RESP Flashcards
WHAT INFECTIONS CAN OCCUR IN THE UPPER RESPIRATORY TRACT
CORYZA
PHARYNGITIS
TONSILITIS
ACUTE OTITIS MEDIA
SINIBITITIS
WHAT PATHOGENS CAUSE CROUP
RHINOVIRUS
RSV
WHAT ARE THE TREATMENTS OF CORYZA
ANALGESIA
REASSURENCE
INFORM COUGH CAN LAST FOR 4 WEEKS
WHAT IS THE PRESENTATION OF CROUP
RHINORRHEA
SORE THROAT
LOW GRADE FEVER
INSPIRATORY HARSH STRIDOR
BARKING COUGH
RESP DISTRESS/CHEST RECESSION
WHAT IS THE TREATEMENT OF CROUP
SUPPORTIVE UNLESS O2 SATS DROPPING
THEN
PREDNISIOLONE
O2
NEBULISED ADRENALINE
WHAT IS PSEUDOMEMBRANOUS CROUP
SEVERE INFLAMMATION OF URT ASSOCIATED WITH SLOUGHING OF RESPIRATORY EPITHELIUM AND MACROPAPULENT SECRETIONS
WHAT IS THE PRESENTATION OF PSEUDOMEMBRANOUS CROUP
HIGH FEVER
ILL LOOKING CHILD
RAPIDLY PROGRESSING OBSTRUCTION
COUPIUS THICK AIRWAY SECRETIONS
WHAT PATHOGEN CAUSES PSEUDOMEMBRANOUS CROUP
STAPH AUREUS
WHAT IS THE MANAGEMENT OF PSEUDOMEMBRANOUS CROUP
IV ABX - VANCOMYCIN
INTUBATION
VENTILATION
DEFINE PHARYNGITIS
PHARYNX AND SOFT PALLETTE INFLAMMED
DEFINE TONSILITIS
A FORM OF PHARYNGITIS MAINLY AFFECTING TONSILS CAUSING INTENSE INFLAMMATION+PURULENT EXUDATE
WHAT PATHOGEN USUALLY CAUSES PHARYNGITIS AND TONSILITIS
B HEAMOLYTIC STREP
EVB
ADENOVIRUS
WHAT IS THE PRESENTATION OF BACTERIAL TONSILITIS
HEADACHE
WHITE EXUDATE
FEVER
CERVIACLE LYMPHADENOPATHY
ABDO PAIN
WHAT IS THE MANAGEMENT OF PHARYNGITIS
PENICILLIN
ERYTHROMYCIN
AMOXICILLIN
WHAT IS STRIDOR
A HARSH MUSICAL SOUND DUE TO A PARTIALLY OBSTRUCTED AIRWAY
HOW DO YOU DISTINGUISH THE SEVERITY OF CROUP
NON AUDIBLE
CRYING
RESTING
BIPHASIC
WHAT ARE THE COMMON CAUSES OF STRIDOR
VIRAL LARYNGOBRONCHITIS
EPIGLOTITIS
FOREIGN BODY
WHAT ARE CAUSES OF CROUP
PARAINFLUENZA
RHINOVIRUS
(RSV AND INFLUENZA CAN HAVE A SIMILAR PICTURE)
WHAT IS RSV
Respiratory syncytial virus (RSV) is a common, and very contagious, virus that infects the respiratory tract
WHAT IS THE PRESENTATION OF RSV
cold SX sx - coryza etc
But for a small percentage, infection with RSV can lead to pneumonia or bronchiolitis,
what are the RF for a serious RSV infection
prem
Children<2y w heart or lung disease
Immunocomprimised
Children under 8 to 10 weeks old
how do you diagnose RSV
nose and throat swab
chest x ray
what can be given to high risk babies t prevent rsv
palivizumab
what is acute epiglotitis
intense swelling of the epiglottis and surrounding tissue
what are the dangers of acute epiglotitis
associated w septicemia
can cause airway obstruction
at what ages does acute epiglotitis usually present
1-6y
why is acute epiglotitis rare in uk
HiB vacciene
how do you treeat acute epiglotitis
immidiate intubation
(remove after 24hrs)
bloods and cultures
antibiotics - ceftriaxone + rifampacin for 3-5days
rifampacin given to close contacts
what are the differences of acute epiglotitis and croup
what is bronchiolotis
a common serious respiratory illness due to blockage of small airways in the lungs
what commonly causes bronchiolitis
RSV
parainfluenza
rhinovirus
always viral!
