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Y4: Paeds > Resp > Flashcards

Resp Flashcards

1
Q

Management of croup

A
  • oral dexamethasone regardless of severity
  • admit if mod or above
  • nebulised adrenaline + oxygen via face mask if severe obstruction
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2
Q

Presentation of croup

A
  • initial coryza and fever
  • BARKING seal-like cough, often worse at night
  • hoarseness
  • harsh stridor
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3
Q

Presentation of epiglottitis

A
  • very acute onset
  • may be drooling
  • high fever, very ill, look toxic
  • PAIN - troubling speaking/swallowing
  • soft stridor
  • rapidly increasing respiratory difficulty
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4
Q

Management of epiglottitis

A
  • call for senior help: anaesthetist, paeds, ENT
  • transfer to ITU/anaesthetic room
  • intubate in controlled setting under GA (or tracheostomy if not possible)
  • once airway secured: blood culture + IV Abx (e.g. cefuroxime)
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5
Q

Management of bacterial tracheitis (pseudomembranous croup)

A

IV Abx +/- intubation and ventilation if required

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6
Q

How does bacterial tracheitis (pseudomembranous croup) present

A
  • similar to epiglottitis
  • high fever, very il
  • rapidly progressive obstruction with copious thick airway secretions
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7
Q

Bronchiolitis age range

A

most aged 1-9 months

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8
Q

Management of bronchiolitis

A

supportive +/- humidified oxygen +/- CPAP, NG/IV feeds

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9
Q

What is palivizumab (Synagis) for?

A

Mab to RSV - passive immunity against bronchiolitis

- given as monthly IM injection during high risk period for high risk children

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10
Q

What is asthma worse?

A

night and early morning

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11
Q

What improvement in peak flow or FEV1 with bronchodilators signifies reversibility?

A

> /=12%

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12
Q

What is 1st choice add-on therapy after SABA and low-dose ICS for children <5y?

A

LTRA (montelukast PO)

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13
Q

What is 1st choice add-on therapy after SABA and low-dose ICS for children >5y?

A

LABA e.g. salmeterol INH

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14
Q

Incidence of CF and carrier rate?

A

1 in 2500 live births, 1 in 25 are carriers

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15
Q

Diagnosis of CF

A
  1. Heelprick test - raised IRT
  2. Sweat test: chloride 60-125mml/l (normal 10-40)
  3. Screened for common CF gene mutations
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16
Q

Which bacteria cause initial infections in CF?

A

Staph aureus, Haemophilus influenza

17
Q

Which bacteria cause later infections in CF?

A

Pseudomonas aerioginosa, Burkholderia

18
Q

Diagnosis of pancreatic insufficiency (e.g. in CF)

A

low faecal elastase

19
Q

What continuous prophylactic Abx should patients with CF be on?

A

flucloxacillin usually

20
Q

Presentation of whooping cough

A
  • 1 week coryza (catarrhal phase)
  • paroxysmal/spasmodic cough +/- ‘whoop’ at the end, hard to breathe
  • often worse at night
  • may cause vomiting
  • goes red/blue in face during cough, mucus from nose and mouth
  • may get epistaxis/subconjunctival haemorrhages
  • apnoea more common than whoop in infants
  • paroxysmal phase may last up to 3 months
  • symptoms gradually decrease (convalescent phase), may persist for months
21
Q

Who gets vaccinated against whooping cough?

A
  • children as part of 6 in 1 and 4 in 1 vaccines

- pregnant women

22
Q

How does obstructive sleep apnoea present in children?

A
  • excessive daytime sleepiness or hyperactivity
  • learning and behaviour problems
  • faltering growth
  • if severe: pulmonary HTN
23
Q

What is obstructive sleep apnoea in children usually due to?

A

upper airway obstruction secondary to adenotonsillar hypertrophy

24
Q

Ix of obstructive sleep apnoea in children

A
  • overnight pulse oximetry: normal = severe physical consequences unlikely
  • polysomnography if more complex (monitors various things during sleep)
  • sometimes more details electrophysiological assessment
25
Q

Management of obstructive sleep apnoea/sleep-related breathing disorders in children

A
  • if adenotonsillar hypertrophy: adenotonsillectomy

- if other sleep-related breathing disorders: CPAP or BiPAP at night

Y4: Paeds (7 decks)

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