophysiology of croup?

A
  • inflammation and swelling resulting in partial obstruction of the upper airway
  • oedema in larynx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the most common causes of croup?

A
  • parainfluenza
  • influenza
  • adenovirus
  • respiratory syncytial virus (RSV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does croup present?

A
  • increased work of breathing
  • barking cough in clusters of coughing episodes
  • hoarse voice
  • stridor
  • low grade fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is croup managed?

A
  • supportive: fluids and rest
  • oral dexamethasone
  • infection control measures: handwashing, off school
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the order of treatment for croup?

A
  • oral dexamethasone
  • oxygen
  • nebulised budesonide
  • nebulised adrenalin
  • intubation and ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is bronchiolitis?

A
  • chest infection causing inflammation and infection in the bronchioles
  • lower resp tract infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the epidemiology of bronchiolitis?

A
  • observed in winter
  • mostly between 1-9 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes bronchiolitis?

A
  • Majority attributed to respiratory syncytial virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the presentation of bronchiolitis?

A
  • coryzal symptoms
  • resp distress
  • wheezing
  • tachypnoea
  • grunting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the signs of respiratory distress?

A
  • raised RR
  • accessory muscle breathing
  • inter and subcostal recessions
  • nasal flaring
  • head bobbing
  • tracheal tugging
  • cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is wheezing and what is the cause?

A
  • whistling sound
  • narrowed airways
  • heard in expiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is grunting?

A
  • exhaling with glottis closed
  • increases positive end-expiratory pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is stridor?

A
  • high pitched inspiratory noise
  • obstruction of upper airway
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What resp reasons would cause a child to be admitted?

A
  • 50-75% less than normal milk intake
  • RR above 70
  • clinical dehydration
  • O2 sats below 92%
  • apnoea
  • head bobbing/deep recessions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can ventilation be assessed in children?

A
  • capillary blood gases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What capillary blood gas results show poor ventilation?

A
  • rising pCO2
  • falling pH
  • respiratory acidosis
  • if also hypoxic: type 2 resp failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can ventilatory support be provided?

A
  • high-flow humidified oxygen via a tight nasal cannula
  • oxygenates lungs and adds positive end-expiratory pressure to maintain airway
  • CPAP
  • intubation and ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is bronchiolitis managed?

A
  • adequate fluid intake
  • saline nasal drops
  • supplementary oxygen
  • ventilatory support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is palivizumab?

A
  • monoclonal Ab targeting RSV
  • given to high risk babies
  • ex-premature
  • congenital heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why is aspirin usually avoided in children?

A
  • Reye’s syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the pathophysiology of viral induced wheeze?

A
  • children <3 have small airways
  • when encountering virus they develop inflammation and oedema
  • swelling walls and restricting airflow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How can you tell the difference between viral induced wheeze and asthma?

A
  • presenting before 3 years old
  • no atopic history
  • only occurring during viral infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does viral induced wheeze present?

A
  • evidence of viral illness
  • SOB
  • signs of resp distress
  • expiratory wheeze throughout chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the cause of wheeze?

A
  • narrowing of airways causes laminar flow to become turbulent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which types of drugs are used to relax airway smooth muscle?

A
  • β-2 agonists
  • anti-muscarinics
  • theophyllines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which types of drugs are used to dampen inflammation?

A
  • corticosteroids
  • leukotriene receptor antagonists
  • biologics
  • macrolides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What breaks a breath hold?

A

raised CO2 detected in CSF

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

Where does gas exchange begin?

A
  • in the respiratory bronchioles
  • terminal bronchioles > resp bronchioles > alveolar ducts > sacs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is asthma?

A
  • chronic inflammatory condition causing variable (but reversible) airway obstruction
  • narrowed airways > obstruction of airflow to lungs
  • varies over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the presentation of asthma?

A
  • episodic
  • diurnal variability and worse at night
  • dry cough, wheeze, shortness of breath
  • atopic triad: hayfever, eczema, asthma
  • family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the physiology behind asthma?

