Brainscape's Knowledge GenomeTM

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


See full index

Year 4 Paediatrics > Paediatric Respiratory Problems > Flashcards

Paediatric Respiratory Problems Flashcards

1
Q

What is apnoea

A

Transient breathing cessation

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

Causes of apnoea

A

Prematurity

Obstructive sleep apnoea

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

Treatment of apnoea in neonates

A

Caffeine - stimulates the respiratory centre in the brain - stopped at 34 weeks

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

Causes of breathlessness in children

A 
Asthma 
Viral wheeze 
Bronchiolitis 
CF 
URTI 
Pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes or cough in children

A 
Bronchiolitis 
Croup 
Pneumonia 
URTI
Respiratory distress in neonates 
Foreign body 
Whooping cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of cyanosis in children

A

Cyanotic heart conditions - tetrology of fallot, transposition of the great arteries, total anomalous pulmonary artery drainage, tricuspid atresia

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

Causes of stridor in children

A

Laryngomalacia - most common cause
Croup
Acute epiglottitis

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

Wheeze in children

A 
Viral induced wheeze 
LRTI - Bronchiolitis
Asthma 
Foreign body 
Cystic fibrosis 
Ciliary dyskinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Presentation of asthma

A 
Wheeze 
Reduced exercise tolerance 
Worse when sleeping 
Associated with atopy 
SOB 
Chest tightness
Dry cough  
Respiratory distress 
Diurnal variability

(Diagnosed at 5 yo)

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

Investigations for asthma

A
  1. Spirometry with bronchodilator reversibility
  2. FeNO2 > 35ppb
  3. Peak expiratory flow variability
  4. Challenge testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of asthma for under 5yo

A
  1. Salbutamol
  2. Low dose ICS
  3. Montelukast
  4. Refer to specialist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features of severe asthma

A 
Inability to complete sentences 
Peak flow - 50 - 33% of normal 
Oxygen > 93% 
RR > 40 in 1 - 5 years or 30 in > 5yo 
HR - 140 in 1- 5 years or 125 in > 5yo 
Cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Features of life threatening asthma

A 
Silent chest 
Peak flow - less than 33% of normal
Cyanosis 
Saturations < 92% 
Hypotension 
Altered consciousness or confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of severe asthma

A
  1. Nebulised salbutamol
  2. Oral prednisolone/ IV hydrocortisone
  3. Oxygen
  4. Ipratropium bromide
  5. Magnesium sulphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Presentation of bronchiectasis

A

Recurrent chest infections

Chronic cough

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

Investigations for bronchiectasis

A

CT scan - signet ring sign

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

Management of bronchiectasis

A

Ensure adequate feeding - NGT or IV may be required
Supplementary oxygen if sats < 92%
Ventilation if required

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

Presentation of bronchiolitis

A 
Wheeze 
Crackles on auscultation 
Fever 
Coryzal symptoms 
Mucous
Signs of RDS 
Dyspnoea 
Tachypnoea 
Poor feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Investigations for bronchiolitis

A

Chest auscultation - crackles

Capillary blood gases from toe - if severe respiratory distress

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

Management of bronchiolitis

A

Supportive - oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features of cystic fibrosis

A

Crackles in chest
Chronic cough
Thick pancreatic and biliary secretions - Failure to thrive and pancreatitis - steatorrhoea
Thick aiway secretions - Recurrent chest infections
Congenital bilateral abscence of the vas deferens - Infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complications of cystic fibrosis

A

Meconium ileus
Diabetes
Malnutrition

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

Investigations for cystic fibrosis

A

Heel prick test - newborn bloodspot test
Sweat test - gold standard
Genetic testing - amniocentesis or chorionic villous sampling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Management of cystic fibrosis

A 
2-3 times a day - physiotherapy massage 
Exercise 
High carbohydrate, high fat diet 
Enzymes (creon) and vitamins given
Prophylactic antibiotics - flucloxacillin 
Vaccinations 
Nebulised saline, DNase 
Salbutamol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lower respiratory tract infections

A

Bronchiolitis

Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Causative organism of bronchiolitis

A

Respiratory syncytial virus

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

Causative organism of pneumonia in different age groups

A

Haemophilus influenza
Streptococcus pneumonia
Mycoplasma or chlamydia

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

Presentation of pneumonia

A 
High Fever 
Secretions 
Cough - wet and productive 
Crackles in chest - focal and course 
Dull to percuss 
Bronchial breathing 
SOB 
Tachycardia 
Lethergy 
Delirium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Investigations for pneumonia

A

Respiratory exam
Chest X ray - not required but can be helpful
Sputum culture
Capillary blood gas

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

Management of pneumonia

A

Haemophilus influenza - Co- amoxiclav
Streptococcus pneumonia - Amoxicillin
Mycoplasma or chlamydia - erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Presentation of obstructive sleep anoea

