Paeds- resp

Question 1

Dosage of antenatal steroid prophylaxis in PTL

Answer 1

Beclamethasone 12mg

2 doses given 24 hours apart

Question 2

Clinical signs of respiratory distress syndrome

Answer 2

RR>60
Cyanosis
Grunting
Chest wall recession

Question 3

Management of RDS

Answer 3

1) OXYGEN - incubator (nasal CPAP)
2) Homeostasis - RADIANT WARMER monitor glucose, U+Es, VBC, IV nutrition
3) SURFACTANT THERAPY - via TRACHEAL TUBE
4) ABX

Question 4

Otitis media - presentation

Answer 4

Fever, coryza

Ear: pain/pulling/popping/fullness

Question 5

Appearance of otoscope in otitis media

Answer 5

Red
bright + bulging
Loss of normal light reflection

Question 6

Presentation of otitis externa

Answer 6

Swelling + pain on jaw movement = thick discharge

Question 7

Complications of otitis media

Answer 7

Perforated tympanic membrane
Spread to brain
Febrile convulsions

Question 8

Mx of otitis media for all children

Answer 8

Analgesia + warm compress

Question 9

Otoscopy appearance of glue ear

Answer 9

Dull + retracted eardrum
Loss of light reflex
Visible fluid level1!!

Question 10

Ix for otitis media w effusion (glue ear) + results?

Answer 10

Tympanometry (soft sensor in ear and air pressure is measured) –> flat trace

Pure tone audiometry if >4yo –> conductive hearing loss

Question 11

ImpDDx for pharyngitis and tonsilitis

Answer 11

Epiglottitis
Kawasaki’s
Scarlet fever
Infectious mononucleosis

Question 12

Centor criteria

Answer 12

1) absence of cough
2) exudates on tonsils
3) Fever
4) Tender anterior cervical LNs

Question 13

Abx therapy for tonsilitis

Answer 13

Phenoxymethylpenicillin for 10 days

Question 14

When to consider abx for tonsillitis/pharyngitis

Answer 14

Centor =3
immunocompromised
DM
Hx of rheumatic fever

Question 15

When to refer for tonsillectomy

Answer 15

>5 episodes/year
FTT
Disruption to ADLs
Sleep apnea/daytime drowsiness
Sx >1 year

Question 16

Pertussis Mx

Answer 16

Erythromycin in first 21 days
Erythromycin + vaccination to close contacts
PHE -notifiable illness

Question 17

Epiglottitis = mx of contacts

Answer 17

rifampicin

Question 18

Complications of sinusitis

Answer 18

CNS spread –> vomiting

Orbital spread –> visual changes

Question 19

mx of sinusitis

Answer 19

analgesia
topical decongestant
warm face packs
FLUIDS

+/- 7 days amoxicillin

Question 20

Mx of CF initially

Answer 20

RESP: physio + Abx prophylaxis + vaccinations + annual flu jab
+ Nebulised aentispeudomonal abx + DNAse
(ultimately, transplant)

NUTRITION:

• high cal diet + overnight feeding via gastrostomy
• Creon!!!!
• Vit ADEK

PSYCH support

Question 21

Later complications of CF

Answer 21

DM
Liver failure
DIOS
Pneumothorax + haemoptysis
Male infertility