what age group does bronhiolitis affect the most
1-9 months
what is the presentation of bronchiolitis
coryzal sx
dry wheezy cough
breathlessness
feeding difficulties
recurrent apnea
thachycardia and tachyopnea
resp distress signs
fine end resp crackles
what investigations are required in bronchiolitis
oximetry
c xr
blood gasses for resp failure
what is the management of bronchiolitis
o2
fluids
CPAP
what is the presentation of asthma
biphasic tendancy
wheeze w/o viral infection
interval symptoms
atopic FHx
+ve response to asthma therapy
how do you investigate asthma
peak expiratory flow rate via spirometry
improvement of 12% on FEV asthma test
what is the treatment for asthma
mild
- SABA
- inhaled corticosteriods
mod
- <5y = leukotrine receptor agonist
- >5y =LABA
Severe
- increase Inhaled steroids
- add po steroids
list names of asthma medication and their class
b2 agonist = salbutemol
anticholinergic = ipatromium bromide
ICS = beclomethasone
LABA = salmeterol
oral steroids = prednisolone
leukotrine antagonsist = monteleukast
a parent of a child under 5 is dure her child has asthma. what are the two diagnoses that are correct
and why
viral episodic wheeze
multiple trigger wheeze
asthma cannot be diagnosed in uder 5
why do viruses cause wheeze
mucosal inflmmation and swelling
what is cystic fibrosis
autosomal recessive condition causing mutation of CFTR gene causing lung and pancreatic dysfunction
what is the pathophysiology of CF
cystic fibrosis transmembrane conductance receptor (CFTR) is defective.
causes abnormal ion (cl-) transport causing thickening of secretions and a reduction in airway liquid layer with impaired cillary fuction
also causes disordered immune / inflammatory response
what is the presentation of CF in inflants
thick meconium / meconium ilues
prolonged jaundice
recurrant chest infections
malabsorbtion
what is the presentation of CF in young children
bronchiectasis due to recrrent infections
rectal prolapse
nasal polyp
sinusitis
what can CF cause in teens
diabetes mellitus
cirrhosis
portal htn
allergic bronchopulmonary displasia
distal intestinal obstruction
pneumothorax
male sterility
what are some signs of CF
hyperinflation
crepitus
expiratory wheeze
malabsorbtion
steatorrhea
how do yo manage CF
lung physio
flucloxacillin profylaxis
saline nebs
regular azythromycin
urseodioxycholic acide
Pancreatin enxyme replacement therapy
high calorie dies
vit suppliements
insulin if dm
lung/liver transplant
how do you diagnose CF
gurthies test
sweat test
what measurement is used to determine progression of CF
FEV1
what infections are common in CF
and whatis management
s aureus
h influena
pseudomonas arginosa
burkholderia
iv abx
what is acute otitis media
infection and inflammation of the middle ear
when does otitis media commonly present
6-12m
what is the presentation of acute otitis media
pain
fever
red tympanic membrane +/- pus
name the common viral and bacterial causes of otitis media
viral
- rsv
- rhinovirus
bacterial
- strep. pneumoniae
- H.influenza
what antibiotics should be used in otitis media
amoxicillin
what are the two kinds of hearing loss
sensorineural
conductive
how does hearing loss present in childhood
delayed language and speech
behavioural issues
learning difficulties
what is the cause of sensorineural hearing loss
cochlea or auditory nerve lesion
how do you manage sensori neural hearing loss
hearing aids
regular follow ups
cochlear implant
lifestyle modifications
- sit at front of class
- speech therapy
- markaton sign language
- schools for the deaf
what is conductive hearing loss
usually caused by glue ear (urti) and is less severe than sensorineural hearing loss
how do you investigate deafness
impedence audometry tests (check middle ear pressure)
CT/MRI
what is glue ear
common cause of conductive hearing loss
otitis media + efffusion causing conductive hearing loss
what are the RF for glue ear
downs
cleft pallette
atopic hx
what is the management of glue ear
usually resolves on its own within 3m
otherwise = decongestants and abx +/- grommets
what are grommets
tympanostomy tubes +/- adenoid removal
allows for pressure to equalise and fluid to drain
naturally fall out after 6-12m as infection clears and ear heals