Respiratory

Question 1

Asthma Severity
and discharge advice

Answer 1

Criteria for discharge
Resolution of symptoms and vitals indicating moderate severity
Adequate oxygenation - sats 90-94%
3 hours without needing SABA
Normal activity
Good PO intake
No social concerns
Proximity to health care services

Discharge Instructions
Education: assess knowledge and understanding and address gaps on:
- symptom recognition and management
- when to seek medical attention emergency management
- role of reliever and preventer therapy
- inhaler technique
Follow-up organised with long term care provider (GP or specialist)
Updated Asthma Action Plan
Consider associated atopic condition education and management
- Anaphylaxis morbidity and mortality is increased if asthma is not well controlled
- Allergic rhinitis

Question 2

Bronchiolotis Severity

Answer 2

Clinical Diagnosis

Risk Factors for more serious disease
* Chronological age at presentation less than 10 weeks
* Chronic lung disease
* Congenital heart disease
* Chronic neurological conditions
* Indigenous ethnicity
* Immunodeficiency
* Trisomy 21

Criteria for discharge
Maintianing oxygenation and oral intake

Question 3

FB Bronchoscopy Indications

Answer 3

1. Hx = coughing/choking eposide + persitent cough or cyanosis
2. Exam = unilateral wheeze or decreased AE
3. Ix = hyperexpansion on expiratory CXR or subsegmental atelectasis

Question 4

Stridor

Answer 4

Acute
1. Inhaled FB
2. Infection - Croup, B tracheiitis, epiglottitis
3. Anaphylaxis
4. Vocal Cord dysfunction

Chronic
1. Larynx - laryngomalacia, Vocal COrd Palsy
2. Subglottic - Stenosis, web or cyst, haemoangioma
3. Trachea - tracheomalacia, vascular ring (double aortic arch or right sided arotic arch w/ abberant L SCA)