Paeds resp

Question 1

what is the most common age to get bronchiolitis

Answer 1

under 2 years- most common 3-6 months

Question 2

what four things are signs that you should diagnose bronchiolitis
what other features could occur (3)

Answer 2

coryzal prodrome (cold symptoms) 1-3 days
persistent dry cough
tachypnoea and/or chest recession
high pitched wheezes and/or fine inspiratory crackles on chest auscultation

hyper inflation of chest
tachycardia
cyanosis/pallor

Question 3

When would you admit to hospital with bronchioloitis (4)

Answer 3

if any of the following are present:
apnoea
O2 sats <92 persistently
inadequate oral fluid intake (50-75% of usual)
severe resp distress (grunting/RR>70/min)

Question 4

What investigations do you do in suspected bronchiolitis

Answer 4

Pulse oximetry

CXR and blood gas only recommended if resp failure

Question 5

What is the main cause of bronchiolitis

Answer 5

RSV (respiratory insitial virus)

Question 6

Other causes of bronchiolitis

Answer 6

adenovirus, rhinovirus, parainfluenza virus, influenza virus

Question 7

Management of bronchiolitis (normal)

Answer 7

Humidified oxygen if sats <92
CPAP if resp failure
chest physio if neuromusc disease
upper airway suctioning if apnoea/severe resp distress/feeding difficulties

Question 8

Mangement of bronchiolitis- resp failure

Answer 8

O2 if <92
CPAP
Upper airway suctioning
IV fluids

Question 9

Management bronchiolitis- feeding issues

Answer 9

O2<92
upper airway suctioning
fluids by naso/gastric tube (IV if cannot tolerate tubes)

Question 10

Recovery time and future implications bronchiolitis

Answer 10

2 weeks- half will have recurrent eps cough and wheeze

Question 11

pathophysiology bronchiolitis

Answer 11

virus= inflamm of lining of epithelial cells in small airways causing increased mucus production, inflammation and necrosis. The inflamed cells can cause obstruction of the airways- wheeze