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Leeds MBCHB Year 4 Peads > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Most common cause of bronchiolitis

A

RSV

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2
Q

Most common age group to get bronchiolitis

A

Under 6 months

Rarer under 1 year

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3
Q

Symptoms of bronchiolitis

A

Coryzal symptoms, dyspnoea, tachypnoea, LOW GRADE FEVER, wheeze and crackles

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4
Q

5 signs of respiratory distress

A

Use of accessory muscles, nasal flaring, head bobbing, tracheal tugging, recessions.

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5
Q

Cause of grunting

A

Exhaling with glottis partially closed to increase PEEP

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6
Q

Typical RSV infection history

A

URTI with coryzal symptoms

3-4 days later, half develop bronchiolitis

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7
Q

Reasons to admit children with bronchiolitis

A

Under 3 months
Prematurity, downs, CF
Clinical dehydration
O2 sats below 92, resps above 70

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8
Q

Bronchiolitis management

A

Supportive

High flow humidified O2

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9
Q

RSV vaccination drug

A

Palivizumab

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10
Q

Which children should receive Palivizumab

A

Congenital heart disease and premature

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11
Q

Which children should receive Palivizumab

A

Congenital heart disease and premature

Monthly until 1/2 years

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12
Q

Poiseuille’s law

A

Flow rate is proportional to radius^4

Half airways = 1/16th flow

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13
Q

Features of viral induced wheeze instead of asthma

A

Presenting before 3 years
No atopic history
Only occurs during viral infections

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14
Q

Does asthma cause a focal wheeze

A

NO - foreign body or tumour

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15
Q

Management of viral induced wheeze

A

Same as acute asthma

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16
Q

Type of wheeze in asthma

A

Expiratory

Heard throughout the chest

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17
Q

Asthma severity in extremely tachycardic and tachypnoeic children

A

Severe

Any HR/ RR cannot cause life threatening asthma. Raised causes severe

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18
Q

Type of asthma severity with 91% sats

A

Can be severe or life threatening.

Depends on other symptoms

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19
Q

4 key types of management in VIW/ acute asthma

A

O2, bronchodilators, steroids, abx

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20
Q

4 common bronchodilators

A

Salbutamol, ipatropium, MgSO4, aminophylline

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21
Q

7 step wise management in acute asthma

A

Salbutamol spacer, salbutamol/ ipratropium nebs, oral prednisone, iv hydro, iv mgso4, iv salbutamol, iv aminophylline

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22
Q

3 causes of a focal wheeze

A

foreign body, tumour, lobular pneumonia

NOT VIW/ ASTHMA

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23
Q

Step down approach for child on inhaled salbutamol and starting dose

A 
10 puffs every 1 hour
10 puffs every 2 hours
10 puffs every 4 hours
6 puffs every 4 hours
4 puffs every 6 hours
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24
Q

What do you need to check when giving high doses of salbutamol

A

Potassium (of course)