A
  • difficulty sleeping - increased naps during the day
  • fatigue
  • lack of concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Chronic cough

A

8 + weeks

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

Causes of chronic cough

A

Persistent bacterial bronchitis
Recurrent aspiration
Bronchiectasis
Cystic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Persisted bacterial bronchitis features

A
  1. Wet cough > 4 weeks
  2. Absence of other signs, symptoms and causes
  3. Responds to abx - co - amoxiclav 2 wks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Causes of obstructive sleep apnoea

A

Obesity - metabolic disorder
Adenotonsillitis
Allergic rhinitis
Down syndrome

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

Features of viral induced wheeze

A

Bronchoconstriction which responds to inhalers
Due to rhinovirus type C
Allergy to virus - wheeze triggered by virus
Symptoms of a cold and RDS
FHx

37
Q

How to perform a bronchodilator reversibility test

A
  1. 4 puffs of salbutamol via spacer and MDI
  2. Repeat spirometry after 10 - 15 mins
  3. Increase in absolute FEV1 of > 12% is positive
38
Q

How to do a FeNO2 test

A
  1. Empty lungs
  2. Close lips around the mouth piece
  3. Inhale deeply untill full
  4. Exhale slowly through a filter as a constant pace
  5. Need 10 seconds of exhalation
39
Q

Positive FeNO2 test

A

> 40 ppb - adults

> 35 ppb - children

40
Q

Challenge testing

A

Direct - use methacholine or histamine to assess drop in lung function

Indirect - exercise, mannitol inhalation, cold

41
Q

What is bronchiolitis?

A

Inflammation of the bronchioles caused by respiratory syncytial virus

42
Q

Which age group is most susceptible to bronchiolitis

A

6 months - 1 year

43
Q

Signs of respiratory distress

A 
Tachypnoea > 60bpm 
Use of accessary muscles 
Intercostal and subcostal recessions 
Nasal flaring 
Head bobbing 
Tracheal tug 
Cyanosis 
Abnormal airway noises - wheeze, grunting or stridor
44
Q

Typical course of bronchiolitis

A 
Starts with URTI with coryzal symptoms
1 - 2 days - chest symptoms
Symptoms worse on day 3 - 4 
Last 7 - 10 days 
Most patients recover in  2 - 3 weeks
45
Q

When to admit a child

A

Aged under 3 months with a fever
Pre - existing condition such as CF, Down syndrome or prematurity
50 - 75% less of their normal milk intake
Clinical dehydration
Resp rate > 70 bpm
Moderate to severe respiratory distress - grunting, head bobbing, recessions
Apnoea

46
Q

Positive end expiratory pressure (PEEP)

A

High flow humidified oxygen via a nasal cannula which delivers continuous oxygen and pressure to oxygenate the lungs and prevent the airways from collapsing

47
Q

Continuous positive airway pressure

A

Sealed nasal cannula which delivers higher controlled pressure of oxygen

48
Q

Palivizumab

A

A monoclonal antibody that targets RSV given as a monthly injection to high risk patients to prevent bronchiolitis in ex premature infants or patients with congenital heart disease

49
Q

Difference between viral induced wheeze and bronchiolitis

A

Viral induced wheeze causes bronchoconstriction and can be treated with inhalers

50
Q

At which age are you more susceptible to viral induced wheeze?

A

3 - 5 years old

51
Q

Presentation of viral induce wheeze

A

Tachypnoea
Respiratory distress
Wheeze

52
Q

Management of viral induced wheeze

A

Salbutamol inhaler
Oxygen if required
NGT or IV if required for feeding

53
Q

Asthma discharge plan

A

Weaning inhalers - 6 puffs 4 hourly
Finish course of steroids (3 days)
Safety netting
Individualised asthma action plan

54
Q

Managemnt for asthma in 5 - 12yo

A
  1. Salbutamol
  2. Low dose ICS
  3. Montelukast
  4. Long acting beta agonist
  5. Medium dose ICS + LABA - MART
  6. High dose ICS
55
Q

Side effects of inhalers

A
  • ICS slightly reduce growth velocity by max 1cm, dose dependent
56
Q

MDI technique with a spacer

A
  1. Assemble the spacer
  2. Shake the inhaler
  3. Attach the inhaler to the correct end
  4. Lift the chin slightly up, can sit or stand
  5. Make a seal around the mouthpiece
  6. Spray dose
  7. Take 5 normal breaths
57
Q

Spacer care

A
  • cleaner once a month
  • avoid scrubbing
  • air dry
58
Q

Age range susceptible to croup

A

6 months to 2 years

59
Q

Croup pathophysiology

A

URTI causing oedema in the larynx due to parainfluenza virus

60
Q

Presentation of croup

A 
Increased work of breathing 
Barking cough 
Hoarse voice 
Stridor 
Low grade fever
61
Q

Management of croup

A
  1. Oral Dexamethasone
  2. Oxygen if required
  3. Nebulised budesonide
  4. Nebulised adrenaline
  5. Ventilation and intubation
62
Q

Acute epiglottitis pathophysiology

A

Inflammation and swelling of the epiglottis caused by haemophilus influenza B

63
Q

Presentation of acute epiglottitis

A 
Sore throat 
Stridor 
Drooling 
Tripod position - leaning forward 
High fever 
Painful swallowing,  not moving head
64
Q

Investigations of acute epiglottitis

A

Do not examine throat!

