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My Phase 3a Revision > PAEDS RESPIRATORY > Flashcards

PAEDS RESPIRATORY Flashcards

1
Q

RESP OVERVIEW
What are some causes of respiratory infections in children?

A

80-90% viral –
- Respiratory syncytial virus (RSV), rhinoviruses, metapneumovirus, parainfluenza
Bacterial –
- Strep. pneumoniae, h. influenzae, moraxella catarrhalis, bordatella pertussis

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2
Q

RESP OVERVIEW
What are some risk factors for respiratory infections?

A
  • Parental smoking
  • Poor socioeconomic status
  • Male gender
  • Immunodeficiency
  • Underlying lung disease
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3
Q

RESP OVERVIEW
Cough is a very common symptoms with many causes.
What are some of the causes of cough?

A
  • Recurrent colds, allergic rhinitis (post-nasal drip)
  • Infections
  • Reflux (aspiration)
  • Passive smoking
  • CF, bronchiectasis, asthma
  • TB
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4
Q

URTI
What is the most common presentation of an upper respiratory tract infection (URTI)?

A
  • Combination of nasal discharge + blockage
  • Fever, sore throat, earache
  • Cough
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5
Q

URTI
How does coryza present?

A

Clear or mucopurulent nasal discharge + blockage

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6
Q

URTI
What are some complications of URTIs?

A
  • Difficulty feeding + breathing
  • Febrile convulsions
  • Acute exacerbations of asthma
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7
Q

URTI
What is coryza?

A
  • Commonest infection in childhood (rhinoviruses, coronaviruses, RSV)
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8
Q

URTI
What is the management of coryza?

A
  • Conservative (paracetamol, ibuprofen, fluids)
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9
Q

OTITIS MEDIA
How would you investigate otitis media?

A
  • Tympanic membrane bright red + bulging with loss of normal light reflection
  • May be pus visible with hole in TM in acute perforation
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10
Q

LARYNX/TRACHEAL ISSUES
What are laryngeal + tracheal infections characterised by?

A
  • Stridor (rasping sound on inspiration)
  • Hoarseness of voice (inflamed vocal cords)
  • Barking cough
  • Variable degree of dyspnoea
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11
Q

LARYNX/TRACHEAL ISSUES
What are some causes of stridor?

A
  • Croup
  • Epiglottitis
  • Laryngomalacia
  • Inhaled foreign body
  • Tracheitis
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12
Q

LARYNX/TRACHEAL ISSUES
How can the severity of upper airway obstruction be clinically assessed in laryngeal and tracheal infections?

A
  • Chest recession (none, only on crying, at rest)
  • Degree of stridor (none, only on crying, at rest or biphasic)
  • Tracheal tug (none, present)
  • Sternal wall retractions (present or marked)
  • Lethargy or agitation + RD = severe
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13
Q

LARYNX/TRACHEAL ISSUES
What is the main issue with laryngeal and tracheal infections?
How can this be avoided?

A
  • Mucosal inflammation + swelling can rapidly cause life-threatening obstruction
  • Do NOT examine throat, keep calm
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14
Q

CROUP
What is the epidemiology?

A
  • Peak incidence 2y (6m–3y), commonly Autumn
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15
Q

CROUP
What are the causes?

A
  • Parainfluenza viruses (#1), less so RSV, metapneumovirus, influenza
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16
Q

CROUP
What is croup (laryngotracheobronchitis)?

A
  • URTI causing oedema in larynx, oedema of subglottis dangerous (narrow trachea)
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17
Q

CROUP
What is the clinical presentation of croup?

A
  • Initial low grade fever + coryza start and are worse at night
  • Barking (seal-like) cough, harsh stridor + hoarseness
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18
Q

CROUP
When would you admit a patient to hospital?

A
  • Mod-severe croup, <6m or upper airway issues (laryngomalacia)
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19
Q

CROUP
How do you assess croup severity?

A

Westley score for severity
(chest wall retractions, stridor, cyanosis, air entry + consciousness)

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20
Q

CROUP
What are the investigations for croup?

A
  • Clinical but if CXR done PA view shows subglottic narrowing (steeple sign)
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21
Q

CROUP
What is the management of croup?

A
  • PO dexamethasone 0.15mg/kg 1st line, can repeat at 12h
  • Nebulised budesonide (steroid)
  • High flow oxygen + nebulised adrenaline (more severe/emergency cases)
  • Monitor closely with anaesthetist + ENT input, intubation rare
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22
Q

ACUTE EPIGLOTTITIS
What is acute epiglottitis?