A
  • smooth muscle contracts on irritation
  • chronic inflammation leads to scarring and airway remodelling
34
Q

What are the causes of asthma?

A
  • environmental: pollen, smoke, dust, mould
  • genetics
  • hygiene hypothesis
35
Q

What is the investigation for asthma?

A
  • spirometry: FEV1/FEV <0.7
  • reversibility: give salbutamol and see if ratio normal (0.8)
  • fractional exhaled nitric oxide: over 50ppb (adults)
36
Q

What is the management of asthma?

A
  • SABA PRN
  • SABA + ICS
  • SABA + ICS + LABA
  • plus LTRA e.g. monteleukast
37
Q

What is an example of:
1. SABA
2. LABA
3. SAMA
4. LAMA?

A
  1. salbutamol
  2. salmeterol
  3. ipratropium bromide
  4. tiotropium bromide
38
Q

How do leukotriene receptor antagonists work?

A
  • Leukotrienes produced by immune system
  • cause inflammation, bronchoconstriction, mucus secretion
  • antagonists block effects
39
Q

What is cystic fibrosis?

A
  • autosomal recessive condition affecting mucus glands
  • caused by genetic mutation of CFTR gene on chromosome 7 coding for chloride channels
40
Q

How is cystic fibrosis diagnosed?

A
  • newborn blood spot testing
  • sweat test (GOLD)
  • genetic testing for CTFR by amniocentesis or chorionic villous sampling
  • faecal elastase
41
Q

What is the sweat test for cystic fibrosis?

A
  • pilocarpine applied to patch of skin
  • electrodes placed either side
  • current passed causing sweating and sample sent to lab for chloride conc testing
  • > 60mmol/L is diagnostic
42
Q

What are the symptoms of cystic fibrosis?

A
  • chronic cough
  • thick sputum
  • recurrent resp tract infections
  • steatorrhoea
  • child tastes salty due to conc sweat
  • failure to thrive
43
Q

What are signs of cystic fibrosis?

A
  • low weight or height
  • nasal polyps
  • clubbing
  • crackles and wheeze on auscultation
  • abdo distention
44
Q

Which bacteria commonly affect children with cystic fibrosis and how is it prevented?

A
  • S. aureus
  • Pseudomonas aeruginosa
  • prophylactic flucloxacillin taken
45
Q

What is the first sign of cystic fibrosis?

A
  • meconium ileus
  • thick and sticky black stool - obstructs bowel
  • not passing within 24 hrs of birth > abdo distention and vomiting
46
Q

What is the pathophysiology behind cystic fibrosis?

A
  • thick pancreatic and biliary secretions: block ducts > lack of digestive enzymes
  • low volume, thick airway secretions > reduce clearance leading to bacterial colonisation and infection
  • congenital bilateral absence of vas deferens
47
Q

What is the pathology of cystic fibrosis?

A
  • issues with Cl- channel on apical membrane of epithelial cells
  • dec Cl- secretion and inc Na+ absorption leads to reduced water secretion and thickened mucus
48
Q

What is the management of cystic fibrosis?

A
  • chest physio: clear mucus
  • exercise: improve resp function
  • high calorie diet: malabsorption
  • bronchodilators: salbutamol
49
Q

What is pneumonia?

A
  • infection of lung tissue and inflammation
  • causes inflammation and sputum in airways and alveoli
  • community, hospital acquired or aspiration
50
Q

What are the symptoms of pneumonia?

A
  • wet, productive cough
  • high fever
  • inc work of breathing
  • lethargy and delirium
51
Q

What chest signs present with pneumonia (of consolidation)?

A
  • bronchial breath sounds: harsh
  • focal coarse crackles + wheeze: air passing through sputum
  • dullness to percussion
52
Q

What are signs of pneumonia?

A
  • tachycardia
  • tachypnoea
  • hypoxia
  • hypotension
  • confusion
53
Q

What investigations are done for pneumonia?

A
  • CXR
  • sputum cultures and throat swabs
  • viral PCR
  • blood culture if septic
  • capillary BG if unwell
54
Q

What is the pathophysiology behind pneumonia?

