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Royal Super 4th Year Brain > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

Side effects of ventolin and MgSO4?

A

Ventolin: Tachycardia, hypokalemia, hyperglycemia, lactic acidosis
- IV: Arrhythmia
MgSO4: Hypotension, bradycardia

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2
Q

Signs/symptoms of CF (acronym)

A 
CF PANCREAS
Chronic cough, FTT, Pancreatic insufficiency (malabsorption), Alkalosis + hypoNa dehydration, Nasal polyps + neonatal mec ileus, CXR changes + clubbing, rectal prolapse, electrolyte elevation in sweat, absent or congenital atresia of vas deferens, sputum (S. aureus or pseudomonas)
-DIOS, intussception/volvulus
-PTX
-Vitamin deficiency
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3
Q

CF - basic defect + pathophysiology

A

Defect in CF transmembrane conductance regulator protein = ion channel dysfunction = Cl poorly secreted into lumen + there is increased Na absorption from luminal surface = dehydrated + viscid secretions

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4
Q

Diagnosis of asthma in preschoolers

A
  1. Documentation of airflow obstruction
  2. Documentation of reversibility of airflow obstruction
    - Preferred: by professional
    - Alternative: response to 3 month trial of ICS or parental report of response to SABA
  3. No clinical evidence of an alternative diagnosis
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5
Q

Alternative diagnoses to asthma

A
  • GERD
  • EoE
  • Post nasal drip
  • Swallowing dysfunction, aspiration
  • Immune dysfunction
  • BPD
  • Bronchiolitis
  • Rhinosinusitis
  • CPAM
  • Primary ciliary dyskinesis
  • CF
  • Pulmonary edema
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6
Q

x3 organisms that we worry about in CF for airway colonization?

A
  • Pseudomonas aeruginosa
  • Staph aureus
  • Burkholderia cepacia
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7
Q

Intestinal complications of CF (x7)

A
  • DIOS
  • Mec ileus
  • Rectal prolapse
  • Reflux
  • Malabsorption
  • Biliary cirrhosis
  • Pancreatitis
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8
Q

Definition of acute vs chronic cough

A

-Chronic >3-4 weeks

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9
Q

DDx for chronic cough

A

-Frequent viral illness
-Post-viral cough
-Pertussis or pertussis like cough
-Asthma
-Chronic rhinitis
-Persistent bronchitis
-GERD
-Psychogenic cough
-CF
-Immunodeficiency
-Primary ciliary dyskinesia
-Foreign body aspiration
-Recurrent pulmonary aspirations
-TB
-Anatomic disorder
Interstitial lung disease

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10
Q

Diagnosis of Cystic Fibrosis

A

Clinical signs OR NMS+ OR sibling with CF
PLUS
x2 sweat chloride OR x2 CFTR mutations OR abnormal nasal potential difference

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11
Q

Poor prognostic features for Cystic Fibrosis

A
  • Male
  • Lung disease: FEV1, Burkholderia cepacia, PTX
  • Nutritional: DM, growth parameters
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12
Q

What to think of in case of neonatal respiratory distress for unclear reason or requiring supplemental oxygen for longer than expected?

A

Primary Ciliary Dyskinesia

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13
Q

Key features of primary ciliary dyskinesia (x4)?

A
  • Unexplained resp distress in term neonate
  • Year round daily cough/congestion
  • Laterality defects
  • Recurrent AOM
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14
Q

Asthma control criteria (x7)

A
  • Daytime symptoms <2 days/week
  • Nighttime symptoms <1 day/week
  • Physical activity = normal
  • Exacerbations = mild/infrequent
  • Absence from school/activities = none
  • Fast acting B-agonist <2 doses/week
  • FEV1 or PEF = >90% of personal best
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15
Q

Diagnosis of asthma in children >5 years old

A
  • Clinical symptoms PLUS
  • Objective evidence: spirometry (dec FEV1/FVC + bronchodilator response >12%), peak flow (inc by 20% following bronchodilator), or metacholine challenge (<4mg/mL)
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16
Q

Diagnosis of asthma in children 1-5 years old

A
  • Documentation of airflow obstruction
  • Documentation of reversibility of airflow obstruction
  • No clinical evidence of alternative diagnosis
17
Q

Predictive index for asthma in 1-5 years olds

A

1 Major = parental asthma, personal eczema, personal aeroallergen
OR
2 minor = wheezing between episodes, peripheral eosinophila, sensitization to food allergens
AND
>3 wheezing episodes

18
Q

At what age should you move from full mask to mouthpiece for asthma puffers?

A

5 years old

19
Q

Management algorithm for children with asthma <5 years old?

A
  1. Low ICS
  2. Medium ICS
  3. Add in leukotriene receptor antagonist
20
Q

Management algorithm for children with asthma 5-11 years old?

A
  1. Low ICS
  2. Medium ICS
  3. Add LABA or LTRA
  4. Add the other from above
21
Q

Management algorithm for children with asthma >12 years old?

A
  1. Low ICS
  2. Low ICS + LABA
  3. Med ICS or SMART or LTRA
  4. Low-med ICS + LABA + LTRA +/- SMART
22
Q

Roughly what is low-medium-high dose of Fluticasone for (a) children 6-11 years old and (b) children >12 years old

A

(a) <200, 200-400, >400

(b) <250, 250-500, >500

23
Q

Should you do a CT with or without contrast for investigation of recurrent pneumonia?

A

With

24
Q

x4 stages of snoring pathology

A
  • Primary snoring
  • Upper airway resistance syndrome
  • Obstructive hypoventilation syndrome
  • OSA
25
Q

Causes of OSA (x4)

A
  • Obesity
  • Enlarged tonsils/adenoids
  • Craniofacial syndromes
  • Hypotonia
26
Q

OSA clinical features

A
  • Daytime fatigue, difficulty waking in the AM
  • Headaches
  • Enuresis
  • FTT
  • Behaviour, ADHD, poor school performance
  • Developmental delay
27
Q

x2 cardiovascular complications from OSA

A
  • HTN

- Cor pulmonale

28
Q

x3 potential investigations for OSA

A
  • PSG = gold standard
  • Pulse oximetry = does not differentiate causes
  • XR = poor correlation, but could be enough in combination with symptoms
29
Q

Management for OSA

A
  • Non-pharma: nasal hygiene, sleep hygiene, weight loss
  • Pharma: intranasal steroids, montelukast
  • Surgical: adenoidectomy/tonsillectomy
  • Other: CPAP
30
Q

What to think of in a child with CF who has eosinophilia and high Ige?

A

Aspergillosus

Royal Super 4th Year Brain (25 decks)

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