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Paeds > Resp > Flashcards

Resp Flashcards

1
Q

What are some symptoms of Asthma in paeds?

A

Recurrent cough worse at night/exercise
Expiratory wheeze
SOB

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2
Q

What are some triggers of asthma?

A

Cold
Allergens
Exercise
Smoke

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3
Q

How can suspected asthma be investigated in children?

A

Peak Flow if >5y
Clinical Diagnosis if <5y
CXR - Rule out PTX if suspicious

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4
Q

What are symptoms of an acute asthma attack in paeds?

A 
Acute SOB
Cough
Wheeze
Increased work of breathing
Frightened
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5
Q

How is a mild asthma attack defined for paeds?

A

Breathless
Not distressed
PEF >50%

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6
Q

How is a severe asthma attack defined for paeds?

A

Too breathless to talk/feed
RR>50
Pulse >130
PEF <50%

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7
Q

How is a life-threatening asthma attack defined for paeds?

A 
PEF <33%
Silent chest
Cyanosis
Fatigue
Drowsiness
Confusion
Hypotension
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8
Q

How should Asthma be managed in under 5y?

A
  1. SABA - Salbutamol
  2. Regular LTRA - Montelukast
  3. Low Dose ICS + LTRA
  4. Increasing doses of ICS
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9
Q

How should asthma be managed in over 5y?

A
  1. SABA - Salbutamol
  2. Low dose ICS
  3. Low dose ICS + LABA/LTRA
  4. Increase ICS dose or add LABA/LTRA
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10
Q

What should be used with an inhaler in under 5y?

A

Metered dose inhaler with a spacer

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11
Q

How can acute exacerbations of asthma in kids be managed?

A 
Reliever medication
Aggressive treatment with:
High Flow O2
Beta 2 Agonists
Ipratroprium Bromide
Systemic Corticosteroids
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12
Q

Which gene is responsible for development of Cystic Fibrosis?

A

Mutation of CFTR gene on Chromosome 7

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13
Q

What is the pathophysiology behind Cystic Fibrosis?

A

Excessive thick secretions obstruct small and large airways giving recurrent infections

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14
Q

What are some of the systemic effects of CF?

A 
ENT - Polyps, Sinusitis
Liver - Biliary Stasis
Poor Growth - Malabsorption
GI - Pancreatic insufficiency, DM, Meconium Ileus
Congenital absence of Vas Deferens
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15
Q

What are some complications of CF?

A 
Recurrent chest infections
Malabsorption due to pancreatic insufficiency
DM
Salt loss
Biliary stasis
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16
Q

How is CF diagnosed?

A

Newborn - Bloodspot screening
Gene testing
Sweat Test - Measures NaCl

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17
Q

How should confirmed CF be managed?

A

Nutritional and respiratory support

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18
Q

What is Whooping Cough?

A

Highly infectious notifiable disease due to Bordella Pertussis, particularly in infants under 3m

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19
Q

When are children vaccinated against Pertussis?

A

2m, 4m, 3y4m

20
Q

What are the distinct phases of Whooping cough?

A

Catarrhal Phase
Paroxysmal Phase
Convalescent Phase

21
Q

How does the Catarrhal Phase of Whooping Cough present?

A 
Rhinitis
Conjunctivits
Irritability
Sore Throat
Low-grade fever
Dry cough
22
Q

How does the Paroxysmal of Whooping Cough present?

A

Episodes of severe coughing followed by a characteristic inspiratory “Whoop”

23
Q

How does the Convalescent Phase of Whooping Cough present?

A

Cough decreases in severity over 3m

24
Q

What will be found upon examination with Whooping cough?

A 
Normal 
Low grade fever
Conjunctival haemorrhoage
Facial petichiae
Auscultation - Normal
25
Q

Which investigations are appropriate for suspected Whooping Cough?

A

Culture of Nasopharyngeal Aspirate
IgG Serology
FBC

26
Q

How should confirmed Whooping Cough be managed?

A

Admit if <6m, significant breathing/feeding problems

Clarithromycin to reduce infectivity

27
Q

How long should a Whooping Cough patient avoid school for?

A

Either until:
They’ve had the cough for 21 days
They’ve taken Clarithromycin for 5 days

28
Q

What is Croup?

A

A viral URTI leads to mucosal inflammation giving a cough

29
Q

What are common causative organisms of croup?

A

Parainfluenza
Adenovirus
Rhinovirus
Influenza A+B

30
Q

What are some risk factors for Croup?

A

Male
Autumn/Spring seasons
Genetic variation

31
Q

What are some symptoms of Croup?

A 
10-14d history of:
Non-specific cough
Rhinorrhoea
Fever
Progression to barking cough
32
Q

What are some clinical signs of Croup?

A 
Stridor
Normal chest/reduced air entry
Tachypnoea/Tachycardia
Recession
Cyanosis 
Lethargy
Reduced Consciousness
33
Q

How does mild Croup present?

A

Occasional cough
No stridor at rest
No recession

34
Q

How does moderate Croup present?

A

Frequent cough
Audible stridor at rest
Suprasternal and Chest Wall retraction at rest

35
Q

How does severe Croup present?

A

Frequent cough
Prominent inspiratory stridor at rest
Marked retractiosn
Distressed child at rest

36
Q

How should Croup be managed?

A

Mild - Supportive, NSAIDs

Moderate/Severe - IP admission, Oral Steroids, Nebulised Adrenaline

37
Q

What are some potential complications of Croup?

A 
Lymphadenitis
Otitis Media
Dehydration
Pulmonary Oedema
Pneumothorax
38
Q

What is Bronchiolitis?

A

A viral infection of bronchioles by Respiratory Syncytial Virus 1 which is common in children under 3y in winter and spring

39
Q

What happens in Bronchiolitis?

A

Infection leads to mucus hypersecretion, bronchiolar constriction, hyperinflation, increased airway resistance, atelectasis and VQ mismatch

40
Q

What are some risk factors for Bronchiolitis?

A

Breast fed for <2m
Smoke exposure
Has siblings that attend nursery
Prematurity

41
Q

What are some symptoms of Bronchiolitis?

A 
Increasing severity for 2-5d of:
Low grade fever
Nasal congestion
Rhinorrhoea 
Cough
Feeding Difficulty
42
Q

What may be found upon examination with Bronchiolitis?

A 
Tachypnoea
Grunting
Nasal Flaring
Recessions
Inspiratory crackles
Expiratory Wheeze
Hyperinflated chest
Cyanosis/Pallor
43
Q

Which investigations are appropriate for suspected Bronchiolitis?

A 
Throat swab for RSV
Blood/Urine cultures
FBC
ABG
CXR
44
Q

How should bronchiolitis be managed?

A

At home with supportive measures

45
Q

When should bronchiolitis be admitted?

A

O2 <92%
Fluids/NGT needed
CPAP

46
Q

What are some complications of bronchiolitis?

A 
Hypoxia
Dehydration
Fatigue
Respiratory failure
Cough/Wheeze
Bronchiolitis Obliterans

Paeds (11 decks)

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