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1 Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

How many peak flow measurements should be taken?

A

three, take average reading

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2
Q

What are peak flow results dependent on?

A

height

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3
Q

Child is snoring at night. What study can be conducted?

A

home oximetry study

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4
Q

Name an important aspect of a history of someone with wheeze and cough?

A

sleep quality

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5
Q

What specific question should be asked about wheeze?

A

where can you hear the wheeze? in chest then likely asthma, if in mouth then something else

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6
Q

six month baby, five day hx of cough and coryzal symptoms. Wheeze and crackles. Nappies are normal. What is the most appropriate initial management?

A

reassure and discharge home with worsening advice. Self-limiting + encouraging observations (feeding, normal nappy)

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7
Q

At what age can you diagnose a child with asthma?

A

Not until >5 due to compliance with peak flow and spirometry

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8
Q

What diagnosis is wheeze + cough associated with in children <2 years old?

A

bronciolitis

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9
Q

What diagnosis is wheeze + cough associated with in older children >2?

A

viral induced wheeze

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10
Q

What is the difference between bronchiolitis and viral induced wheeze?

A

While bronchiolitis is wet lungs, viral wheeze is bronchospasm. Plus difference in age of child

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11
Q

Why doesn’t bronchiolitis respond to salbutamol?

A

babies don’t develop B2 receptors until a later stage

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12
Q

4 year old, barking cough and stridor, given adrenaline. Temp is still 38.2. What is the diagnosis and next step in management?

A

Croup, oral steroids.

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13
Q

Should you examine the throat of a child with croup?

A

Never examine throat of patient with child, or blood tests, don’t do anything the child will be distressed by, crying will make it worse, therefore clinical diagnosis.

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14
Q

2 hours after c section, term baby develops tachyopnoea. Mother had uncomplicated pregnancy, no infection, amniotic fluid clear. What is the likely diagnosis?

A

transient tachyopnoea of the newborn
TTN

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15
Q

Why does transient tachyopnoea of the newborn (TTN) happen?

A

TTN due to residual fluid in lungs. C section without mechanical push leaves residual fluid, this resolves within hours.

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16
Q

What is the difference between TTN and respiratory distress?

A

Respiratory distress in preterm neonates due to poor development of lungs and is more serious and requires medical input. TTN is transient and resolves spontaneously.

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17
Q

Questions to ask in history about a cough

A

duration, worse during day or night, exercise, triggers, wheeze/bark

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18
Q

What are the components of the 6-in-1 vaccine?

A

diptheria, tetanus, pertussis, polio, Hib disease

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19
Q

Harrison sulcus is a sign of which condition?

A

Chronic asthma
=indentation of chest around 6th rib

20
Q

Nasal polyps is a sign in which respiratory condition?

A

cystic fibrosis

21
Q

Name three factors which influence lung function

A

Height
Sex
Age
Ethnicity

22
Q

What is the main virus that causes bronchiolitis?

A

RSV

23
Q

Three signs of respiratory distress?

A

raised RR
accessory muscles
nasal flaring
head bobbing
cyanosis
abnormal airway noises

24
Q

List three abnormal airway noises

A

wheezing
grunting
stridor

25
Q

What is the time course of RSV infection?

A

Coryzal symptoms
Chest symptoms day 1-2
Worst on day 3/4
Symptoms last 7-10 days in total and most recover fully within 2-3 weeks

26
Q

Name a drug given in the prevention of bronchiolitis?

A

Palivizumab

27
Q

Why is it important to feel for liver edge in respiratory exam in child?

A

may be pushed down by hyper expanded lungs

28
Q

Three differentials for acute cough

A

URTI
Croup
Bronchiolitis
Pneumonia
Pertussis
Inhaled foreign body

29
Q

Two differentials for chronic cough in child

A

asthma
infection- TB
GORD
Cystic fibrosis
Kartagener syndrome

30
Q

Two differentials for acute stridor

A

Inhaled foreign body
Croup
Epiglottitis

31
Q

Which organism typically causes croup

A

parainfluenza

32
Q

How is cough described in croup?

A

barking

33
Q

Briefly describe the pathophysiology of cystic fibrosis

A

disorder of exocrine gland function wherein mutations in CFTR causes thickened secretions which accumulate in the lunga

34
Q

Which organs are affected in cystic fibrosis?

A

pancreas
lungs
reproductive tract

35
Q

Three features of cystic fibrosis?

A

respiratory
poor growth
pancreatic insufficiency
anaemia of chronic disease

36
Q

What screening is involved in cystic fibrosis?

A

Neonatal blood spoot- immunoreactive trypsin levels (newborn screening)
sweat test
genetic test

37
Q

What is the mode of inheritance of cystic fibrosis?

A

autosomal recessive

38
Q

both parents are healthy, one sibling has cystic fibrosis and a second child does not have the disease, what is the likelihood of the second child being a carrier?

A

We know the child doesn’t have the condition, so the answer is two in three.

39
Q

What is the first sign of cystic fibrosis in newborn?

A

meconium ileus

40
Q

Three signs of cystic fibrosis?

A

low weight growth charts
nasal polyps
finger clubbing
abdominal distention
crackles and wheeze

41
Q

Name two common colonisers in cystic fibrosis

A

staph aureus
pseudomonas

42
Q

Three causes of finger clubbing in children?

A

cyanotic heart disease
cystic fibrosis
TB
IBD
Liver cirrhosis
Infective endocarditis

43
Q

List three differences between the presentation of a pneumonia and URTI

A

URTI- runny nose, sore throat, sneeze, ear pain. Clear sounds upon auscultation!!!

Pneumonia- Cyanosis, tachyopnoea, abnormal breath sounds, general body malaise

44
Q

Cystic fibrosis can cause which condition in children?

A

Diabetes!

Cystic fibrosis presents in childhood with respiratory symptoms, but as the disease progresses, further features begin to develop. If the pancreas becomes affected, then diabetes mellitus can develop. It can take time for the pancreas to be affected enough to cause diabetes, which is why children with cystic fibrosis may develop diabetes later in life.

45
Q

State two severity markers for croup deterioration?

A

Sternal/intercostal recession, asynchronous chest wall and abdominal movement.
Fatigue, pallor or cyanosis, decreased level of consciousness or tachycardia.
The degree of chest wall recession may diminish with the onset of respiratory failure as the child tires.
A respiratory rate of over 70 breaths/minute is also indicative of severe respiratory distress.

46
Q

After dexamethasone, which treatment should you offer if child continues to deteriorate with croup?

A

nebulised adrenaline

1 Paediatrics (19 decks)

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