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Year 4 - Child Health > Resp > Flashcards

Resp Flashcards

1
Q

What are the main pathological features in childhood asthma?

A

Inflamed airways
Hypersensitivity
Airway remodelling

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2
Q

Which cells mediate the inflammation in asthma?

A

Eosinophils and CD4+

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3
Q

What is the classic presentation of asthma?

A

Wheeze, cough, chest tightness, dyspnoea

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4
Q

What are common asthma triggers?

A

Cold
Exercise
Allergens
Stress

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5
Q

What will PEFR investigation show for asthma?

A

Low for age/height

Better at rest and with a bronchodilator

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6
Q

What will spirometry show for asthma?

A

15% improvement in FEV1 following inhalation of bronchodilator

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7
Q

How is asthma managed chronically?

A

Stepwise ladder

SABA&raquo_space; +ICS&raquo_space; + LABA&raquo_space; + LTR antagonist&raquo_space; + oral steroids

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8
Q

Which inhaler devices should be used in asthma 0-2 years?

A

Spacer + mask

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9
Q

Which inhaler devices should be used in asthma 2-7 years?

A

MDI + spacer

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10
Q

Outline acute management of asthma:

A 
Oxygen
Salbutamol nebulised
Ipratropium nebulised
IV hydrocortisone
MgSO4
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11
Q

What is the most common cause of bronchiolitis?

A

RSV

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12
Q

Give risk factors for bronchiolitis:

A

Prem; chronic resp conditions; CHD

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13
Q

Which age group get brnociolitis?

A

Under 18m

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14
Q

How does bronchiolitis present?

A

Wheeze, dry cough, fever, nasal flaring, increased WOB, difficulty feeding

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15
Q

What is found on examination of bronchiolitis?

A

Fine insp crackles

Exp wheeze

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16
Q

How is bronchiolitis invesigated?

A

Tends to not be unless severe

If severe: nasopharyngea laspirate, blood gas, CXR

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17
Q

How is bronchiolitis managed?

A

Mild: advice and safety net
Mod: admit or humidified oxygen and bronchodilation
Sev: HDU for ventilation and IV fluids

18
Q

How long does bronchiolitis generally take to clear?

A

2 weeks

19
Q

How does bronchitis present?

A

Productive cough and fever

20
Q

How is bronchitis managed?

A

Generally self-limiting

Supportive measures

21
Q

What mainly causes croup?

A

Parainfluenza virus

22
Q

What is croup?

A

Laryngotracheobronchitis

23
Q

How does croup present?

A

Barking cough
Harsh rasp stridor
Resp distress
Apyrexial

24
Q

How is croup treated?

A

Oral or nebulised steroids if severe enough

Nebulised adrenaline if o2 <94%

25
Q

True or false:

CF is an autosomal dominant condition

A

False

its AR

26
Q

Where is the mutation in CF?

A

CFTR gene on the long arm of chromosome 7

27
Q

What does the mutation in CF cause?

A

Abnormal Cl- channels, abnormal ion transport leading to abnormally thick mucus

28
Q

How does CF present in infants?

A 
Malabsorption
Large stools
Failure to thrive
Meconium ileus
Prolonged jaundice
29
Q

How does CF manifest in young kids?

A

Rectal prolapse

Nasal polyps

30
Q

How does CF manifest in older kids?

A 
Aspergillus infection
DM
Cirrhosis 
Portal hypertension
Obstruction
Pneumothroax
31
Q

How is CF investigated?

A 
Sweat test (increased Cl in sweat)
Guthrie test (raised immunoreactive trypsin)
32
Q

How is CF managed?

A

MDT

Mucolytics, nebulisers, abx and diet

33
Q

What commonly causes epiglottiis?

A

H influenzae

34
Q

What should YOU do to manage epiglottitis?

A

Nothing
do not touch this child
you can make things much worse
Call ENT who may involve anaesthetics

35
Q

How does epiglottitis present?

A

Unwell child, drooling, fever, soft stridor
Reluctant to speak
No cough

36
Q

How is pneumonia managed in kids?

A

Same realy
Oral abx and safety net if mild
O2 and IV abs if moderate

37
Q

What organism causing whooping cough?

A

Bordetella pertussis

38
Q

How does whooping cough present?

A

Catarrhal phase: coryzal symptoms

Paroxysmal: cough following by inspiratory whoop, apnoea, worse at night

Epistaxis and subconjunctival haemorrhages can occur

Note that coughing may cause vomiting

39
Q

How is whooping cough investigated?

A

Nasal swab

40
Q

How is whooping cough maanged?

A

Marcolide abx

Clarithromycin

Year 4 - Child Health (2 decks)

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