Resp - ENT Flashcards

Question

What is the causative organism of epiglottitis?

Answer 1

HiB | >99% reduction due to vaccine

Answer 2

Life-threatening emergency (high risk of resp obstruction) Swelling of epiglottis and surrounding tissues associated with septicaemia Usually 1-6year olds VERY ACUTE: High fever, ill-looking. Intensely painful throat (prevents from speaking/swallowing). Saliva drools down the chin Soft inspiratory stridor and rapidly increasing respiratory difficulty. Sitting upright, immobile, with open mouth.

Answer 3

``` CROUP Onset over days. Preceding coryza. Cough - severe, barking. Able to drink. No drooling saliva. Appears unwell and fever <38.5°C. Stridor harsh and rasping. Voice hoarse. ``` ``` Epiglottitis: Onset over hours. No coryza. Absent cough/slight. Unable to drink. Drooling saliva. Toxic appearance, very ill. >38.5°C. Soft, whispering stridor. Reluctant to speak. ```

Answer 4

< 3 months old with >38°C 3-6 months old with >39°C Or other signs of being unwell: persistent vomiting, refusal to feed, floppiness, or drowsiness Sometimes even rash, fits/seizures, SOB

Answer 5

Plenty of fluid/milk even if isn't thirsty. Appropriately dressed, but eg. thinner sheets Paracetamol and ibuprofen, but only if DISTRESSED! Never both at the same time. If one does not work, can give the other one later on. If >41°C, methods such as cooling blankets are indicated

Answer 6

Can occur in any child <6 years of age If no previous afebrile seizures or neurological pathology. Most last <15 min (simple)

Answer 7

Can cause febrile seizures in children. Increases stress in cardiac/pulmonary illness due to raising BMR. >41°C can cause damage: protein denaturation, cytokines activate inflammatory cascade leading to cellular and organ failure. DIC due to activation of coagulation cascade.

Answer 8

Fever results when something raises the hypothalamic set point, triggering vasoconstriction and shunting of blood from the periphery to decrease heat loss; sometimes shivering, which increases heat production, is induced. These processes continue until the temperature of the blood bathing the hypothalamus reaches the new set point. Resetting the hypothalamic set point downward (eg, with antipyretic drugs) initiates heat loss through sweating and vasodilation.

Answer 9

Rare but dangerous. Pseudomembranous croup. The difference to viral croup is that there is: High fever Toxic appearance Rapidly progressing airway obstruction with copious thick airway secretions. Loud, harsh stridor

Answer 10

Croup most common (coryza and mild fever) Foreign body (sudden onset cough) Epiglottitis (painful throat, high fever, toxic) Bacterial tracheitis (high fever, toxic) Laryngomalacia or congenital airway abnormality (recurrent) ``` Allergic laryngeal angioedema Infectious mononucleosis Measles and diphtheria Trauma Retropharyngeal abscess ```

Answer 11

Skin thinner, thus burns quicker. Most deaths caused by house fire are due to smoke inhalation. There is a chance of developing respiratory complications and CO poisoning. There should be a low threshhold to protect the airway.

Answer 12

Face - disfiguring | Mouth - compromise to airway from oedema

Answer 13

Assess: resusc, smoke inhaled? Depth and surface are of burns Analgesia (may require iv morphine) IV fluids (plasma expanders) Wound care (cling film) Irrigate only for <10% SA burns. Check tetanus immunisation status.

Answer 14

Usually spontaneously resloves within 24h For pain and fever: paracetamol, change to ibuprofen if persists Alternate between paracetamol and ibuprofen if still persists

Answer 15

CENTOR criteria ``` Tender cervical lymphadenopathy Absence of cough White exudate Temperature >38°C Age 3-14 ```

Answer 16

10 day course of penicillin or erythromycin AVOID amoxicillin, as it may cause widespread maculopapular rash if infection is due to infectious mononucleosis