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25
Course of steroids in asthma
3 days
26
When is asthma typically worse
Night and early morning (unless obvious triggers such as a pet)
27
4 ways to diagnose asthma (all ages)
Fractional exhaled nitric oxide Spirometry with reversible testing (salbutamol) Direct bronchial challenge test (with histamine) Peak flow diary
28
Management of asthma is split by age. What are the different age groups?
Under 5 years - montelukast or ICS 2nd line 5-12 years - LABA line 3 12 + years (adults) - LABA line 3
29
Effects of steroids in children
If treatment greater than 12 months 1 cm growth height reduction and growth velocity reduction
30
Atypical bacterial cause of pneumonia in kids and treatment
Mycoplasma Macrolide - erythromycin
31
Pneumonia sound on acusultation
Bronchial breath sounds Focal course crackles (Dull to percussion)
32
Most common cause of pneumonia in children
Streptococcus pneumonia
33
Most common viral cause of pneumonia
RSV
34
First line treatment of pneumonia
Amoxicillin Macrolide if concerned about atypical
35
Most common cause of croup
Parainfluenza virus
36
Barking cough -> dx
Croup
37
Croup 1st line treatment
Oral dexamethasone single dose 150mcg/kg
38
Treatments for croup other than oral dex
O2, neb budesonide (ICS), neb adrenalin
39
Pathophysiology of croup
Oedema in the larnyx caused by parainfluenza virus
40
Most common cause of epiglottis
Haemophilus influenza type B
41
Common presentation/ signs of epiglottis
Drooping, sitting forward in tripod position, high fever, muffled voice
42
Unvaccinated child with fever, sore throat and drooling -> dx
Epiglottis haem influ B vaccinated against (most common cause)
43
Management of epiglottis
``` Early anaesthetic help (?intubtation/ trachy) IV ABX (ceftriaxone) Steroids (dex) ```
43
Management of epiglottis
``` Early anaesthetic help (?intubtation/ trachy) IV ABX (ceftriaxone) Steroids (dex) ```
44
Common complication of epiglottis (other than airway obstruction)
Epiglotis abcess - can also threaten airway
45
Laryngomalacia cause and presentation
Partial airway obstruction above vocal chords due to shape of larynx Chronic stridor in inspiration
46
Peak age of laryngomalacia presentation
6 months
47
Is the inspiratory stridor in laryngomalacia persistent
No Worse when eating, upset or lying on back
48
Laryngomalacia management
Self limiting Trachy if obstructive
49
Whooping cough is cause by?
Bordetella pertussis (gram negative) Vaccinated against in UK
50
Whooping cough presentation
Mild corzyl symptoms Severe coughing fits with gaps in between (paroxysmal) cough Cough so hard develop pneumothorax, faint or vomit
51
How to diagnose whooping cough
PCR if first 2 weeks | Anti-pertussis toxin IgG if after 2 weeks
52
Management of whooping cough
Notifiable disease and close contact prophylactics Supportive care Macrolide abx if within first 21 days
53
Complication of whooping cough
Most resolve within 8 weeks but some "100 week cough" Bronchiectasis
54
Chronic Lung Disease of Prematurity typically occurs in which babies
Born before 28 weeks
55
How can risk of Chronic Lung Disease of Prematurity be reduced after birth
CPAP instead of ventilation Caffeine to stimulate resp effort Not over oxygenating
56
What injection do babies with Chronic Lung Disease of Prematurity need?
Palivizumab - protects against RSV (bronchiolitis)
57
How to manage babies with Chronic Lung Disease of Prematurity
Palivizumab | Formal sleep study to titrate minimal required O2
58
Most common gene mutation in CF
Delta-F508 Codes for chloride channel
59
3 key consequences of CF
Thick pancreatic secretions (blocked ducts, lack of lipase) Low volume but thick airway secretions -> bilateral consolidation Bilateral absence of vas defrays
60
CF inheritance
AR
61
How if CF diagnosed
Sweat test Newborn heal prick Genetic testing
62
First sign of CF in newborn
Meconium ileus Should be black and passed within 24 hours
63
Positive CF sweat test result
Chloride concentration of greater than 60 mmol/l
64
2 key respiratory infection organisms in CF
Staph A Pseudomonas aeruginosa
65
Organism that causes significant increase in mortality in CF
Pseudomonas aruginosa Hard to treat as resistant -> tobramycin nebulised
66
Should CF kids meet each other
No as spreads pseudomonas aeruginosa
67
Treatment of pseudomonas aeruginosa in CF
Neb ABX - tobramycin/ oral ciprofloxacin
68
Treatment of pancreatic insufficiency in CF
CREON tablets
69
What is neb DNase used for
Enzyme that breaks down DNA in respiratory secretions to make it less thick
70
Prophylaxis abx in CF
Flucoxacilin
71
Key endocrine disease that patients with CF develop
DM that needs treatment with insulin
72
Name of Primary Ciliary Dyskinesa
Kartagners syndrome
73
Kartagners syndrome inheritence
AR
74
Kartagners triad of symptoms/ signs
Situs inversus (everything reversed in body) Bronchiectasis Paranasal sinusitis
75
Kartagners pathophysiology
Dysfunction of motile cilia Resp tract infections and infertility
76
Consanguinity meaning
Parents related
77
Management of Kartagners
Similar to CF Daily physio, abx pro, high calorie diet

Leeds MBCHB Year 4 Peads (21 decks)

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