A
  • alveolar macrophages phagocytose bacteria
  • become overwhelmed and produce proinflammatory response to attract neutrophils
  • results in dead bacteria, neutrophils, tissue fluid & inflammatory proteins = inflammatory exudate or ‘pus’ in the airspaces
  • known as consolidation
55
Q

What are the atypical causes of pneumonia and how are they treated?

A
  • S. pneumoniae
  • Group A strep
  • S. aureus
  • Mycoplasma pneumoniae
56
Q

Which bacteria cause pneumonia in prevaccinated children?

A
  • Group B strep
  • H. influenza
57
Q

What are viral causes of pneumonia?

A
  • RSV
  • parainfluenza virus
  • influenza virus
58
Q

How is pneumonia managed?

A
  • amoxicillin
  • add a macrolide
  • IV Abx if sepsis
  • O2 above 92%
59
Q

What is the management of children with recurrent admission for LRTI?

A
  • FBC
  • CXR
  • serum immunoglobulins
  • IgG
  • sweat test
  • HIV test
60
Q

Which bacteria is epiglottitis typically caused by?

A
  • haemophilus influenza type B
61
Q

What is epiglottitis?

A
  • inflammation and swelling of the epiglottis
62
Q

What is epiglottitis?

A
  • inflammation and swelling of the epiglottis
63
Q

How does epiglottitis present?

A
  • sore throat
  • stridor
  • drooling
  • tripod position
  • high fever
  • painful swallow
  • muffled voice
64
Q

How is epiglottitis investigated?

A
  • lateral X-ray of neck
  • thumb(print) sign
  • soft tissue shadow looks like thumb pressed into trachea
  • caused by oedematous and swollen epiglottis
65
Q

Which bacteria is epiglottitis typically caused by?

A
  • haemophilus influenza type B
66
Q

How is epiglottitis managed?

A
  • not distressing the patient as this could prompt airway closure
  • don’t examine and don’t upset
  • secure airway
  • prepare to intubate at any time
67
Q

What medical management is there for epiglottitis?

A
  • IV Abx (ceftriaxone)
  • steroids (dexamethasone)
68
Q

What is the prognosis of epiglottitis?

A
  • most recover without intubation
  • epiglottic abscess
69
Q

What is whooping cough?

A
  • URTI
  • caused by Bordetella pertussis
70
Q

What type of bacteria is Bordetella pertussis?

A
  • gram negative
71
Q

What are the initial symptoms of whooping cough?

A
  • mild coryza symptoms
  • low grade fever
  • paroxysmal cough
72
Q

What is paroxysmal cough?

A
  • sudden and recurring fits with cough free periods
73
Q

How does whooping cough present after a week?

A
  • paroxysmal cough
  • severe fits > loud inspiratory whoop
74
Q

What are the complications of severe coughing fits in whooping cough?

A
  • fainting
  • vomiting
  • pneumothorax
75
Q

How do infants present in whooping cough?

A
  • sometimes without whoop
  • with apnoea
76
Q

How is whooping cough diagnosed?

A
  • nasopharyngeal or nasal swab
  • PCR testing or bacterial culture
  • if >2 weeks then test for anti-pertussis toxin IgG
77
Q

How is whooping cough managed?

A
  • supportive care
  • notify PHE
  • macrolide Abx e.g. clarithromycin
78
Q

What is a key complication of whooping cough?

A
  • bronchiectasis
79
Q

What is bronchopulmonary dysplasia?

A
  • infants who still require oxygen at an age of 36 weeks
80
Q

What is the cause of bronchopulmonary dysplasia?

A
  • lung damage
  • from pressure and volume trauma of artificial ventilation, oxygen toxicity and infection
81
Q

What is seen on CXR in bronchopulmonary dysplasia?

A
  • widespread opacification
  • cystic changes
  • fibrosis
82
Q

How is bronchopulmonary dysplasia treated?

A
  • weaning onto CPAP
  • additional oxygen where needed

Osha 3a (14 decks)

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