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Child Health > Paediatric Respiratory & ENT > Flashcards

Paediatric Respiratory & ENT Flashcards

1
Q

How is CF inherited?

A

Autosomal recessive

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2
Q

The gene affected by CF is the CFTR gene- this affects the movement of which ion across epithelial surfaces?

A

Chloride

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3
Q

In Northern Europe, 1 in every how many individuals are a carrier for CF?

A

1 in 25

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4
Q

Nasal polyps are a feature of which chronic lung condition seen in children?

A

CF

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5
Q

What gastrointestinal problem is seen in 20% of neonates with CF?

A

Meconium ileus

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6
Q

Children with CF can become deficient in which vitamins?

A

Fat soluble vitamins (ADEK)

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7
Q

What happens to the levels of sodium and chloride ions in the blood of individuals with CF?

A

Both low

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8
Q

When screening for CF, the serum concentration of what is measured?

A

Trypsinogen (will be raised in CF)

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9
Q

What is the gold standard investigation for CF?

A

Chloride sweat test

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10
Q

In CF patients, chronic infection with what organism is associated with a deterioration in lung function and a poorer prognosis?

A

Pseudomonas aeruginosa

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11
Q

What kind of diet is recommended for children with CF?

A

High calorie, high fat diet

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12
Q

Because of impaired pancreatic function, there is a risk that children with CF may develop what other chronic condition?

A

Diabetes mellitus

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13
Q

What fungal organism colonises up to 60% of CF patients?

A

Aspergillus fumigatus

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14
Q

What is the median lifespan of an individual with CF?

A

40 years

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15
Q

What medication is used to treat cystic fibrosis patients who are homozygous for the delta F508 mutation?

A

Lumacaftor/Ivacaftor

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16
Q

Most children with CF are on what prophylactic antibiotic?

A

Flucloxacillin

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17
Q

Which organism is responsible for > 90% of childhood URTIs?

A

Rhinovirus

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18
Q

How are viral URTIs treated in children?

A

Paracetamol and/or ibuprofen and adequate fluid intake

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19
Q

What can sometimes be the only sign of pneumonia in children?

A

Abdominal pain

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20
Q

The peak incidence of bronchiolitis is less than how old?

A

18 months

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21
Q

What organism is responsible for causing 80% of cases of bronchiolitis?

A

Respiratory syncytial virus (RSV)

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22
Q

What is the natural history of bronchiolitis infection?

A

Worsening of symptoms until days 5-7, followed by a gradual improvement and resolution by around day 10

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23
Q

A diagnosis of bronchiolitis is usually made clinically. However, the RSV virus can be detected on what investigation?

A

Nasopharyngeal aspirate

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24
Q

Which children with bronchiolitis are admitted to hospital?

A

If they are hypoxic or if they are unable to take half of their normal feeds

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25
Q

How is bronchiolitis managed?

A

Supportive care with oxygen therapy and feeding (possible NG)

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26
Q

What treatments may be indicated in babies with bronchiolitis who have worsening hypoxia, exhaustion or apnoea?

A

CPAP or mechanical ventilation

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27
Q

What organism is responsible for causing whooping cough?

A

Bordetella pertussis

28
Q

How long does the cough associated with whooping cough usually last for?

A

> 3 months

29
Q

How is whooping cough treated?

A

Supportive care only

30
Q

Viral laryngotracheobronchitis is also known as what?

A

Croup

31
Q

What is the most common cause for upper airway obstruction, manifesting as stridor with breathing difficulties?

A

Croup

32
Q

A ‘barking cough’ is characteristically heard in what condition?

A

Croup

33
Q

Croup is most common in children of what age?

A

6 months to 3 years

34
Q

What is the most common causative organism of croup?

A

Parainfluenza virus

35
Q

In young children, what should always be considered as a differential diagnosis for upper airway obstruction?

A

Inhaled foreign body

36
Q

What is the most important aspect of managing a child with upper airway obstruction?

A

Don’t distress them

37
Q

How are children with croup treated?

A

Oral dexamethasone (or nebulised budesonide)

38
Q

What organism causes acute epiglottitis?

A

Haemophilus influenzae type B

39
Q

Other than an inhaled foreign body, what are the two main causes of stridor in children?

A

Croup and acute epigottitis

40
Q

How is acute epiglottitis treated?

A

IV ceftriaxone

41
Q

If tonsillitis is bacterial, which bacteria is most likely to be the cause?

A

Group A strep

42
Q

Tonsillectomy can be considered for children with how many episodes or more of tonsillitis yearly, that are severe enough for them to have to miss school?

A

6 episodes

43
Q

What is the commonest cause of acute stridor in the neonatal period, up to several weeks of age?

A

Laryngomalacia

44
Q

What is the clinical course of laryngomalacia?

A

Should resolve spontaneously by 12 months

45
Q

What clinical condition causes the tympanic membrane to be red and bulging?

A

Acute otitis media

46
Q

If a child with acute otitis media remains unwell beyond 48 hours, how should they be treated?

A

PO amoxicillin

47
Q

What is the most significant complication of acute otitis media to be aware of?

A

Mastoiditis

48
Q

In otitis media with effusion, there is a chronic effusion in the middle ear lasting for how long?

A

> 3 months

49
Q

What type of hearing loss can be caused by otitis media with effusion?

A

Conductive

50
Q

Otitis media with effusion usually resolves within how long?

A

4-6 months

51
Q

What are the main risk factors for obstructive sleep apnoea in children?

A

Obesity, neuromuscular conditions and large adenoids

52
Q

What is the first line investigation for obstructive sleep apnoea in children?

A

Overnight pulse oximetry

53
Q

If results of overnight pulse oximetry are negative for sleep apnoea but symptoms persist, what investigation should be performed?

A

Overnight polysomnography

54
Q

How should children with obstructive sleep apnoea as a result of large tonsils be treated?

A

Adenoidectomy

55
Q

How should children with obstructive sleep apnoea without large tonsils be treated?

A

Overnight non-invasive ventilation

56
Q

What is diagnosed when a child aged between a few months to three years presents with multiple episodes of wheeze associated with URTIs?

A

Transient early wheeze

57
Q

In children who are too young to undergo lung function tests, how is asthma diagnosed?

A

On a trial of bronchodilators- asthma can be diagnosed if there is relief from symptoms

58
Q

What investigation is used to diagnose asthma in older children?

A

Peak expiratory flow rate

59
Q

In children aged under 5, if more therapy is needed for suspected asthma than a SABA alone, what should be started next?

A

Moderate dose ICS (8 week trial)

60
Q

What is always an important differential to keep in mind for children presenting with acute difficulty breathing and wheeze, even in children with known asthma?

A

Anaphylaxis

61
Q

In children with acute severe asthma, how should SABAs be given?

A

10 puffs either through a spacer or a nebuliser

62
Q

Children with acute severe asthma can be discharged from hospital when they are stable for how long between taking their SABA inhaler?

A

4 hours

63
Q

How often can SABA/ipratropium be given in acute severe asthma?

A

Up to every 20 minutes for 1 hour

64
Q

How long should oral steroids be given for in a child with an acute asthma exacerbation?

A

3-5 days

65
Q

Respiratory distress which occurs shortly after birth and appears to improve upon crying, is suggestive of what diagnosis?

A

Choanal atresia

Child Health (10 decks)

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