Paeds

Question 1

Causative agent of bronchiolitis?

Answer 1

Respiratory Syncytial Virus (RSV)

Question 2

Management of bronchiolitis - mild and severe cases?

Answer 2

Supportive

Severe - oxygen, NG feeds, suction, intubation and CPAP

Question 3

Indications for admitting a child with bronchiolitis?

Answer 3

Based on severity:
Severe respiratory distress
Apnoeic episodes, cyanotic
Low intake of fluids, or severely dehydrated

Based on Co-morbidity:
Congenital heart disease
Survivor of extreme prematurity
Significant hypotonia (e.g trisomy 21 - less able to cope with resp compromise)

Question 4

What are the risks of Varicella Zoster in Prenancy?

Answer 4

If mother contracts:
Before 20 weeks - Congenital Varicella Syndrome
After 20 weeks - risk of neonatal zoster when born (reactivation of VZV - shingles )
7 days +/- birth - baby risk of neonatal varicella

Question 5

What are the features of congenital varicella syndrome?

Answer 5

Limb hypoplasia
Microcephaly
Scarring

Question 6

How would you manage a pregnant lady who has come into contact with someone with chicken pox?

Answer 6

Ask if she has had chicken pox before
If no - test IgG status
If negative - GIVE VZIG

Question 7

Can you develop chicken pox after exposure to someone with shingles?

Answer 7

YES

through direct contact