resp Flashcards
croup - what is it?
URTI of larynx, trachea + bronchi
croup - cause
parainfluenza virus
crouP - Parainfluenza
croup - what age affected
6mo-3y
croup - presentation
stridor barking cough worse at night fever coryza increased breathing work
croup - management (general + emergency). any cautions?
single dose oral dexamethasone ± repeat in 12h
emergency: high flow O2 + neb adrenaline
DON’T: examine airway, CXR, bloods
acute breathlessness in a child - differentials
acute asthma bronchiolitis croup epiglottitis FBA allergy/anaphylaxis
epiglottitis - what prevents it?
HiB vaccination
epiglottitis - age
2-7
epiglottitis - presentation
rapid onset fever + unwell stridor, cough, muffled voice leaning forwards + extended neck drooling from impaired swallowing airway obstruction
epiglottitis - management
emergency airway management + O2
IV abx
dexamethasone
don’t stimulate
respiratory distress - signs
tracheal tug
intercostal + subcostal recession
nasal flaring
cystic fibrosis - initial presenting features (neonate + childhood)
neonate - prolonged jaundice, meconium ileus (BO due to sticky meconium. sx: delay in meconium (>24h), abdo distension ± bilious vomiting)
recurrent chest infections
steatorrhoea + failure to thrive (malabsorption)
liver disease
cystic fibrosis - features (later on)
short height + delayed puberty
diabetes
bulky stools → rectal prolapse
infertility (male), subfertility (female)
cystic fibrosis - management
chest physio, postural drainage, deep breathing
high calorie diet, pancreatic enzyme supplements, vitamins
heart transplant
what is bronchiectasis?
permanent bronchi dilation due to chronic infection or inflammation
bronchiolitis - what causes it? presentation? exam finding?
RSV infection of bronchioles
wheeze, cough, coryza
breathing work
poor feeding, unsettled, vomiting
wheeze + crackles at same time
bronchiolitis - management in GP + hospital
sats probe
consider hosp if dehydrated/feeding 50-75%:
support feeds - oral or NG
O2 if < 92
safety net:
999 - apnoea, looks v unwell, resp dep, cyanosis, sats <92
no need cxr/gases
asthma management in kids >5y
SABA ± low dose ICS
+ either montelukast (LRTA) or a LABA (eg salmeterol, formoterol)
asthma management in kids <5y
SABA ± 8wk trial mod dose ICS (continue at low dose if works)
+ montelukast (LRTA)
CF - diagnosis
sweat test - high chloride
episodic viral wheeze (wheezy when have a viral URTI) - treatment
1 - SABA via spacer
2 - montelukast ± ICS
surfactant deficient lung disease (respiratory distress syndrome) - what is it?
insufficient surfactant production
structural immaturity of the lungs
surfactant deficient lung disease (respiratory distress syndrome) - RFs
prematurity
diabetic mother
caesarean
surfactant deficient lung disease (respiratory distress syndrome) - features
tachypnoea
intercostal recession
expiratory grunting
cyanosis
surfactant deficient lung disease (respiratory distress syndrome) - CXR
ground glass appearance
indistinct heart border
surfactant deficient lung disease (=respiratory distress syndrome) - management
prevention in pregnancy - maternal corticosteroids
oxygen, assisted ventilation
exogenous surfactant via endotracheal tube
whooping cough - features - symptoms, exam finding, bloods?
2-3d coryza, then: coughing bouts - esp night + post-feed ± vomiting, cyanosis subconjunctival haemorrhages syncope, seizure ~3mo
inspiratory whoop
lymphocytosis ++
whooping cough - diagnosis
nasal swab culture - days-weeks return
whooping cough - management
cough started <21 days ago - oral macrolide (-mycin)
chronic breathlessness in kids - differentials
asthma transient viral-induced wheeze congenital heart defect bronchiectasis? CF?
