Resp Flashcards
Pharyngitis causes
adenovirus
enterovirus
rhinovirus
GABHS (older)
Tonsilitis causes
GABHS
EBV
Tonsilitis GABHS can result in..
scarlet fever
Tonsilitis EBH can result in….
infectious mononucleosis
Scarlet fever characteristics
GABHS (+ve chains)
sandpaper like rash
strawberry tongue
flushed cheeks with perioral sparing
Infectious mononucleosis characteristics
EBV monospot test membranous exudate splenomegaly maculopapular exanthema
Tonsilitis abx and when
CENTOR 3+
Phenoxymethylpenicilin 10d/ erythromycin
Sinusitis is uncommon in which sinus in children and why
frontal
not developed until late childhood
Acute otitis media TM appearance
bright red
bulging
loss of normal light reflection
Acute otitis media cause
RSV rhinovirus pneumococcus H. influenza Maraxella
Acute otitis media Rx
analgesia
delayed abx prescription (amoxicillin)
Recurrent ottis media results in:
Effusion
Glue ear
Glue ear management
self limiting
grommets (ventilation tubes)
adeneidectomy
Stridor causes
Croup
acute epiglottis
foreign body
Croup characteristics
laryngotracheal infection
6m- 6hrs
barking cough
stridor
Croup cause
parainfluenza virus
Croup Rx
oral dexamethasone/prednisolone / neb bedenoside
if severe
neb adrenaline
Acute epiglottis cause
HiB
Acute epiglottis characteristics
drooling stirifor dysphagia toxic-looking minimal cough
Acute epiglottis Rx
ENT, anaesthetic, pads input
incubation in controlled environment
Blood cultures + Abx
Rifampicin prophylaxis
Wheeze causes
bronchiolitis asthma viral wheeze atypical pneumonia foreign body anaphylaxis
? Asthma investigations
skin prick testing for common atophy CXR- r/o other causes PEFR Spirometry - 12%+ response to bronchodilators
Asthma in children management
SABA / +ICS / +LRTA
switch to LABA if no improvement
MART
Acute asthma: life threatening characteristics
Cyanosis (central) Hypotension, arrhythmia Exhaustion Silent chest Tachy- cardia & -pnoea
PERF <33%
altered consciousness
Acute asthma management
SABA x 10 / nebuliser salbutamol (2.5mg <8yrs) oral prednisone 1-2mg/kg (max 40mg) -> IV hydrocortisone if severe \+/- ipratropium, IV B2 agonist/aminophyline/mg
Bronchiolitis cause
RSV
Bronchiolitis characteristics
wheeze
chesty sounding -> end-ins creps
apnoea (complication)
displaced liver
Bronchiolitis management
o2 if required
fluids NG/IV if required
ventilation NIV w/ CPAP
infection measures
Bronchiolitis complication
apnoea bronchiolitis obliterates (permanent damange, submucosal fibrosis)
Respiratory distress in newborn
transient tachypnoea in newborn (c-section) meconium aspiration pneumonia pneumothorax milk aspiration persistent pulmonary hon of the newborn diaphragmatic hernia
Pneumonia cause infants
RSV
S.pneumonia
H.influenza
Pneumonia cause in newborn
group B strep
gram -ve enterococci and bacilli
Pneumonia cause in 5ys +
mycoplasma pneumonia
strep. pneumonia
chlamydia pneumonia
Pneumonia abx no recessions
mild LRTI
PO amoxicillin +/- erythromycin
Pneumonia abx recessions +/- cyanosis
Moderate/severe LRTI
IV cefuroxime +/-
PO clarithromycin
Common pneumonia complication in children
parapneumonic effusion (1/3)
Whooping cough cause
Pertussis (Bordatella pertussis)
Whooping cough characteristics
catarrhal phase
paroxysmal phase- inspiratory whoop, worse at night, may cause vomiting +/- epistaxis/ subconjunctival haemorrhages- up to 3m
convalescent phase
Whooping cough Rx
macrolide- erythromycin
macrolide prophylaxis for close contacts
immunisations
Whooping cough Ix
culture paranasal swab or PCR marked lymphocytosis (>15) on FBC
CF: infancy features
failure to thrive meconium ileus neonatal jaundice recurrent chest infections malabsorption
CF: childhood features
nasal polyps bronchiectasis rectal prolapse allergic bronchopulmonary aspergiliosis pneumothorax recurrent haemoptysis
CF: adolescence features
psychological problems aspergilliosis pneumothrorax cirrhosis portal HTN distal intestitial obstruction male sterility
CF: mutation
1 in 25 Caucasians are carriers
Cystic fibrosis transmembrane conductance regulator (cAMP-reg Na/CL channel)
delta F508- most common
CF screening
newborns- heel prick immunoreactive trypsinogen (IRT) -> common mutations -> sweat test w/ pilocarpine chloride >60
CF spirometry pattern
obstructive
reduced FVC
increased lung volumes
