Brainscape's Knowledge GenomeTM

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


See full index

Paediatrics > Paediatric Respiratory > Flashcards

Paediatric Respiratory Flashcards

1
Q

Give three ways in which childhood asthma differs from adult asthma

A

Gender - boys > girls in childhood, women > men in adulthood
Severe asthma
Occupational asthma is uncommon

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

Describe the clinical presentation of asthma

A 
Wheeze
SOB at rest
 - "sooking in" of ribs
Dry cough
 - nocturnal, exertional
Usually at least one trigger
Parental asthma/atopy
Responds to treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What breath sounds are often mistaken for wheeze by parents?

A

Rattle
Stertor (“snoring”)
Stridor

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

What is the most likely cause of respiratory illness in children under 18 months old?

A

Infection

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

In what age group is asthma most likely to present?

A

Children 5 years and over

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

What is the differential diagnosis for an isolated cough?

A 
NOT asthma! (No wheeze)
Bronchitis
Pertussis
Habitual cough
Tracheomalacia (lifelong loud cough)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the goals of asthma treatment?

A
  • “minimal” symptoms during day and night
  • minimal need for reliever medication
  • no attacks (exacerbations)
  • no limitation of physical activity

( normal lung function (in practical terms FEV1 and/or PEF >80% predicted or best) - this is not what the patient is worried about)

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

How can control of asthma be measured?

A 
SANE:
SABA use per week (>2 = poor control)
Absence of school/nursery
Nocturnal symptoms per week (>1 = poor control)
Exertional symptoms per week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the first treatment that should be tried in the management of asthma?

A

Low dose inhaled corticosteroids (regular preventer)

Also, don’t forget non-medicinial interventions e.g. stop smoking, remove environmental triggers etc

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

What is the main treatment for acute asthma in children?

A

Oral steroids (not nebuliser)

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

How long do symptoms of rhinitis usually last?

A

1 - 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long do the symptoms of otitis media (esp earache) usually last?

A

2 - 6 days

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

What pathogens most commonly cause otitis media?

A

Primary infection is usually viral
- rhinovirus

May develop secondary bacterial infection:

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

How should otitis media be treated?

A

Analgesia

Does NOT require antibiotics (lots of side effects for minimal benefit)

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

What pathogens most commonly cause croup, epiglottitis and tracheitis?

A

Croup: para flu 1
Epiglottitis: H. influenzae B
Tracheitis: staph or strep

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

Which types of respiratory tract infection typically present with a “barking cough”?

A

Croup

Tracheitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment for croup?

A

Oral dexamthasone

18
Q

How long does croup usually last? If it persists beyond this, what is a more likely diagnosis?

A

1 - 3 days

Croup which does not resolve is more likely to be tracheitis

19
Q

How does croup differ from epiglottitis?

A

Child with epiglottitis is systemically unwell (low bp, febrile, lethargic) and will require intubation and antibiotics asap (epiglottitis is a medical and surgical emergency)

20
Q

How much does the epiglottis have to swell to obstruct the airway?

A

The epiglottis obstructs the airway when it becomes three times the size

21
Q

How can you differentiate viral tonsillitis from bacterial tonsillitis?

A

Throat swab - cannot tell just by looking

22
Q

Which antibiotic is contraindicated in tonsillitis/pharyngitis? Why?

A

Amoxicillin should not be given in case the infection is caused by EBV (glandular fever)

23
Q

How long do the symptoms of pharyngitis/tonsillitis (sore throat) usually last?

A

1 - 5 days

24
Q

What are the management options for pharyngitis / tonsillitis?

A

Analgesia

If antibiotics are to be given, give 10 days penicillin (but not amoxicillin)

25
Q

What pathogens most commonly cause lower respiratory tract infections?

A
  • Viruses in <35% (higher in younger)
  • Bacteria: Pneumococcus, Mycoplasma, Chlamydia
  • Mixed infection in <40%
26
Q

Describe the main clinical features of tracheitis

A

Croup which doesn’t get better (barking cough)
Child becomes systemically unwell
- fever
Biphasic stridor

27
Q

What pathogens most commonly cause bronchiolitis?

A

RSV
Paraflu III
HMPV

28
Q

What age group are affected by bronchiolitis?

A

infants (under 1 year)

29
Q

What are the symptoms of bronchiolitis?

A
  • Nasal stuffiness
  • Tachypnoea
  • Poor feeding (due to nasal stuffiness)
  • Crackles with or without wheeze
30
Q

Describe the management of bronchiolitis

A

Maximum observation, minimal intervention

- no routine need for CXR, bloods or bacterial cultures; usually monitor O2 sats

31
Q

Describe the natural history of bronchiolitis

A

Well for the first 2 days after cough develops
deteriorates between 2 - 5 days after cough develops
Stabilises 5 - 7 days after cough develops
Starts to recover 7 days after cough develops (can take up to 14 days for child to fully recover)

32
Q

What are the main clinical features of bronchitis?

A

Child is systemically well
Loose rattly (wet) cough with URTI
No wheeze/creps in chest

33
Q

Which pathogens most commonly cause bronchitis?

A

Pneumococcus

Haemophilus

34
Q

Describe the pathopysiology of bronchitis

A

Disturbed mucociliary clearance due to interference by the infection
o Minor airway malacia (floppiness) can exacerbate it
o Cough simply replaces mucociliary escalator
o The problem is not infection; endogenous bacteria proliferate due to loss of the mucociliary escalator (therefore antibiotics will not help)

35
Q

Describe the natural history of bronchitis

A 
Following URTI
Lasts 4 weeks
60-80% respond 
First winter bad
Second winter better
Third winter fine
Pneumococcus/H flu
36
Q

When should we worry about respiratory infection in a child? (What are the red flags?)

A
  • Age <6 mo, >4yr
  • Static weight
  • Disrupts child’s life
  • Associated SOB (when not coughing)
  • Acute admission
  • Other co-morbidities (neuro/gastro)
37
Q

Which type of respiratory infection causes conjunctival haematoma in children?

A

Whooping cough (pertussis)

38
Q

When can a LRTI be called a pneumonia?

A

Focal signs
Creps
High fever
(generally avoid using the word “pneumonia” due to associated anxiety)

39
Q

Describe the management options for pneumonia/LRTI

A

Nothing if symptoms are mild - address hydration, nutrition and oxygenation
(always offer to review if things get worse!)
Give antibiotics if 2 days fever, cough and focal signs
- Oral Amoxycillin first line
- Oral Macrolide second choice (if allergic or atypical pathogen)

Oral: only IV if vomiting

40
Q

For which respiratory infections should antibiotics be given?

A

Tracheitis - augmentin
LRTI/pneumonia (usually) - oral amoxycillin
Empyema - IV antibiotics

NOT bronchitis/bronchiolitis/croup

Paediatrics (12 decks)

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