Brainscape's Knowledge GenomeTM

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


See full index

Y5 Paediatrics > Resp 2 > Flashcards

Resp 2 Flashcards

1
Q

What is a wheeze due to?

A

obstruction of the intrathoracic airways

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

What are causes for wheeze

A

bronchiolitis
asthma
foreign body

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

What is bronchiolitis

A

inflammation of the bronchioles (smallest airways) due to RSV

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

What are symptoms of bronchiolitis

A

Dry cough
SOB
Wheeze
Recurrent apnoea

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

What is investigations for bronchiolitis

A

Clinical (pulse oximetry)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who is at especially high risk for bronchiolitis

A

children born prematurely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are examination findings in bronchiolitis

A 
dry wheezy cough 
tachypnoea, tachycardia 
Subcostal, intercostal recession 
Chest hyperinflation 
Fine end-inspiratory crackles 
Cyanosis 
Pallo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is management for bronchiolitis^?

A 
Oxygen supplementation if SaO2 <92
Consider CPAP
consider upper airway sunction if increased secretions 
Fluids by NG/OG tube 
Supportive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What medication can you give as prevention from bronchiolitis?

A

Palivizumab

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

Who do you give Pavililzumab to

A

High risk pre term infants

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

Give three patterns of wheezing which are similar to asthma

A

Viral episodic wheeze
Multiple trigger wheeze
Asthma

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

Explain why Viral episodic wheeze occurs

A

in response to viral infection

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

How do you manage Viral episodic wheeze

A

Salbutamol inhaler (using spacer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the max dose of salbutamol a child can receive if wheezy?

A

10 puffs every 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes multiple trigger wheeze

A

multiple triggers:

  • infection
  • dust
  • cold air
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the definition of atopic astham

A

Recurrent wheezing associated with

  • interval symptoms (symptoms between viral infections)
  • allergy to one or more inhaled allergens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are key features of asthma

A

Wheezing
Worse at night and in early morning
Non-viral triggers
Interval symptoms (between acute exacerbations)

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

What is wheezing described as

A

a whistling in the chest when the child breathes out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a visible sign of early onset asthma on the chest?

A

Harrison sulk (depressions at the base of thorax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are investigations for asthma in a child under 5

A

NONE- clinical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are investigations for asthma in a child over 5

A

Spirometry
Bronchodilator reversibility
Peak expiratory flow variability
FeNo test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is PEFR in life threatening asthma?

A

PEFR<33%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Sp02 in life threatening asthma?

A

<92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are other features in life threatening asthma

A 
altered consciousness 
exhaustion 
hypotension 
cyanosis 
poor respiratory effort 
silent chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What should PaCO2 be like in someone with life threatening asthma? What will REALLY WORRY you?

A

PaCO2 should be LOW - because patient is hyperventilating

If normal - means patient is no longer compensating - you need to WORRY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Who do you admit in acute asthma?

A

anyone with moderate or severe asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How do you manage acute asthma?

+ what do you give on discharge

A

Supplemental oxygen
Nebulised SABA
— if SABA ineffective:
Nebuilised TIOTROPIUM BROMIDE

– if ineffective try: (bolus then infusion)
IV Magnesium sulphate
IV Aminophylline
IV Salbutamol

PO prednisolone 3-5 days on discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the dose of salbutamol you give in acute asthma

A

2.5 mg if under 5

5mg if over 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the dose of Nebuilised TIOTROPIUM BROMIDE you give in acute asthma

A

under 2: 10mg
2-5yrs: 20mg
>5yrs: 30-40mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do you manage acute asthma if hospital admission is not required

A 
SABA with large volume spacer 
Oral prednisolone (short course of 3-7 days)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

For chronic asthma, when should you escalate treatment

A

SABA use >3 times weekly
Symptoms > 3 times weekly
Waking up from sleep > 1 time weekly
Hospital admission requiring corticosteroids

32
Q

What is the typical presentation of foreign body inhalatuion

A

abrupt onset cough
followed by wheeze
in previously well child

33
Q

What investigation should you get in suspected foreign body inhalation

A

CXR

34
Q

What will a CXR in foreign body inhalation show

A

Ipsilateral volume loss

contralateral hyper expansion from air trapping

35
Q

How do you manage foreign body inhalation

A

If conscious: encourage coughing, external maneuvres (back blows, chest thrust, abdominal thrust)

If unconscious: secure airway immediately

Removal of foreign body: flexible / rigid bronchoscopy

36
Q

What pathogen causes whooping cough

A

bordatella pertussis

37
Q

What is the presentation of whooping cough

A

A week of coryza (catarrhal phase) +
Development of paroxysmal / spasmodic cough
Characteristic inspiratory whoop - lasts up to 3 months

Bouts of coughing last worse at night, after eating
May cause vomiting

During spasm, child goes blue > mucous shoots from nose/mouth

38
Q

What investigations for whooping cough

A

Perinasal swab > culture / PCR

Serology

39
Q

How do you treat whooping cough

A

NOTIFY HEALTH PROTECTION UNIT

Prescibe antibiotic within 1 month from cough onset

  • <1 month: clarythromycin
  • > 1 month: azithromycin
  • pregnant: erythromycin
40
Q

how do you manage pneumonia in children

A

Amoxicillin 7-14 days

41
Q

What is bronchitis

A

Persistent inflammation of lower airways due to chronic infection

42
Q

What are key causes of persistent bronchitis

A

h influenza

Moraxella catarrhal is

43
Q

What are differentials for wet cough in a c child

A

Pneumonia
Persistent bacterial bronchitis
Bronchiectasis

44
Q

Explain CF mutation

A

Defective CF Transmembrane Conductance Regulator
On Chr 7
Chloride dependent channel
Results in thickened mucous and retention of mucopurulent secretions

45
Q

How do you investigate CF

A

IRT in newborn (<6 weeks)

Sweat test after first 6 weeks

46
Q

What are presentation of CF in the body=?

