Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A TO REVISE - PHASE 3A > PAEDS RESPIRATORY TO DO > Flashcards

PAEDS RESPIRATORY TO DO Flashcards

1
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

BRONCHIOLITIS
What are some risk factors for bronchiolitis?

A
  • Premature babies
  • CHD
  • Cystic fibrosis
  • Immune deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
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?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ASTHMA
What are the important side effects of SABAs?

A

Hypokalaemia,
tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ASTHMA
What is the stepwise management of chronic asthma in <5y?

A
  1. SABA
  2. SABA + 8-week trial of MODERATE dose ICS
  3. SABA + LOW dose ICS + LTRA
  4. stop LTRA and refer to paeds asthma specialist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ASTHMA
What is the stepwise management of chronic asthma >5y?

A
  1. SABA
  2. SABA + LOW dose ICS
  3. SABA + ICS + LTRA
  4. SABA + ICS + LABA
  5. SABA + MART (includes LOW dose ICS)
  6. SABA + MART (includes MODERATE dose ICS) / SABA + MODERATE dose ICS + LABA
  7. SABA + HIGH dose ICS/theophylline and seek advise from expert
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
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%
17
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
18
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

19
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
20
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
21
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
22
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
23
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
24
Q

CROUP
How do you assess croup severity?

A

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

25
Q

PNEUMONIA
What are indications for hospital admission?

A
  • SpO2 <92%, severe tachypnoea, grunting, apnoea, not feeding, family unable to provide appropriate care
26
Q

ASTHMA
What are some risk factors for asthma?

A

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

27
Q

VIRAL INDUCED WHEEZE
What are some risk factors?

A

Maternal smoking during/after pregnancy + prematurity

28
Q

VIRAL INDUCED WHEEZE
What is the management?

A

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

29
Q

VIRAL INDUCED WHEEZE
How is it different to asthma?

A
  • Preschool (1-3y),
  • no atopy
  • only during viral infections
30
Q

ASTHMA
What is the mechanism of action for ICS?

A

Reduces inflammation + reactivity of airways

31
Q

ASTHMA
What is the mechanism of action for theophyllines?

A

Relaxes bronchial smooth muscle + reduces inflammation

32
Q

ASTHMA
What are the important side effects of ICS?

A

Oral thrush,
adrenal + growth suppression,
DM,
osteoporosis

33
Q

ASTHMA
What are the important side effects of theophylline?

A

Vomiting,
insomnia,
headaches

34
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)

35
Q

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

A

Pneumococcus,
mycoplasma pneumoniae,
chlamydia pneumoniae

A TO REVISE - PHASE 3A (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions