respiratory Flashcards
treatment of mycoplasma
macrolide - kids
levofloxacin - adults /teens
age for mycoplasma and pattern on x ray
> 5
usually an interstitial type usually Lower lobe
diagnosis of pneumocystis + treatment
BAL + gastric washings(early in the moring ) but a lot of kids will still ne negative its quite difficult
biseptol!
lab findings which indicates strep pneumonia
a very sudden onset high fever herpes septic condition abc >15 000 CRP more than 100
Prevention of pneumonia
h. Infuenza type b vaccine
Flu vaccine
Pneumococcal conjugate vaccine
destructive pneumonia caise
staph /strep
group A
klebsiella - bilateral +smaller
pseudomonoans
destructive pneumonia complications
sepsis
bull rupturing (life threatening)
pericarditis
what does infiltrate give you on examination
bronchophony
key word for nectrotzing pneumonias
cavities
which ideates do you do a cold agglutination test
mycoplasma pneumonia are IG M antibodies
empirical treatment for all pneumonias regardless of type
cephalosporins
antistaphy drugs
vancomycin+ clindamycin
definition of chronic pneumonia
> 3 months
will there always be stridor in a foreign body
no depends on the location if upper then yes but if lower then more likely coughing
which bronchus gets more affected by foreign bodies
right cos its more vertical
what’s important to always remember about pneumonias
always localised!
> 2 in pneumonia
more likely to be infiltrate (localised)
which disease is associated with vomitting
whooping cough
causes of stridor
upper airway obstruction
croup
epiglottis laryngitis
what age are children mostt likely to get brocnhiollits
<6 months
lab finding ABG bronhcioloitis
acidosis due to hypercapnia
most common cause of pneumonia is neonates top 3
e.coli
chlamydia
listeria monocytogense
s.pneumonia
h.influenz
general treatment for pneumonia
what does zinc do
amoxicillin - mild
severe- co amoxiclav
if mycoplasma- add macrolide
in poor counttries it helps with recovery
can you have crackles in bronhcioloitis
yes
what organisms are a precursor to brochieactatsis
morexella catrrhalis + h. influenza
types of bronchiactiais
generalised - CF , PRMARY ciliary dyskinesia
focal - previous sever pneumonia, foreign body
main symptom of bronchieacasi s
wet cough (purulent)
other signs of bronhcieatayts
clubbing hemoptosqis wheezing dyspnea coughing fatigue weigh loss ]
labs of cf
metabolic alkalosis
hyonatremia + hypochloremia
syndrome of CF
oedema
anemia
hypoproetinemia
malabsorption
what respiratory condition is rectal propse associated with
CF
DIAGNOSIS OF CF
trypinsogen in blood - high
fecal elastase - in faeces in low
sweat test - standard >60 abnormal
genetic screening
what values of sweat test indicate cF
> 60
tx CF
CREON mucolytics antibiotics prophylaxis vitamin supplements ppi (gerd) bone scans for osteoporosis
negative test for sweat test
<40
how many times do you do sweat test
at least 2 times
IGRA
Blood test to diagnose tb but cannot differentiate between latent + active infection
types of tb
- latent - asymptomatic
2. active
why is it hard to diagnose Tb
children find it hard to produce sputum
also in children there is few tb bacteria , sample not enough
dx of tb
LIP - lymphoid interstitial pneumonitis which happens in some kids with TB so all children with tb should be tested for HIV and vice versa
which tb drug causes peripheral neuropathy
isoniazid
should we treat symptomatic children with TB
yes to decrease the risk of reactivation later in life give them rifampicin +isoniazid for 3 months or just I for 6 months.
CI for bcg vaccine
HIV as it is a live vaccine
immunodeficiency
spirometry values for asthma
FeV1- decreased
FVC- normal or slightly decrease
ratio- less than 70%
signs not suggestive of asthma
clubbing symptoms done get worse at night productive cough normal lung function tests wheezing immediately after birth unilateral wheezing - ASTHMA IS DIFFUSE!
when do we diagnose asthma
> 2
when can we perform spirometry
> 5 years
side effects of salbutwmal
hypo k
tremors
tachycardia + myocardial ischemia
asthma attach management
predislon - 3 days regarless of severity
SABA
common age for tonsillitis to occur
3-5
what do we avoid giving in toniliaiti
amzociillin cos maculopapular rash
indications for adenoidectomy
osa
recurrent tonsilitis
abscess in tonsil
recurrent otitis media with effusion
common age for otitis media
6-12 months
most likely cause of otitis media
s.pneumonia
what to look out for in otitis media
unexplained fever !
otoscope - red bulging membrane loss of light reflex
complication of otitis
mastoiditis
meningits
hearing loss
otitis media with effusion
as a result of recurrent infections
otoscope: dull membrane
can cause deafness
which sinus is not present at birth
frontal
age for croup
<6
true croup cause
pseudo croup
diphtheria
other viruses, bacteria
key feature of croup
no drooling
barking cough
treatment of croup
self limiting
severe: give cs, nebuliser adrenaline
x ray sign for croup
steeple sign (tapering trachea)
bacterial tracheitis causes
staph + strep
tracheitis vs croup
tracheiits has a higher fever
more severe obstruction with more secretions
how to treat tracheitis
treat with croup protocol but then the condition will not improve AS U NEED ANTIBIOTICS
cause of epiglottis
h. influenza
key points for epiglottis
cough is not the leading factor
severe intoxication
drooling
muffled voice
sign for epiglottis on x ray
thumb sign
tx epiglottis
antibiotics - cephalosporins
which disease do we give nebuliser adrenaline
croup
what type of stridor is the worst
when its very soft
hand foot and mouth disease is caused by
coxakie virus (belongs to enterovirus family)
values for positive ASO titre
> 200
how to dx bronchiolotis + pneumonia
pneumonia - appear more toxic and higher fever and wheezing is not as predominant
bronchiolotits- often a history of a viral
is there hyperinflation in CF
yes there can be
is CF associated with lung abscess
no abscess are uncommon in pedes and often causes by aspiration
asthmatic that improves then quickly detroriates
tension pneumothorax
1st line therapy ASTHMA
- salbutwmal
2. CS second line
mild croup
severe croup
mild - cs
severe - adrenaline
what kind of lung disease is CF
most common lN affected TB
obstructive
hilar, then cervical
scrofula (submandibular)
allergic bronchopulmonary aspergillosis
flase negative TST
an exaggerated response to aspergillum occurigm most often in CF
immunodeficiency (too weak to even mount a response)
too early on in illness
Mantoux tets
miliary tb diagnois
48-72 h
liver or bone marrow bipsy
tb meningitis
what can hilar lymphadenpathy cause
DEXAMTHESOSN initially
air trapping and hyperinflation
can also compress trachea and bronchi
FROSTED GLASS
in which condition may TST be non reactive
PNEUMOCYSTIS
miliary Tb due to anergy
