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Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is the most common cause of bronchiolitis?

A

RSV

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2
Q

In which age group is bronchiolitis most common?

A

3-6 months

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3
Q

Describe the typical presentation of bronchiolitis.

A 
Coryzal symptoms
Respiratory distress
Dyspnoea
Tachypnoea
Poor feeding
Mild fever
Apnoeas
Wheeze and crackles on auscultation
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4
Q

What are the signs of respiratory distress?

A 
Tachypnoea
Use of accessory muscles
Intercostal and subcostal recessions
Nasal flaring 
Head bobbing 
Tracheal tugging
Cyanosis
Abnormal airway noises
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5
Q

What are the criteria for admission in bronchiolitis?

A 
Age <3 months and any underlying health conditions
50-75% less of normal milk intake 
Clinical dehydration 
RR >70
O2 sats <92%
Moderate-to-severe respiratory distress 
Apnoeas
Parents feeling incapable of managing at home
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6
Q

What is the management for bronchiolitis?

A

Supportive management only

Saline nasal drops and suctioning

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7
Q

What role does Palivizumab play in bronchiolitis?

A

Prevention

Monoclonal antibody that targets RSV
Monthly injection to prevent bronchiolitis
Given to high-risk babies

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8
Q

What are the causes of croup?

A

Most common:
Parainfluenza
Influenza

Less common:
Adenovirus
RSV
Diphtheria

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9
Q

How does croup present?

A 
Increased work of breathing 
'Barking' cough, occurring in clusters of coughing episodes
Hoarse voice
Stridor
Low-grade fever
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10
Q

What is the management for croup?

A

Oral dexamethasone (150 micrograms/kg)

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11
Q

In which age group is croup most common?

A

6 months - 3 years

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12
Q

What is the cause of whooping cough?

A

Bordetella pertussis (gram -ve bacteria)

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13
Q

How does whooping cough typically present?

A 
Croyzal symptoms 
Low grade fever
Severe coughing fits 
Large, loud inspiratory whoop when coughing ends 
Post-tussive vomiting
Fainting and/or pneumothorax
Apnoeas
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14
Q

How can whooping cough be diagnosed?

A

Nasopharyngeal/nasal swab with PCR testing or bacterial culture
Test for anti-pertussis toxin immunoglobulin G (when cough has been present for more than 2 weeks)

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15
Q

How is whooping cough managed?

A

Supportive care
Macrolide abx (azithromycin, erythromycin, clarithromycin)
Vulnerable close contacts should be given abx

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16
Q

What is a potential complication of whooping cough?

A

Bronchiectasis

17
Q

What is laryngomalacia?

A

Where the structure of the larynx causes partial obstruction of the airway

18
Q

What is the characteristic shape of the larynx in laryngomalacia?

A

Omega

19
Q

How does laryngomalacia typically present?

A

Stridor - more prominent when feeding, laying on back, or during URTI
No associated respiratory distress

20
Q

How is laryngomalacia managed?

A

Usually no intervention is required - resolves as the larynx matures and grows and is better able to support itself
Rarely a tracheostomy may be required

21
Q

What is the most common cause of epiglottitis?

A

Haemophilus influenza type B

22
Q

Describe the typical presentation of acute epiglottitis.

A 
Sore throat and stridor
Drooling
Tripod position
High fever
Difficulty or painful swallowing 
Muffled voice
Scared and quiet 
Septic and unwell appearance
23
Q

What is the typical appearance of epiglottitis on x-ray?

A

Thumbprint sign - soft tissue shadow that looks like a thumb pressed into the trachea
Caused by oedematous and swollen epiglottis

24
Q

What is the management for acute epiglottitis?

A

Alert the most senior paediatrician and anaesthetist
Ensure the airway is secure
IV abx (ceftriaxone)
Steroids (dexamethasone)

25
Q

What a common complication of epiglottitis?

A

Epiglottic abscess - life-threatening emergency

26
Q

What is primary cilia dyskinesia/Kartagner’s syndrome?

A

Autosomal recessive condition affecting the cilia, particularly of the respiratory tract

27
Q

How does PCD usually present?

A

Similar presentation to CF
Frequent and chronic chest infections
Poor growth
Bronchiectasis

28
Q

What is Kartagner’s triad?

A

3 key features of PCD

Paranasal sinusitis
Bronchiectasis
Situs inversus

29
Q

How is PCD diagnosed?

A

Sample of ciliated epithelium of the upper airway via nasal brushing or bronchoscopy and examine cilia action

30
Q

How is PCD managed?

A

Similar to CF and bronchiectasis - daily physiotherapy, high calorie diet, abx

31
Q

How does pneumonia usually present?

A 
Cough (productive)
High fever
Tachypnoea
Tachycardia
Increased work of breathing 
Bronchial breath sounds
Focal coarse crackles 
Lethargy 
Delirium
32
Q

What are the bacterial causes of pneumonia?

A 
Streptococcus pneumonia (most common)
Group A strep
Group B strep 
Staphylococcus aureus 
Haemophilus influenza 
Mycoplasma pneumonia, atypical bacteria
33
Q

What are the viral causes of pneumonia?

A

RSV
Parainfluenza virus
Inlfuenza virus

34
Q

What is the imaging modality of choice in pneumonia?

A

CXR

35
Q

What is the 1st line treatment for pneumonia?

A

Amoxicillin

36
Q

When are macrolides used for the treatment of pneumonia?

A

Atypical pneumonia

Penicillin allergy

Paediatrics (14 decks)

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