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Paediatrics > Paediatric Respiratory > Flashcards

Paediatric Respiratory Flashcards

1
Q

What causes the common cold?

A

Rhinovirus

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2
Q

What can the common cold be a prodrome to?

A

Bronchitis
Bronchiolitis
Meningitis
Sepsis

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3
Q

What bacteria causes Otitis media?

A

Pneumococcus

H. Influenzae

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4
Q

What is the pathology of otitis media?

A

Rhinovirus infection causing blockage of eustacian tube

Then bacterial infection

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5
Q

Signs of otitis media?

A

Erythema
Bulging drum
Loss of light reflex
Pain

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6
Q

When should antibiotics be given in otitis media?

A

<2 y/o

Bilateral

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7
Q

What other treatment should be given?

A

analgesia

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8
Q

What causes pharyngitis/tonsilitis?

A

EBV

Group A strep

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9
Q

What are the signs of pharyngitis/tonsilitis?

A 
Pain on swallowing
Swollen tonsils 
Headache
Voice changes
Pus on tonsils
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10
Q

Ix pharyngitis?

A

Throat swab and culture

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11
Q

Treatment for bacterial pharyngitis?

A

Antibiotics

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12
Q

What antibiotics are good in group A strep?

A

Penicillins

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13
Q

What should not be given in pharyngitis before swab results?

A

Amoxicillin

causes rash in EBV infection

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14
Q

What is croup?

A

Laryngotracheobronchiolitis

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15
Q

What causes croup?

A

Parainfluenza type 1

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16
Q

What are the symptoms of croup?

A

Systemically well
Cold like symptoms
BARKING COUGH

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17
Q

What breath sound might be heard with croup?

A

Stridor

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18
Q

Tx for croup?

A

Dexamethasone

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19
Q

What causes Epiglottitis?

A

H. Influenzae type B

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20
Q

What is the presentation of epiglottitis?

A

Fever
Tachycardia
Stridor (red flag)
Drooling

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21
Q

Treatment of epiglottitis?

A

Must intubate

Antibiotics

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22
Q

What antibiotic should be used in epiglottitis?

A

Cefotaxime IV

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23
Q

What causes Tracheitis?

A

Staph/strep

Essentially same as croup but doesn’t get better

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24
Q

What is the presentation of tracheitis

A

Swollen trachea
Narrowed trachea

Fever
Can be septic

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25
Q

What is the treatment of tracheitis?

A

Oxygen
Hydration
Antibiotics

26
Q

Antibiotic for tracheitis?

A

Amoxicillin

27
Q

What causes bronchitis?

A

H. Influenza

28
Q

Presentation of bronchitis?

A

Long term cough in very young child

29
Q

Pathology of bronchitis?

A

Infection of RSV/adenovirus leading to ciliary dysfunction

H influenza then moves in and infects

30
Q

What are the symptoms of bronchitis?

A

Cough
URTI/previous URTI
NO WHEEZE
NO CRACKLES

31
Q

Treatment of bronchitis?

A

No treatment - should recover

32
Q

What does RSV cause?

A

Bronchiolitis VERY COMMON IN INFANTS

33
Q

Typical presentation of bronchiolitis?

A

Not recurrent
Nasal stuffiness
Poor feeding

Starts coughing day 1, gets worse then doctors day 5, stabilises and recovers up to 14 days

CRACKLES +/- WHEEZE

34
Q

Bronchitis vs Bronchiolitis?

A

Bronchitis no crackles or wheeze cause by H. influ

Bronchiolitis crackles and wheeze caused by RSV

35
Q

Investigation of bronchiolitis?

A

Nasopharyngeal swab

SATS

36
Q

Management of bronchiolitis?

A

No treatment

MAXIMUM OBSERVATION MINIMAL INTERVENTION

37
Q

What are the most common causes of pneumonia in kids?

A

Pneumococcus
Neisseria meningitidis
Mycoplasma
Chlamydia

38
Q

Symptoms of pneumonia?

A

48hr history

  • Fever
  • Productive cough
  • Wheeze
  • Reduced breath sounds
  • Focal signs
39
Q

What is a wheeze more likely to indicate in pneumonia?

A

Viral cause

40
Q

What are focal signs of pneumonia?

A

Creps

Bronchial breathing

41
Q

Investigations of pneumonia?

A

Can do sputum culture

Rarely CxR

42
Q

What indicates antibiotic use in pneumonia in kids?

A
  • Longer than 2 days
  • Neonates
  • Sepsis
43
Q

What antibiotics should be used in neonates?

A

Broad spectrum

44
Q

What antibiotics are first line in kids?

A

Amoxicillin

Macrolides

45
Q

What is a complication of pneumonia that requires immediate treatment?

A

Empyema thoracis

46
Q

What is treatment of empyema thoracis?

A

Drain

IV antibiotics

47
Q

When would asthma cause SOB at rest?

A

If lung function is reduced by >30%

48
Q

What trial can be done to diagnose asthma?

A

If true wheeze

Then

2 month trial of corticosteroid

If it gets better - asthma

49
Q

What is the treatment protocol of asthma for >5yrs?

A
  1. SABA +/- ICS
  2. Add LABA if symptomatic 3x per week
  3. Stop LABA, increase ICS to medium
  4. Increase ICS to max. Consider theophylline
  5. Contiuous/frequent ora steroid.
50
Q

What shouldn’t be used in <5yrs in asthma

A

LRTA instead of ICS and LABA

51
Q

Example of LRTA?

A

Monteklast

52
Q

When can dry powder inhalers be used?

53
Q

What shouldn’t be used without ICS?

54
Q

Side effects of ICS?

A

Height suppression

Adrenocortical suppression

55
Q

Define moderate acute asthma?

A

Sats >92%

PEF > = 50% pred.

56
Q

Treat moderate acute asthma?

A

SABA with spacer

Oral pred

57
Q

Define severe acute asthma?

A

Sats <92%
PEF 33-50%
Unable to talk
HR and RR very high

58
Q

Treatment severe acute asthma?

A

Nebulised ipratropium

59
Q

Define life threatening asthma?

A 
SILENT CHEST
POOR RESP EFFORT
AGITATION/CONFUSION
REDUCED GCS
CYANOSIS
60
Q

Treatment of life threatening asthma?

A

Nebulised SABA and ipratropium

If unable to nebulised

  • IV theophylline, SABA, ICS
  • Intubation
61
Q

DDx wheeze?

A

Virus
Asthma
CF
Aspiration

Paediatrics (8 decks)

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