Lateral Xray of the neck - thumb sign

65
Q

Management of acute epiglottitis

A

Alert senior paediatrician and anaesthetist
May need intubation or tracheostomy

IV abx - ceftriaxone
Steroids - dexamethasone

66
Q

Causative organism of whooping cough

A

Bordetella pertussis - gram negative

67
Q

Investigations for whooping cough

A

Nasopharyngeal swab and PCR
Bacterial culture

If cough for 2 weeks - anti pertussis toxin IgG from saliva or blood

68
Q

Complications of whooping cough

A

Bronchiectasis

69
Q

Chronic lung disease of prematurity features

A

Bronchopulmonary dysplasia in premature babies at 28 weeks gestation

  • RDS
  • require oxygen, intubation and ventilation at birth
70
Q

How a diagnosis of chronic lung disease of prematurity is made

A

Chest Xray changes

Still requiring oxygen therapy after 36 weeks gestational age

71
Q

Presentation of chronic lung disease in prematurity

A 
Low oxygen saturations
Increased work of breathing
Poor feeding and weight gain
Crackles and wheezes on chest auscultation
Increased susceptibility to infection
72
Q

Prevention of chronic lung disease of prematurity

A

Give corticosteroids to mothers that show signs of premature labour at less than 36 weeks gestation can stimulate surfactant production by type II pneumocytes

  • Use CPAP rather than intubation and ventilation
  • Using caffeine to stimulate the respiratory effort
  • Not over-oxygenating with supplementary oxygen
73
Q

Management of chronic lung disease of prematurity

A

Formal sleep study - assesses o2 sats
Oxygen at home via nasal cannula
Monthly palivizumab injection - protects against RSV

74
Q

Cystic fibrosis gene mutation

A

Chromosome 7 - CFTR

Autosomal recessive

75
Q

Meconium ileus presentation

A

Not passing meconium in first 24 hours
Abdominal distension
Vomiting

76
Q

Signs of cystic fibrosis

A 
Low weight or height on growth charts 
Nasal polyps 
Finger clubbing 
Crackles and wheezing 
Abdominal distention
77
Q

Causes of clubbing in children

A 
Cyanotic heart disease 
Infective endocarditis 
Cystic fibrosis 
TB 
Inflammatory bowel disease 
Liver cirrhosis
78
Q

Causative organisms of LRTI in patients with cystic fibrosis

A

Staphylococcus aureus - take prophylactic flucloxacillin

Pseudomonas aeruginosa - ciprofloxacin

79
Q

Monitoring cystic fibrosis

A

Specialist clinic visits every 6 months

  • Sputum culture
  • Screening for diabetes, osteoporosis, vitamin D deficiency and liver failure
80
Q

Primary cilia dyskinesia features

A

Autosomal recessive
Common in consanguinity

Respiratory cilia - mucus accumulation and recurrent chest infections

Fallopian tubes - infertility

81
Q

Complications of primary ciliary dyskinesia

A

Bronchiectasis
Recurrent chest infections
Failure to thrive

82
Q

Kartageners triad

A

(Due to PCD)

Situs invertus
Paranasal sinusitis
Bronchiectasis

83
Q

Diagnosis of primary ciliary dyskinesia

A

Nasal brushing or bronchoscopy - microscopy of ciliated epithelium of the upper airway

84
Q

Management of primary diliary dyskinesia

A

Regular physiotherapy massages
High calorie diet
Vaccinations
Prophylactic antibiotics - flucloxacillin

85
Q

Causes of bronchiectasis

A

Cystic fibrosis

Whooping cough

86
Q

Mild croup

A

Seal-like barking cough
No stridor
No sternal/intercostal recession at rest

87
Q

Moderate Croup

A

Seal-like barking cough
Stridor and sternal recession at rest
No (or little) agitation or lethargy

88
Q

Severe croup

A

Seal-like barking cough
Stridor and sternal/intercostal recession
Agitation or lethargy

89
Q

Impending respiratory failure

A

Minimal barking cough
Stridor may become harder to hear
Increasing upper airway obstruction
Sternal/intercostal recession
Asynchronous chest wall and abdominal movement
Fatigue, pallor or cyanosis, decreased level of consciousness or tachycardia.

RR > 70 breaths/minute - severe respiratory distress.

Year 4 Paediatrics (19 decks)

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