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paediatrics > respiratory > Flashcards

respiratory Flashcards

1
Q

what are some LRTIs

A 
tracheitis 
pneumonia
bronchitis
empyaema
bronchiolitis
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2
Q

what are features of LRTIs

A
  • 48 hrs, fever (>38.5C), SOB, cough, grunting
  • wheeze (bacterial unlikely)
  • reduced or bronchial breath sounds
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3
Q

what are common infective agents

A

bacterial

  • streptococcal pneumoniae
  • haemophillus influenzae
  • moxarella catarrhalis
  • mycoplasma pneumoniae
  • chlamydia pneumoniae

viral

  • RSV
  • parainfluenza
  • influenza A & B
  • adenovirus
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4
Q

what are the principles of management for LRTI?

A
  • make a diagnosis
  • assess the patient (oxygenation, hydration, nutrition)
  • treat or wait for resolve
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5
Q

describe tracheitis

A 
uncommon
croup (which does not get better)
fever, sick child
staph or strep invasion
tx: augmentin
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6
Q

describe bronchitis

A

common
loose, rattly cough, post tussive glut, chest free of wheeze/creps
haemophillus, pneumococcus
self limiting

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7
Q

describe bacterial bronchitis

A

nasal stuffiness. tachypnoea, poor feeding, crackles +/- wheeze
disturbed mucociliary clearance
RSV/adenovirus
secondary bacterial infection/overgrowth

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8
Q

describe pneumonia

A

signs are focal
crepitations
high fever
tx: if symptoms are mild then no management, oral amoxycillin, macrolide

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9
Q

describe empyaema

A

complication of pneumonia
extension of infection into pleural space
chest pain, unwell
tx: antibiotics, drainage

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10
Q

describe bronchiolitis

A

< 12 months
3 days before reach peak
fever rarely >38 degrees

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11
Q

describe pertussis

A

coughing fits
vomiting and colour change
vaccination reduces risk and severity

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12
Q

what are some URTIs

A 
rhinitis
tonsilitis
laryngitis
epiglottitis
otitis media
pharyngitis
croup
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13
Q

what are features of URTIs

A
  • common, fever

- child ill (bacterial, child well (viral)

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14
Q

describe rhinitis

A
  • very common (5 - 10/year)
  • winter months
  • self limiting
  • prodrom to: pneumonia, bronchiolitis, meningitis, septicaemia
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15
Q

describe otitis media

A
  • common
  • spontaneous rupture of drum
  • primary viral infection
  • secondary infection with pneumococcus/h. influenzae
  • self-limiting (antibiotics don’t help)
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16
Q

describe sore throat (tonsilitis/pharyngitis)

A
  • common
  • viral or bacterial - throat swab
  • either nothing or give 10 days penicillin
  • don’t give amoxycillin
17
Q

describe croup

A
  • common
  • parainfluenza
  • child is well
  • coryza, stridor, hoarse voice, barking cough
  • oral dexamethasone
18
Q

describe epiglottitis

A
  • rare
  • h. influenzae type B
  • toxic, stridor, drooling
  • tx: intubation and IV antibiotics
19
Q

describe asthma

A
  • chronic
  • wheeze, cough, SOB
  • multiple triggers
  • variable/reversible
20
Q

what causes asthma

A
  • genes
  • allergen
  • smoking
21
Q

what is the epidemiology of asthma

A
  • 1 million UK children
  • 110, 000 in Scotland
  • 5% UK children on inhaled steroids
22
Q

what diagnostic tests are useful in asthma

A

there is no diagnostic asthma test

  • peak flow
  • spirometry
  • allergy tests
  • exhaled nitric oxide
  • examination (stethoscope)
23
Q

describe SOB in asthma

A
  • significant respiratory difficulty (<30% lung function)
  • airway obstruction
  • sooking in of ribs
24
Q

describe cough in asthma

A
  • dry
  • nocturnal
  • exertional
25
Q

what is the association between asthma and atopy?

A
  • parent Hx of asthma

- personal history of eczema, hayfever or food allergies

26
Q

how is asthma treatment trialled?

A

2 month trial of ICS with steroid holiday after

27
Q

what is the ideal presentation for asthma diagnosis?

A
  • wheeze with and without URTI
  • SOB at rest
  • parental asthma
  • responds to treatment
28
Q

what is the differential diagnosis for asthma with onset <5 years?

A
  • congenital
  • CF
  • PCD
  • bronchitis
  • foreign body
29
Q

what is the differential diagnosis for asthma with onset >5 years?

A
  • dysfunctional breathing
  • vocal cord dysfunction
  • habitual cough
  • pertussis

paediatrics (37 decks)

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