A
  • Life-threatening emergency as high risk of obstruction due to intense swelling of epiglottis + surrounding tissues associated with septicaemia
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23
Q

ACUTE EPIGLOTTITIS
What causes it?

A
  • Haemophilus influenza B (HiB), most common 1–6y
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24
Q

ACUTE EPIGLOTTITIS
What is the clinical presentation of acute epiglottitis?

A
  • Rapid onset, no preceding coryza
  • High fever in an ill, toxic looking child
  • Intensely painful throat (can’t drink, speak, drooling saliva)
  • Soft inspiratory stridor with absent or minimal cough
  • ‘Tripod’ position > optimise airway by leaning forward + extending neck
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25
Q

ACUTE EPIGLOTTITIS
What is the investigation for acute epiglottitis?

A
  • Clinical Dx but if CXR done lateral view show epiglottis swelling = thumb sign
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26
Q

ACUTE EPIGLOTTITIS
What is the management of epiglottitis?

A
  • Prevention HiB vaccine, rifampicin prophylaxis for close household contacts
  • Do NOT examine throat, anaethetist, paeds + ENT surgeon input
  • Intubation if severe, may need tracheostomy
  • IV ceftriaxone + dexamethasone given once airway secured
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27
Q

BRONCHIOLITIS
What is the epidemiology of bronchiolitis?

A

90% aged 1–9m,
less common after 1,
common in the winter

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28
Q

BRONCHIOLITIS
What is bronchiolitis?

A
  • Inflammation + infection of bronchioles
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29
Q

BRONCHIOLITIS
What are the causes of bronchiolitis?

A
  • RSV #1, others = adenovirus, metapneumovirus + Mycoplasma
  • Adenovirus associated with bronchiolitis obliterans (perm damage due to scarring, Rx steroids)
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30
Q

BRONCHIOLITIS
What are some risk factors for bronchiolitis?

A
  • Premature babies
  • CHD
  • Cystic fibrosis
  • Immune deficiency
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31
Q

BRONCHIOLITIS
What is the clinical presentation of bronchiolitis?

A
  • Coryzal Sx precede a sharp, dry cough with increasing breathlessness
  • Feeding difficulty associated with increasing dyspnoea
  • Respiratory distress
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32
Q

BRONCHIOLITIS
What are some signs of respiratory distress seen in bronchiolitis?

A
  • Subcostal + intercostal recession, apnoea
  • Hyperinflation of chest
  • Accessory muscles
  • Nasal flaring
  • Fine end-inspiratory crackles
  • Tracheal tug
  • Head bobbing
  • Grunting
  • High pitched wheezes
  • Tachypnoea, tachycardia
  • Low grade fever
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33
Q

BRONCHIOLITIS
What are some investigations for bronchiolitis?

A
  • Nasopharyngeal secretions PCR for RSV (immunofluorescence)
  • CXR may show hyperinflation due to small airways obstruction, air trapping + foetal atelectasis
  • Blood gas (capillary) if severe + ?ventilation > falling O2, rising CO2 + pH
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34
Q

BRONCHIOLITIS
What is the mainstay of management for bronchiolitis?

A
  • Supportive
  • Most recover 2w, some have recurrent episodes of cough + wheeze
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35
Q

BRONCHIOLITIS
What are some criteria for admission?

A
  • Apnoea
  • Severe resp distress (RR>60, marked chest recession, grunting)
  • Central cyanosis
  • SpO2 < 92%
  • Dehydration
  • 50–75% usual intake
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36
Q

BRONCHIOLITIS
What is the inpatient management of bronchiolitis?

A
  • Saline nasal drops
  • Small feed (NG 1st or IV if cannot tolerate)
  • Humidified oxygen via nasal cannula
  • Suction if excessive secretions
  • Assisted ventilation by CPAP or fully mechanical (rare)
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37
Q

BRONCHIOLITIS
What can be given as prevention against bronchiolitis?
Who would be given this?

A
  • Monoclonal Ab to RSV = palivizumab as monthly IM
  • Reduces hospital admissions in high-risk infants (preterm, cystic fibrosis, congenital heart disease)
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38
Q

PNEUMONIA
What is pneumonia?

A
  • Infection + inflammation of the lung parenchyma
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39
Q

PNEUMONIA
What are the common causes of pneumonia in neonates?

