Resp

Question 1

Top cause of croup

Answer 1

Parainfluenzae 1-3 (barking parrot on steroids)

Question 2

Age range of croup

Answer 2

6 months - 6 years

Question 3

Risk factors (3)

Answer 3

1. Age (6 months to 6 years)
2. Smoke exposure (double risk)
3. Narrowed airways e.g. instrumentation at delivery, ventilation (prematurity), airway hemangioma

Question 4

Main treatment of croup

Answer 4

Steroids, PO or nebulised for a few days.

Can also give nebulised adrenaline

Question 5

Top cause of bronchiolitis

Answer 5

RSV (bronchiolitis = respiratory (syncytial) virus)

Question 6

Age range of bronchiolitis

Answer 6

Less than 12 months old, usually

Question 7

Risk factors for bronchiolitis (2)

Answer 7

1. Younger age

2. Parental smoking/in the home

Question 8

1-2day prodrome of viral symptoms which deteriorates,

Followed by cough, wheeze, tachypnea, indrawing of chest, fever, decreased feeding.

Answer 8

Bronchiolitis

Question 9

Viral prodrome symptoms,
Noisy and rapid breathing
Hoarse voice
Inspiratory stridor
Cough

Answer 9

Croup

barking cough

Question 10

Pharmacological Rx of bronchiolitis?

Answer 10

NONE!!

Bronchodilators and corticosteroids do not usually help.

Question 11

Management of bronchiolitis that doesn’t require admission (4)

Answer 11

Rest
Small feeds more often
No smoking
Avoid contact with other babies in first few days

Question 12

What management for bronchiolitis requires admission (2)

Answer 12

Oxygen (hypoxic)

IV or NG fluids

Question 13

Emergency management of asthma attack

Answer 13

4x4x4

1. 4 puffs (for each: give 1 puff and breathe in/out 4x)
2. After 4 puffs, wait 4 minutes
3. Repeat
4. If have to do more than 2x with no improv, call 000

Question 14

If unsure asthma attack or anaphylaxis, which do you give first?

Answer 14

Adrenaline/EpiPen

Question 15

Asthma: SABA?

Answer 15

Salbutamol

Question 16

Asthma: LABA?

Answer 16

Salmeterol, Eformoterol

Question 17

Asthma: ICS?

Answer 17

Budenoside, Fluticasone

Question 18

Asthma: leukotriene antagonist

Answer 18

Montelukast

Question 19

Asthma: reliever

Answer 19

SABA, salbutamol

Question 20

Asthma: preventer

Answer 20

corticosteroids

“prevent long term conseq and future attacks”

Question 21

Asthma: symptom controller

Answer 21

LABA, eformoterol

“like a SABA it controls the attack”

Question 22

Signs of increased work of breathing

Answer 22

Head bobbing
Nasal flaring
Grunting
Tracheal tug
Intercostal recession
Subcostal recession
Subcostal notching
Abdominal muscle use

Question 23

Ix for bronchiolitis (if needed?)

Answer 23

NPA

Question 24

Natural history of bronchiolitis

Answer 24

Get worse before they get better
Sick for 3-5 days (worst on day 2-3)
Then recover over next 7-10 days
Cough may continue for 2-4 weeks

Question 25

Bronchiolitis prevention:
anti-RSF IgG passive immunisation “Palivizumab”
INDICATIONS?

Answer 25

If cardiac,