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child health > pediatric allergy in a nutshell > Flashcards

pediatric allergy in a nutshell Flashcards

1
Q

what is the main pathophysiology in asthma ?

A

bronchial hyperresponsiveness

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2
Q

what are the Th1 type cytokines ?

A

IL2
IL 12
IL 18
TNF beta

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3
Q

what are the TH2 type cytokines ?

A

IL 4
IL 5
IL 9
IL 13

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4
Q

what factors favor the Th1 phenotype of asthma ?

A

having older siblings who also suffer from asthma
early exposure to day care
rural environment

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5
Q

what factors favor the Th2 phenotype of asthma ?

A

widespread use of antibiotics

urban environments

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6
Q

what does the hygiene hypothesis claim ?

A

men el a5er environments that are too clean but the child at a higher risk of developing asthma

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7
Q

what are the general features of asthma ?

A 
obstructive lung disease 
recurrent episodes 
completely reversible 
normal between episodes 
symptoms worse at night 
responds to bronchodilators
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8
Q

what are the types of wheezes in preschool children?

A

viral episodic wheezing ( triggered by viral infection)
multiple trigger wheeze
asthma

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9
Q

what are some important physical findings in asthmatic children ?

A 
no clubbing with asthma 
allergic rhinitis 
atopic dermatitis 
harrison sulcus in prolonged asthma patients 
expiratory wheezes
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10
Q

what is the normal peak expiratory volume ?

A

should be above 70%

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11
Q

how is a diagnosis of asthma made ?

A 
mainly clinical and based on history 
exclusion of other causes 
chest x-ray ( to rule out other causes)
CBC and IgE levels 
PEFR 
FEV1 spirometry and reversibility testing
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12
Q

what treatment can be used for an acute attack of asthma ?

A

bronchodilators SABA - salbutamol

or anticholinergic bronchodilator - ipratropium bromide

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13
Q

what can be used for preventative therapy of asthma ?

A 
inhaled corticosteroids such as budesonide 
LABA - salmeterol 
LTRA - montelukast 
Anti IgE monoclonal AB - omalizumab 
oral steroids - prednisolone
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14
Q

what are the availbale inhaler devices ?

A

metered dose inhaler
dry powder inhaler
nebulizer

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15
Q

what is the cause of otitis media ?

A

either bacterial or viral
bacterial - moraxella
viral- RSV

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16
Q

what is the presentation and complication of otitis media ?

A

fever , earache and cough

complication - otitis media with effusion

17
Q

what is the presentation of tonsillitis ?

A

fever chills headache and GI disturbances

red tonsils with exudate on examination

18
Q

what is the main causative organism of tonsillitis ?

A

group a beta hemolytic strep

EBV

19
Q

what is the most common causative organism in bronchiolitis ?

A

RSV

20
Q

what is the treatment for bronchiolitis ?

A

humidified oxygen and supportive therapy

21
Q

what is the causative organism in pneumonia id diff age groups ?

A 
neonates - group b strep 
1-3 months - chlamydia and and mycoplasma in a febrile 
RSV in febrile 
3m- 5 years : RSV 
5-18 years : M. pneumoniae 
S. pneumonia 
C. pneumonia
22
Q

what is the difference in radiology between viral and bacterial pneumonia ?

A

viral pneumonia - interstitial

bacterial pneumonia - lobar pneumonia

23
Q

what does UL pneumonia mimic

what does LL Pneumonnia mimic ?

A

UL - meningitis

LL - appendicitis

24
Q

what is the main caustaive organism of croup ?

A

parainfluenza

25
Q

what is the most common cause of stridor ?

A

croup

26
Q

what is the differential diagnosis of croup ?

A

epiglottitis

27
Q

how is viral induced wheezes diagnosed ?

A

only happens with viral infections
no atopic history
steroids have little role

28
Q

what is the criteria for hospital admission in asthmatic children ?

A

poor response to bronchodilators
exhaustion
marked reduction in predicted
less than 92% on air

29
Q

what are the differential diagnosis of acute asthma ?

A

infection
foreign body inhalation
anaphylaxis

child health (40 decks)

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