Resp with ENT Flashcards
cause of CAP <5yo
viral
benefit of CF
protection against salmonella typhi
organism in chronic otitis media
pseudomonas
hayfever treatments
1) PO or nasal antihistamine
2) nasal corticosteroid (drops if severe obstruction)
abx for severe ezcema/cellulitis
IV benpen and fluclox (or just IV coamox)
rinnes test in sensorineural hearing loss
normal
croup + toxic looking child =
bacterial tracheitis - S aureus
cause and management of bacterial tracheitisi
S aureas or M catarrhalis
IV abx and intubate
dont examine
CAP organisms in neonates
GBS
listeria
S aureus
CAP organisms in under 5s
1) viral
2) strep pneumoniaw
CAP organisms in over 5s
strep pneumoniae and mycoplasma
treatment of >2yo with ?viral CAP
abx (all over 2s get abx as it’s difficult to tell viral vs bacterial clinically)
how to approach an <5yo with ?asthma
8 week trial of moderate dose ICS then 4 weeks off
if symptoms resolve then return, treat
asthma ladder (preventative)
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
which children with CAP should get a CXR
not improving after 48hrs
(CXR not routine initially)
initial management of chronic otitis media with effusion
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
spirometry in asthma
FRV1/FVC <70%
improvement of 12% in FEV1
FeNO in asthma
> 35
asthma low and medium dose ICS
200 and 400
which abx for CAP
amoxicillin
add clarithromycin if not improving after 2 days
coamox if also has influenza
5 days
BPD definition
needing O2 at 36 weeks corrected gestation
BPD CXR
widespread opacification
prognosis of asthma <2yo
gone by secondary school
croup but too unwell for PO dex
INH budesonide
IM dex
false negative sweat test
eczema
coeliac
adrenal insufficiency
treatment for viscous sputum in CF
neb DNAse or hypertonic saline
T1 resp failure - pathophysiology and causes
obstructive
early asthma
pneumonia
PE
pulmonary oedema
T2 resp failure - pathophysiology and causes
restrictive
late asthma
head injury/spinal injury/opiate
pneumothorax
FB causing hyperinflation
pneumocystis pneumonia prophylaxis
Cotrimoxazole
what does heel prick for CF test
high IRT then common mutations
CF abx
S aureus prophylaxis - fluclox or azithromycin
new cough tx - coamox or cotrimoxazole
pseudomonas tx - ciprofloxacin
Needs 2 abx if IV
otitis media without perforation?
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® )
DM in CF
its own type
annual OGTT
webers in conductive loss
loudest on bad side
CF with wheeze and high IgE
allergic bronchopulmonary aspergillosis
steroids daily for 2/52 then every other day for 3 months