A

group B strep (gram -ve enterococci)

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40
Q

PNEUMONIA
What are the common causes of pneumonia in infants + young children?

A

RSV most common,
pneumococcus #1 bacterial,
H. influenzae,
Bordatella pertussis,
chlamydia trachomatis

(S. aureus rarely but = serious)

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41
Q

PNEUMONIA
What are the common causes of pneumonia in children >5?

A

Pneumococcus,
mycoplasma pneumoniae,
chlamydia pneumoniae

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42
Q

PNEUMONIA
What are the common causes of pneumonia in immunocompromised?

A

Pneumocystis jiroveci or TB

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43
Q

PNEUMONIA
What is the clinical presentation of pneumonia?

A
  • Fever + difficult breathing common presenting Sx
  • Often preceded by URTI
  • Productive cough, poor feeding, lethargy
  • Mycoplasma can present extra-pulmonary (erythema multiforme)
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44
Q

PNEUMONIA
What are some clinical signs of pneumonia?

A
  • Tachypnoea + tachycardia - Nasal flaring + chest indrawing, head bobbing
  • End-inspiratory focal coarse crackles
  • Other signs (dull percussion, bronchial breathing) can be absent in young
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45
Q

PNEUMONIA
What are indications for hospital admission?

A
  • SpO2 <92%, severe tachypnoea, grunting, apnoea, not feeding, family unable to provide appropriate care
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46
Q

PNEUMONIA
What are some investigations for pneumonia?

A
  • SpO2 may be low
  • FBC, CRP ± blood cultures + sputum culture
  • CXR to confirm diagnosis
47
Q

PNEUMONIA
How can CXR indicate what the causative organism may be?

A
  • Lobar consolidation (dense white area in a lobe) = pneumococcus
  • Rounded air-filled cavities (pneumatoceles) + multi-lobar = S. aureus
48
Q

PNEUMONIA
What is a complication of pneumonia?

A
  • May have pleural effusion which can lead to empyema
  • Suspect if persistent fever, foul smelling mucus
  • Surgical drainage ± chest drain
49
Q

PNEUMONIA
What is the prophylaxis for pneumonia?

A
  • Prophylaxis PCV vaccine with 13 common pneumococcus serotypes + HiB vaccine
50
Q

PNEUMONIA
What is the management of pneumonia?

A
  • Newborns = IV broad-spec Abx
  • Older = PO amoxicillin with broad-spectrum Abx (co-amoxiclav) if unresponsive or influenza
  • Macrolides (erythromycin) to cover for mycoplasma, chlamydia or if unresponsive
51
Q

VIRAL INDUCED WHEEZE
What is the epidemiology?

A
  • M>F, usually resolves by 5 as airway size increases
52
Q

VIRAL INDUCED WHEEZE
What are the two types of viral induced wheeze?

A
  • Episodic viral = only wheezes when viral URTI + Sx free inbetween
  • Multiple trigger = as well as viral URTIs, other triggers (exercise, smoke)
53
Q

VIRAL INDUCED WHEEZE
What is a wheeze?

A
  • Expiratory, polyphonic breathing sound created by air being forced through narrow air passage
54
Q

VIRAL INDUCED WHEEZE
What are some risk factors?

A

Maternal smoking during/after pregnancy + prematurity

55
Q

VIRAL INDUCED WHEEZE
What causes viral induced wheeze?

A
  • Often decreased lung function from birth from small airway diameter so more likely to narrow + obstruct due to inflammation from viral URTI
56
Q

VIRAL INDUCED WHEEZE
How is it different to asthma?

A
  • Preschool (1-3y),
  • no atopy
  • only during viral infections
57
Q

VIRAL INDUCED WHEEZE
What is the clinical presentation of viral induced wheeze?

A
  • SOB,
  • signs of respiratory distress,
  • widespread expiratory wheeze
58
Q

VIRAL INDUCED WHEEZE
What is the management?

A

1st line = PRN salbutamol
2nd line = Montelukast or ICS or both

59
Q

ASTHMA
What is asthma?

A
  • Chronic inflammatory airway disease causing episodic exacerbations of bronchoconstriction due to smooth muscle contraction of the airways (bronchi)
60
Q

ASTHMA
how does acute asthma present?

A

Worsening dyspnoea,
use of accessory muscles,
tachypnoea,
symmetrical expiratory wheeze,
reduced air entry

61
Q

ASTHMA
What are the characteristics of asthma?

