Resp with ENT

Question 1

cause of CAP <5yo

Answer 1

viral

Question 2

benefit of CF

Answer 2

protection against salmonella typhi

Question 3

organism in chronic otitis media

Answer 3

pseudomonas

Question 4

hayfever treatments

Answer 4

1) PO or nasal antihistamine
2) nasal corticosteroid (drops if severe obstruction)

Question 5

abx for severe ezcema/cellulitis

Answer 5

IV benpen and fluclox (or just IV coamox)

Question 6

rinnes test in sensorineural hearing loss

Answer 6

normal

Question 7

croup + toxic looking child =

Answer 7

bacterial tracheitis - S aureus

Question 8

cause and management of bacterial tracheitisi

Answer 8

S aureas or M catarrhalis
IV abx and intubate
dont examine

Question 9

CAP organisms in neonates

Answer 9

GBS
listeria
S aureus

Question 10

CAP organisms in under 5s

Answer 10

1) viral
2) strep pneumoniaw

Question 11

CAP organisms in over 5s

Answer 11

strep pneumoniae and mycoplasma

Question 12

treatment of >2yo with ?viral CAP

Answer 12

abx (all over 2s get abx as it’s difficult to tell viral vs bacterial clinically)

Question 13

how to approach an <5yo with ?asthma

Answer 13

8 week trial of moderate dose ICS then 4 weeks off
if symptoms resolve then return, treat

Question 14

asthma ladder (preventative)

Answer 14

1) salbutamol
2) salbutamol + LD ICS (200mcg BD)
3) salbutamol + LD ICS + LRTA

if under 5yo, refer now

4) salbutamol + LD ICS + LABA
5) LD MART
6) MD MART or,
salbutamol + MD ICS (400 mcg BD) + LABA

Question 15

which children with CAP should get a CXR

Answer 15

not improving after 48hrs
(CXR not routine initially)

Question 16

initial management of chronic otitis media with effusion

Answer 16

watchful waiting for 3 months, with a hearing test at the start and end of this time

if the child has Down’s syndrome/cleft palate/significant impairment causing developmental issues or school disruption, refer to ENT immediately

Question 17

spirometry in asthma

Answer 17

FRV1/FVC <70%

improvement of 12% in FEV1

Question 18

FeNO in asthma

Answer 18

> 35

Question 19

asthma low and medium dose ICS

Answer 19

200 and 400

Question 20

which abx for CAP

Answer 20

amoxicillin
add clarithromycin if not improving after 2 days

coamox if also has influenza

5 days

Question 21

BPD definition

Answer 21

needing O2 at 36 weeks corrected gestation

Question 22

BPD CXR

Answer 22

widespread opacification

Question 23

prognosis of asthma <2yo

Answer 23

gone by secondary school

Question 24

croup but too unwell for PO dex

Answer 24

INH budesonide
IM dex

Question 25

false negative sweat test

Answer 25

eczema
coeliac
adrenal insufficiency

Question 26

treatment for viscous sputum in CF

Answer 26

neb DNAse or hypertonic saline

Question 27

T1 resp failure - pathophysiology and causes

Answer 27

obstructive

early asthma
pneumonia
PE
pulmonary oedema

Question 28

T2 resp failure - pathophysiology and causes

Answer 28

restrictive

late asthma
head injury/spinal injury/opiate
pneumothorax
FB causing hyperinflation

Question 29

pneumocystis pneumonia prophylaxis

Answer 29

Cotrimoxazole

Question 30

what does heel prick for CF test

Answer 30

high IRT then common mutations

Question 31

CF abx

Answer 31

S aureus prophylaxis - fluclox or azithromycin
new cough tx - coamox or cotrimoxazole
pseudomonas tx - ciprofloxacin

Needs 2 abx if IV

Question 32

otitis media without perforation?

Answer 32

offer ear drops with analgesia and anaesthetic

(Phenazone 40 mg/g with lidocaine 10 mg/g. Apply 4 drops two or three times a day for up to 7 days, available as Otigo® )

Question 33

DM in CF

Answer 33

its own type

annual OGTT

Question 34

webers in conductive loss

Answer 34

loudest on bad side

Question 35

CF with wheeze and high IgE

Answer 35

allergic bronchopulmonary aspergillosis

steroids daily for 2/52 then every other day for 3 months