Paeds Revision Lecture 1 Flashcards
Resp distress + wheeze at 3 months
Brochilolitis (2-6months)
Viral induced wheeze
inhaled foreign upper body
Invs
Nasopharygeal aspirate
Obs + Sats
CXR (high threshold)
VBG if not responding
CXR
No focal area
Hyper-inflated + patchy
Mgmt
Most managed at home
Hospital if:
- feeding < 50% normal, lethargy, significant tachypnoea, grunting, cyanosis, sats < 94%
→ Oxygen, nasogastric feeds
what is a vapotherm?
Oxygen deliveryHeated humidified high-flow (HHHF) therapy is a type of respiratory support method that delivers a high flow (liters per minute) of medical gas to a patient through an interface (nasal cannulae) intended to create a wash-out of the upper airway.
Prognosis
lasts 7-10 days
most make full recovery
mortality is higher with underlying heart & lung disease
immunoprophylaxis is available for certain groups.
Croups signs
Resp distress, fever, inspiratory noises at rest, loud-barking cough
Croups what is it
upper RTI, parainfluenza, 6months-3 years
Tx
Dexamthasone last 3-7 days consider hospital admission if - poor oral intake - age < 6 months - severe obstruction - immunocompromised
Keep upright, minimise stress, give O2 to keep sats > 93%, nebuliser adrenaline
FFT + recurrent chest infections D.D
CF, PCD, immunodeficiency
Perinatal presentation of CF
Screening
meconium lieu
prolonged jaundice
haemorrhagic disease
Infancy and childhood
Recurrent LTU FTT malabsorbtion rectal prolapse nasal polyps acute pancreatitis
Signs of CF
Clubbing, cough, purulent sputum, crackles, wheeze, obstructive FEV1.
Mgmt
Tertiary CG centre.
Resp problems: Chest physio, saline nets, regular sputum samples, prophylactic abx
Pancreatic insufficiency & nutrition
Creon (pancreatic enzymes), vitamin supplements (fat soluble)
Estimated survival is 40-50yrs
Complication
Cor pulmonale (bronchiectasis - pulmonary hypertension - heart failure + resp failure_
Acute SOB, RR 42, HR 138. How she would assessed
ABCDE
Asthma symptoms.
Key questions
interval symptoms!! Symptoms between attacks
- Dry cough
- Wheee
- Chest tightness
- Breathing difficulty
- affect on school, sleep, exercise
- Admissions to hospital
- how often using blue inhaler
acute management of asthma
Oxygen, inhaled/nebs B2 agonist (need more than two consider ipratropium)
early steroids
- MgSO4
→ IVs (salbutamol, aminophylline) & consider critical care review
What is the conc of chloride which is diagnostic of CF
> 60mmol/L
Side effect of inhaled steroids
- oral thrush
- growth stunting (long term) - review every 3 months to see if you can ↓ dose
describing a whooping cough
cough+ loud noise & vomit
- notifiable disease
IV salbutamol or IV steroids fail for acute asthma
Aminophylline