A
  • Airflow limitation due to bronchospasm (reversible spontaneously or with Tx)
  • Airway hyperresponsiveness to various triggers
  • Bronchial inflammation
62
Q

ASTHMA
What is the consequence of bronchial inflammation?

A
  • Oedema
  • Excessive mucus production
  • Infiltration with cells (eosinophils, mast cells, neutrophils, lymphocytes)
63
Q

ASTHMA
What are some risk factors for asthma?

A

LBW, FHx, bottle fed, atopy, male, pollution

64
Q

ASTHMA
What are the 2 main classifications of asthma?

A

Allergic/atopic asthma –
- T1 hypersensitivity IgE mediated reaction (mast cells + histamine)
- PMH/FHx of atopy (eczema, hayfever, food allergies), persistent Sx
Non-allergic asthma –
- Idiopathic but triggers

65
Q

ASTHMA
What are some triggers of non-allergic asthma?

A
  • Smoking, allergens, exercise, cold/damp air, animals, beta-blockers, NSAIDs, occupations
66
Q

ASTHMA
What is the clinical presentation of asthma?

A
  • Dry cough, SOB, chest tightness
  • Bilateral widespread polyphonic wheeze
  • Episodic Sx with diurnal variability (worse at night + early morning)
67
Q

ASTHMA
What are some investigations for asthma?

A
  • Clinical Dx (RCP3 Qs)
  • FBC = eosinophilia (atopy)
  • Fractional exhaled nitric oxide >40ppb = inflamed airways
  • Peak expiratory flow rate diary
  • Spirometry
  • Atopy (skin prick or IgE showing ≥1 allergen + constant wheeze)
  • ?CXR to exclude other causes (hyperinflation)
68
Q

ASTHMA
What are the RCP3 questions and what are they used for?

A

Assessing asthma severity
– Recent waking in the night?
– Usual asthma Sx in the day?
– Interference with ADLs?

69
Q

ASTHMA
What is purpose of a peak expiratory flow rate diary?

A
  • 2 readings a day will show diurnal variation >20% on ≥3d/week
  • Will show bronchodilator responsiveness too
70
Q

ASTHMA
What is the purpose of spirometry?

A
  • Obstructive pattern = FEV1 <80%, FEV1/FVC < 70%
  • Bronchodilator responsiveness = FEV1 ≥12% improvement
71
Q

ASTHMA
What is some conservative management for asthma?

A
  • Inhaler technique
  • Avoid triggers
  • Monitor peak flow diary
  • Yearly flu jab + asthma review
  • Asthma self-management programme
72
Q

ASTHMA
Name 6 potential treatments that can be used in asthma

A
  • SABA = salbutamol, terbutaline “reliever”
  • ICS = beclomethasone “preventer”
  • LABA = salmeterol, formoterol
  • Leukotriene receptor antagonists = montelukast
  • Theophylline = aminophylline
  • Maintenance + reliever therapy = combined low dose ICS + fast acting LABA
73
Q

ASTHMA
What is the mechanism of action for SABAs?

A
  • Adrenaline acts on smooth muscles of airways > dilation,
  • acts fast but lasts only few hours
74
Q

ASTHMA
What are the important side effects of SABAs?

A

Hypokalaemia,
tremor

75
Q

ASTHMA
What is the mechanism of action for ICS?

A

Reduces inflammation + reactivity of airways

76
Q

ASTHMA
What are the important side effects of ICS?

A

Oral thrush,
adrenal + growth suppression,
DM,
osteoporosis

77
Q

ASTHMA
What is the mechanism of action for LABA?

A

Same as SABA but longer effects, useful in exercise-induced asthma

78
Q

ASTHMA
What is the mechanism of action for LTRA?

A

Leukotrienes produced by immune system > inflammation, bronchoconstriction + mucous secretion in airways so blocks this

79
Q

ASTHMA
What is the mechanism of action for MART?

A

Replaces all other inhalers as preventer + reliever

80
Q

ASTHMA
What is the mechanism of action for theophyllines?

A

Relaxes bronchial smooth muscle + reduces inflammation

81
Q

ASTHMA
What are the important side effects of theophylline?

A

Vomiting,
insomnia,
headaches

82
Q

ASTHMA
What is the stepwise management of chronic asthma in <5y? (BTS guidance)

A
  • 1 = PRN SABA
  • 2 = Low dose ICS OR PO montelukast
  • 3 = Other option from 2
  • 4 = refer to specialist
83
Q

ASTHMA
What is the stepwise management of chronic asthma >5y? (BTS guidance)

A
  • 1 = PRN SABA
  • 2 = SABA + low dose ICS
  • 3 = SABA + low dose ICS + LABA (only continue if good response)
  • 4 = increase ICS dose (?LTRA or PO theophylline)
  • 5 = PO steroids in lowest tolerated dose
  • May need immunosuppression or immunomodulation therapy with specialist referral
84
Q

ASTHMA
What is the management of asthma in <5 year olds (NICE guidance)

A
  1. PRN SABA
  2. SABA + 8 week trial of moderate ICS
  3. SABA + low ICS + LTRA
  4. Stop LTRA and refer to specialist
85
Q

ASTHMA
What is the management for children >5yrs old? (NICE guidance)

A
  1. SABA
  2. SABA + low dose ICS
  3. SABA + low dose ICS + LTRA
  4. SABA + low dose ICS + LABA
  5. SABA + MART (including low dose ICS)
  6. SABA + MART (including mod dose ICS) / LABA + moderate dose ICS
  7. SABA + high dose ICS / theothylline + refer to specialist
86
Q

ASTHMA
What are some reasons for failure to respond to treatment for asthma?

A

ABCDE –
- Adherence (#1)
- Bad disease (dose inadequate for severity)
- Choice of drug/device (different pts respond differently)
- Diagnosis (?correct)
- Environment (?trigger)

87
Q

ASTHMA
What is acute asthma?
What can cause it?

A
  • Acute exacerbation of asthma characterised by rapid deterioration in Sx
  • Any of typical asthma triggers
88
Q

ASTHMA
What is classed as a severe asthma exacerbation?

A
  • PEFR 33–50% predicted
  • Unable to complete full sentences
  • RR>50 (2-5y), or >30 (>5y)
  • HR >130 (2-5y) or >120 (>5y)
  • Signs of resp distress (chest recessions)
  • SpO2 <92%
89
Q

ASTHMA
What is classed as a life-threatening asthma exacerbation?

A
  • PEFR 33% predicted
  • Exhaustion/cyanosis
  • Poor respiratory effort
  • Altered consciousness, hypotension
  • Silent chest (airways so tight no air entry)
  • SpO2 <92%
90
Q

ASTHMA
What are some investigations for exacerbation of asthma?

A
  • Monitor RR, peak flow, SpO2, chest auscultation
  • ECG monitoring for arrhythmias (low K+ from SABA + steroids)
  • ABG = initial resp alkalosis as tachypnoea causes drop in CO2, normal pCO2 or hypoxia concerning as indicates exhaustion, resp acidosis from high CO2 very bad sign
91
Q

ASTHMA
What is the management of exacerbations of asthma?

A

O SHIT ME –
- Oxygen (SpO2 94–98%)
- Salbutamol (spacer or neb B2B, IV if no response to this + ipratropium as 2nd line)
- Hydrocortisone IV or PO pred
- Ipratropium bromide (neb if poor response to salbutamol)
- Theophylline (IV)
- Magnesium sulfate (IV)
- Escalate early > ICU if not improving for ventilation ± intubation

92
Q

CYSTIC FIBROSIS
What is cystic fibrosis?

A
  • Mutation in gene encoding cystic fibrosis transmembrane conductance regulator (CFTR) on chromosome 7 which is a cAMP dependent Cl- channel on cell membranes of lungs, pancreas, GI + reproductive tract
93
Q

CYSTIC FIBROSIS
What is the pathophysiology of cystic fibrosis?

A
  • Decreased Cl- excretion into airway lumen + increased reabsorption of Na+ into epithelial cells means less excretion of salt (+ so water) > increased viscosity of airway secretion
94
Q

CYSTIC FIBROSIS
What is the impact of cystic fibrosis in the various parts of the body?

A
  • Thick pancreatic + biliary secretions = blockage of ducts > lack of digestive enzymes in GI tract
  • Lungs = reduction in air surface liquid layer + impaired ciliary function = reduced airway clearance, bacterial colonisation + infections
  • Abnormal function of sweat glands = Na+ + Cl- in sweat (saltier)
95
Q

CYSTIC FIBROSIS
What is the aetiology and epidemiology of cystic fibrosis?

A
  • Autosomal recessive condition
  • Most common mutation is deltaF508 deletion, more commonly in caucasians
  • 1 in 25 carriers + 1 in 2500 have CF
96
Q

CYSTIC FIBROSIS
How does cystic fibrosis present in neonates?