A

Lung: thickened secretions

Intestine: thick meconium, causing meconium ileum (where meconium causes obstruction)

Pancreas: blockage of pancreatic ducts due to secretions > pancreatic enzyme deficiency and malabsorption

47
Q

How do you manage CF

A

MDT approach

48
Q

What is the resp management of CF

A 
Pulmonary monitoring (review children)
Airway clearance (physiotherapists, repeat techniques x2 daily) 
Mucoactive agents (RhDNase, hypertonic saline, mannitol dry power inhalation) 
New agents e.g. Lumacaftor, Ivacaftor
49
Q

What is infection management in CF

A

Continuous prophylactic antibiotics

Rescue oral Abx

50
Q

What is nutritional management in CF

A

pancreatic replacement therapy
High calorie diet (150% normal)
Fat soluble vitamins

51
Q

What kind of management should you consider for CF in adults / teens=

A

Ursodeoxycholic acid (improves bile flow)
liver transplant
laxatives
Fertility counselling

52
Q

what is bronchiectasis

A

Irreversible DILATATION and DISTORTION of the bronchial tree > chronic obstructing lung disease

53
Q

what are symptoms of bronchiectasis

A

chronic cough
sputum
recurrent chest infections

54
Q

what changes to the airways occur in bronchiectasis

A

chronic inflammtion and infection
impaired mucociliary function
mucous plugging

55
Q

what are causes of bronchiectasis

A

GENERALISED BRONCHIECTASIS:

  • Cystic fibrosis
  • Primary ciliary dyskinesia
  • Immunodefiiency
  • Chronic aspitration

FOCAL BRONCHIECTASIS

  • prior severe pneumonia
  • congenital lung abnormality
  • foreign body obstruction
56
Q

How do you manage bronchiectasis

A

exercise, improve nutrition
airway clearance therapy
inhalied broncholilator + inhaled hyperosmolar agent + long term oral macrolide

REFER TO SECONDAY CARE

57
Q

What investigations must you get for bronchiectasis in secondary care

A
  • bronchiectaasis severity index
  • sweat chloride test / CF genetic testing
  • antibody deficiency scrrenign
  • test for primary ciliary dyskinesia
58
Q

what antibiotics can you give for a non-CF bronchiectasis acute exacerbation?

A

start empirical, then guide by sputum sensitivisites

  • ORAL: 1m to 11 years: amox/clarythromycin > co-amoxiclav
  • ORAL: 12y-17y: doxy > co-amoxiclav
59
Q

How do you manage latent TB

A

Isoniazid for 6m

OR

Rifampicin + isoniazid 3m

60
Q

what must you do for TB treatment other than give medications

A

Assign a key worker to monitor patient’s adherence to treatment, treatment response, and any adverse effects

Do contact tracing

61
Q

What spirometry result do you expect for asthma?

A

FEV1/FVC <70%

62
Q

How do you follow up acute asthma episode after discharge3?

A

follow up 2 days later (regardless of whether they were admitted / sent home from A&E)

63
Q

What is bronchiectasis

A

Abnormal irreversible dilatation and distortion of the bronchial tree
Causes Chronic Obstructive lung disease

64
Q

What are causes of bronchieectasis

A

CF
Primary ciliary diskinesia
Immunodeficiecy
Chronic aspiration

OR

Prior severe pneumonia
Congenital lung abnormality

65
Q

How do you diagnose bronchiectasis

A

Chest CT

Broncoscopy if focal bronchiectasis

66
Q

How do you manage bronchiectasis

A 
Exercise, improve nutrition 
Airway clearance therapy (postural draainage, percussion, vibration, oscillatory devices) 
Inhaled broncodiltor 
INhaled hypersomolar agent 
Long term macrolide
67
Q

What result on sweat test indicates CF

A

> 60

68
Q

What is fertility like in CF in men vs women

A

men - always inferttile, use intracytoplasmic sperm injection
women - normal fertility, tolerate opreg ancy

69
Q

What is the mode of inheritance of CF

A

Autosomal RECESSIVE

Most common genetic disease causing lifelong impariment in caucasians

70
Q

Explain primary ciliary dyskinesia

A

Congenital abnormality iin ciliary structure / function

Causes impaired mucociliary clearance

71
Q

What are sx of PCD

A

recurrent productive cough
purulent nasal discharge
chronic ear infections

72
Q

What is PCD associarted with

A

Kartagener syndrome

73
Q

What is Kartagenetr syndorme

A

Dextrocardia + situs invertus

74
Q

How do you manage PCD

A

Daily physio
Treat infections with antibiotics
ENT follow up

75
Q

What is the key cause of OSA in chidlren

A

adenotonsillar hypertrophy

76
Q

How do you manage OSA in children

A

CPAP/BiPAP

OR

adenotonsillectomy

Y5 Paediatrics (30 decks)

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