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Paediatrics > Paediatrics - Respiratory > Flashcards

Paediatrics - Respiratory Flashcards

1
Q

What is it?

2 year old, barking cough, stridor, coryza, temperature

A

Croup - laryngotracheal infection

Differential - epiglottitis

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2
Q

What are the symptoms and treatment of bronchiolitis?

A

Cough, wheeze, viral symptoms, tachypnoea, tachycardia, recession, flared nostrils, poor feeding, crackles
Treatment - supportive

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3
Q

What are the risk factors for developing bronchiolitis?

A

Family smokers, chronic respirtory or cardiac conditions, born premature, immunocompromised

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4
Q

What is bronchiolitis?

A

Infection of the bronchioles - become swollen and full of mucus
Very common in children - 1/3 have it before a year of age

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5
Q

What is the most common causative pathogen of bronchiolitis?

A

RSV (respiratory synctial virus) - 80% of time

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6
Q

What is it?
Child comes in, hyperextended, drooling, increased cappilary refill, stridor, muffled voice
How would you treat this?

A

Epiglottitis
Be very careful with child, do not agitate!
IV antibiotics

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7
Q

What is the main pathogen causing epiglotitis?

A

Hib (haemophilis influenza type B, aerobic diplococci) - decreased since vaccine

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8
Q

What are the treatment steps of chronic childhood asthma?

A
  1. Environment
  2. SABA and ICS
  3. Monteleukast
  4. LABA
  5. Increase ICS
  6. Oral steroids
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9
Q

How do you treat croup?

A

Self-limiting
Steroids - prednisilone, dexamethasone, nebulised budesonide
Occasionally o2, nebulised adrenaline and intubation

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10
Q

What are signs of CF?

A

Neonate - meconium ileus

Older - recurrent chest infections, recurrent wheeze, failure to thrive

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11
Q

How would you treat CF?

A

O2, antibiotics, steroids,
Blocking Na reabsorption - amiloride
Stimulate Cl secretion - adenoside
transplant

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12
Q

What type of inheritance is CF? How common is it?

A

autosomal recessive

1/25 in general public

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13
Q

What is the chronic lung disease of prematurity?

A

needing o2 at 36 weeks or 28 days after birth, decreased lung volume diffusion, decreased alveolar SA defect, increased mortality, recurrent admission

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14
Q

What are some respiratory complications of being born prematurely?

A

lack of surfactant = respiratory distress syndrome surfactant decreased surface tension to prevent alveolar collapse
alveoli absent at 24 weeks
lung damage is worsened by O2, sepsis, ventilation

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15
Q

Name 3 antibiotics used in pneumonia

A

amoxicillin
cefurotxime
cefatamine
beta-lactam

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16
Q

How would you manage epiglottitis?

A

call paediatrician, anaesthetics and ENT surgeon
transfer to ITU - intubate
bloods - culture
IV antibiotics e.g. cefuroxime

17
Q

Name some symptoms of epiglottitis

A 
rapid onset - hours 
no coryza, absent/slight cough 
can't drink 
drool saliva 
> 38.5 temp 
muffled voice 
soft stridor 
appears toxic
18
Q

What is respiratory distress syndrome?

A

lack of surfactant from Type 2 penumocytes results in increased surface tension and alveolar collapse

19
Q

When is it asthma and when is it viral induced wheeze?

A

VIW <5

Asthma >5

20
Q

Name 2 bronchodilators

A

Salbutamol and ipratropium

21
Q

Name 2 steroids to treat acute asthma

A

oral prednisione

IV hydrocortisone

22
Q

What alternative medicines would you use to treat acute asthma?

A

magnesium, aminophylline, salbutamol

23
Q

What would you see on a blood gas in Type 1 respiratory failure?
Name 3 causes

A

low O2 and normal/low CO2

damage to lung tissue (acute hypoxaemic) - pulmonary oedema, pneumonia, ARDS

24
Q

What would you see on a blood gas in Type 2 respiratory failure?
Name 3 causes

A

low O2 and high CO2

failure to ventilate - COPD, GBS, Duchenne’s, opiods, chronic bronchitis

25
Q

What are the symptoms of hypercapnia?

A

CRAB - confusion, reduced consiousness, asterixis, bounding pulse

26
Q

What is the definition of stridor?

A

harsh vibrating noise when breathing, caused by obstruction of windpipe or larynx

27
Q

What is the definition of wheeze?

A

Breathe with a whistling or rattling sound in chest as result of obstruction in air passages

28
Q

What are the main causes of wheeze?

A

Asthma, bronchiolitis, viral induced wheeze, pnuemonia

29
Q

What are the main causes of stridor?

A

Croup, epiglottitis, bacterial tracheitis, diptheria, inhaled foreign body, anaphylaxis

30
Q

What are the signs of respiratory distress?

A

cyanosis, tracheal tug, subcostal/intercostal recession, hypoxia, tachycardia, wheeze, stridor, head bobbing

31
Q

What is palivizumab?

A

monoclonal antibody against RSV - vaccine given once a month during winter to CF, premature, chronic lung disease, immunodeficient

32
Q

What causes pertussis?

A

upper respiratory tract infection - bordetella pertussis - gram negative cocobacilli

33
Q

What causes CF?

A

autosomal recessive gene that alters the cystic fibrosis transmembrane conductance regulatory gene on chromosome 7 - codes for chlorine channels

34
Q

What does ground glass appearance of lungs on a CXR mean?

A

surfactant deficiency - especially common

Surfactant production begins between 24-28 weeks

35
Q

What is bronchiectasis?

A

dilation of bronchioles and poor mucociliary clearance

36
Q

What are the commonest causative organisms of pneumonia in children?

A

steptococcus pneumonia

haemophilis influenza

37
Q

What is an empyema and how would you trest for it?

A

it is a pleural effusion with pus

- pH <7.2, glucose < 3.3

38
Q

What are the levels of acute asthma attack severity and some symptoms?

A

Moderate - o2>92%, RR <30 children >5, can talk normally
Acute severe - o2 <92%, PEF 33-50%, HR >140 in <5s, >125 >5s
Life-threatening - exhaustion, hypotension, cyanosis, silent chest, confusion, PEF <33%, o2 <92%

39
Q

How would you manage an acute asthma attack?

A 
02
salbutamol, terbutaline
ipratropium bromide 
steroids - prednisilone, hydrocortisone 
antibiotics 
LTRA 
nebulised magnesium sulphate
IV salbutamol, aminophylline, magnesium sulphate

Paediatrics (11 decks)

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