Resp Paediatrics Flashcards
common side effects of antibiotics in children
- diarrhoea
- oral thrush
- nappy rash
- allergic reaction
- multi-resistance
management of child presenting with tonsillitis/ pharyngitis
- throat swab
- nothing or 10 days penicillin
- don’t give amoxycillin
presentation of croup
- common
- well
- coryza ++
- stridor
- hoarse voice
- barking cough
presentation of epiglottitis
- rare
- toxic
- stridor
- drooling
management of epiglotittis
intubation and antibiotics
management of croup
oral dexamethasone
principles of management LRTI
- make a diagnosis
- assess the patient (oxygenation, hydration, nutrition)
- treat vs not treat
potential diagnosis for this clinical presentation:
- loose rattly cough
- post-tussive vomit
- chest free of wheeze/ creps
- most self limiting
- child well
- parents worried
bronchitis
potential diagnosis for this clinical presentation:
- nasal stuffiness
- tachypnoea
- poor feeding
- crackers +/- wheeze
- <12 months old
- one off (not recurrent)
bronchiolitis
management of bronchiolitis
- max observation
- min intervention
management of community acquired pneumonia if mild symptoms
nothing
first line management of community acquired pneumonia
oral amoxycillin
second line management of community acquired pneumonia
oral macrolide
when would you give IV antibiotics for pneumonia
if patient vomitting
management of bilateral media under 2 years old
oral amoxycillin
key components of asthma
- wheeze
- variability
- responds to treatment
- SOB@rest
if a patient is short of breath at rest, what is likely percentage of functioning lung
<30%
differential diagnosis for asthma, onset under 5 years
- congenital
- CF
- PCD
- bronchitis
- foreign body
differential diagnosis for asthma, onset >5years
- dysfunctional breathing
- vocal cord dysfunction
- habitual cough
- pertussis
wee poem about asthma?
if you think its asthma
but you’re not sure
give a short course of inhaled steroids
and see if you have a cure
goals of asthma treatment
- minimal symptoms during day and night
- minimal need for reliever medication
- no attacks (exacerbations)
- no limitation of physical activity
- normal lung function
how to measure asthma control/ questions to ask
SANE S - Short acting beta agonists/week A - absence school/ nursery N - Nocturnal symptoms/ week E - exertional symptoms/ week
potential causes of not well controlled asthma
- not taking treatment
- not taking treatment correctly
- not asthma
- other
classes of medication used in asthma
- SABA
- inhaled corticosteroids
- LABA
- leukotriene receptor antagonists
- theophyllines
- oral steroids
when would you prescribe a preventer inhaler
- B2 agonists >2/7
- symptomatic more 3/7+
- waking 1/7 nights
first add on preventer
LABA
management asthma attack
- IV salbutamol
- IV aminophylline
- IV magnesium
- IV hydrocortisone
- intubate and ventilate
initial management for suspected asthma presentation
- allergy testing
- trial of SABA
- trial of low dose ICS
- peak flow reliable
- reduced spirometry