A
  • Meconium ileus (SBO from thick intestinal secretions)
  • Failure to thrive, malabsorption, steatorrhoea
  • Prolonged neonatal jaundice
  • Recurrent chest infections
97
Q

CYSTIC FIBROSIS
What is meconium ileus?
How does it present on imaging?

A
  • Not passing meconium in 24h, vomiting + abdo distension
  • Meconium pellets + microcolon on contrast enema
  • AXR will show dilated loops of bowel
98
Q

CYSTIC FIBROSIS
How does cystic fibrosis present in young children?

A
  • Chronic cough with thick sputum production
  • Bronchiectasis
  • Rectal prolapse
  • Nasal polyps + sinusitis
99
Q

CYSTIC FIBROSIS
How does cystic fibrosis present in older children + adolescents?

A
  • DM (pancreatic insufficiency)
  • Cirrhosis + portal HTN
  • Distal intestinal obstruction
  • Pneumothorax or recurrent haemoptysis
  • Sterility in males as absent vas deferens
100
Q

CYSTIC FIBROSIS
What are some signs of cystic fibrosis?

A
  • Low weight or height on growth charts
  • Hyperinflation due to air trapping
  • Coarse inspiration crepitations ± expiratory wheeze
  • Finger clubbing
101
Q

CYSTIC FIBROSIS
What are some complications of cystic fibrosis?

A
  • Respiratory tract infections
  • Cholesterol gallstones
  • Malabsorption + maldigestion due to pancreatic insufficiency (failure to thrive, steatorrhoea)
  • Biggest cause of death is respiratory failure
102
Q

CYSTIC FIBROSIS
What are some typical causes of respiratory tract infections in cystic fibrosis?

A
  • S. aureus
  • H. influenzae
  • Pseudomonas aeruginosa
  • Bulkholderia cepacia associated with increased morbidity + mortality
103
Q

CYSTIC FIBROSIS
What are some investigations for cystic fibrosis?

A
  • Guthrie test = raised immunoreactive trypsinogen
  • Sweat test = gold standard
  • Low faecal elastase = pancreatic insufficiency
  • Genetic testing for CFTR gene during pregnancy with amniocentesis or CVS
104
Q

CYSTIC FIBROSIS
What is the sweat test?
What result is diagnostic?

A
  • Pilocarpine on patch of skin, attach electrodes + induces sweat
  • Diagnostic Cl- >60mmol/L (normal 1–30mmol/L)
105
Q

CYSTIC FIBROSIS
Who is involved in the care of a patient with cystic fibrosis?

A
  • Resp paeds + GP
  • Physio
  • Specialist nurses
  • Dietician
  • Genetic counsellor for family
106
Q

CYSTIC FIBROSIS
How is the respiratory aspects of cystic fibrosis managed?

A
  • Chest physio ≥BD for airway clearance
  • Rescue Abx when needed (may have portacath) + long-term prophylactic flucloxacillin (S. aureus) –avoid other CF pts
  • Bronchodilators
  • Nebulised hypertonic saline
  • Nebulised DNase
  • Oxygen + CPAP
  • Heart + lung transplant
107
Q

CYSTIC FIBROSIS
What is DNase?

A
  • Enzyme that can break down DNA material in respiratory secretions to decrease sputum viscosity + increase clearance
108
Q

CYSTIC FIBROSIS
What is the nutritional management of cystic fibrosis?

A
  • High calorie, high fat diet
  • Pancreatic enzyme replacement therapy (Creon) with all food
  • Gastrostomy for overnight feeding
  • Fat soluble (ADEK) vitamins
109
Q

SLEEP BREATHING ISSUES
What is the management of sleep related breathing disorders?

A
  • Adeno-tonsillectomy (if adeno-tonsillar hypertrophy) often curative
  • Nasal or facemask CPAP or BiPAP may be required at night
110
Q

RESP PHARMACOLOGY
Give an example of a SABA

A

Salbutamol

111
Q

RESP PHARMACOLOGY
Give an example of a LABA

A

Salmeterol

112
Q

RESP PHARMACOLOGY
Give an example of a LAMA

A

tiotropium

113
Q

RESP PHARMACOLOGY
Give an example of an LTRA?

A

montelukast

114
Q

RESP PHARMACOLOGY
Give an example of an ICS

A

Beclometasone

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