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year 2 - child health > respiratory > Flashcards

respiratory Flashcards

1
Q

common cold causes

A
  • very common in kids, especially 6-8 years old
  • rhinovirus
  • respiratory syncytial virus
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2
Q

common cold presentation

A
  • sneezing, rhinorrhoea, mild fever
  • associated sore throat and acute otitis media
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3
Q

common cold management

A
  • typically last for 10 days
  • rest, fluids, analgesia
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4
Q

common cold complications

A
  • secondary bacterial infection
  • bronchitis
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5
Q

croup causes

A
  • para-influenza virus is most common
  • respiratory syncytial virus causes upper airway obstruction via subglottic inflammation, oedema and exudate
  • most common in 6 months - 6 years
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6
Q

what is croup

A

viral tracheolaryngobronchitis

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7
Q

croup presentation

A
  • intermittent loud, harsh stridor, especially when upset
  • barking cough
  • hoarseness
  • apyrexial, no signs of systemic upset, able to swallow oral secretions
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8
Q

indicators of moderate croup

A

stridor at rest with no agitation or lethargy

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9
Q

indicators of severe croup

A
  • agitation and restless
  • sternal retractions
  • constant stridor
  • cyanosis
  • lethargy
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10
Q

croup diagnosis

A
  • never examine throat in child with group as there is risk of airway obstruction
  • diagnosis is usually clinical
  • AP neck x-ray showing narrow trachea (steeple sign)
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11
Q

mild croup management

A
  • oral dexamethasone stat
  • supportive care at home
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12
Q

moderate croup management

A
  • oral dexamethasone stat
  • nebulaised adrenaline
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13
Q

severe croup management

A
  • oral dexamethasone stat
  • O2
  • nebulised adrenaline
  • possible intubation
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14
Q

epiglottitis causes

A
  • H. influenzae type B
  • most common 2-7 years old
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15
Q

what is epiglottitis

A

acute bacterial infection of epiglottis

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16
Q

epiglottitis presentation

A
  • drooling and unable to swallow
  • constant, soft stridor
  • muffled voice
  • fever, signs of systemic upset, respiratory distress, unable to lie down (adopts tripod position where patient leans forward with neck extended)
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17
Q

epiglottitis diagnosis

A
  • do not examine throat, frighten child or cause more distress
  • lateral neck x-ray shows enlarged epiglottis (thumb print sign)
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18
Q

epiglottitis management

A
  • don’t wait for x-ray to start management
  • call anaesthetics and ENT (critical paediatric airway needing rigid laryngoscopy and intubation)
  • hold oxygen mask close to child
  • supportive care and IV ceftriaxone
19
Q

bronchitis cause

A

often follows upper respiratory tract infection

20
Q

bronchitis presentation

A
  • cough
  • wheeze
  • no fever
21
Q

bronchitis management

A

supportive

22
Q

bronchiolitis causes

A
  • normally under 1 year old (peak 3-6 months)
  • respiratory syncytial virus
23
Q

what is bronchiolitis

A

acute lower respiratory tract infection

24
Q

bronchiolitis presentation

A
  • recent cold followed by cough
  • wheeze
  • intercostal recession
  • cyanosis
  • mild fever
25
Q

bronchiolitis diagnosis

A

chest x-ray showing hyperinflation with patchy changes

26
Q

bronchiolitis management

A
  • supportive
  • if grunting then admit urgently to hospital
  • palivizumab is monoclonal antibody given to kids who are at increased risk of severe disease to prevent respiratory syncytial virus
27
Q

whooping cough causes

A

Bordetella pertussis

28
Q

whooping cough presentation

A

1-2 week history of cold symptoms and cough at night, followed by 2-3 weeks history of
- paroxysms of cough (coughing fits)
- followed by inspiratory whoop
- associated with vomiting and cyanosis

29
Q

whooping cough diagnosis

A

culture of nasopharyngeal aspirate or swab

30
Q

whooping cough management

A
  • supportive care
  • report to public health
  • can give oral macrolide (clarithromycin or azithromycin if present within 21 days)
  • household contacts offered antibiotic prophylaxis
  • school exclusion (can return 48 hours after starting antibiotics or if no antibiotics then 21 days post-onset)
  • infants under 6 months with suspected whooping cough should be admitted
31
Q

pneumonia presentation

A
  • malaise and high fever (> 39 C)
  • respiratory distress
  • pleural pain and crackles in older kids
32
Q

pneumonia diagnosis

A

chest x-ray

33
Q

community acquired non-severe pneumonia management

A
  • under 1: co-amoxiclav
  • > 1: amoxicillin
  • penicillin allergy: clarithromycin
34
Q

community acquired severe pneumonia management

A

co-amoxiclav with possible use of clarithromycin

35
Q

hospital acquired pneumonia management

A

co-amoxiclav

36
Q

what is stridor

A

harsh, inspiratory sound due to upper airway obstruction

37
Q

name 4 causes of stridor

A
  • anaphylaxis
  • foreign body
  • infection (croup, epiglottitis)
  • laryngomalacia (most common cause of stridor in kids)
38
Q

foreign body inhalation management if choking

A

back slaps or abdominal thrusts

39
Q

foreign body inhalation management if not choking

A

removal via bronchoscopy under general anaesthetic

40
Q

asthma step management

A
  1. salbutamol as needed, inhaled coricosteroid (LTRA if < 5)
  2. LABA if > 5, LTRA if < 5
  3. stop LABA and up inhaled corticosteroid dose
  4. inhaled corticosteroid and LTRA
  5. consider trial of medium dose inhaled corticosteroid or theophylline
41
Q

asthma acute attack presentation

A
  • PO2 under 92%
  • PEF 33-50% predicted
  • can’t complete sentences in one breath/too breathless to speak
  • heart rate (> 5: > 125 bpm, 1-5: > 140 bpm)
  • respiratory rate (> 5: > 30, 1-5: > 40)
42
Q

life threatening asthma attack presentation

A
  • PO2 92%
  • PEF less than 33% predicted
  • silent chest with cyanosis
  • poor respiratory effort and exhaustion
  • confusion
  • hypotension
43
Q

asthma attack management

A
  • salbutamol
  • prednisolone
  • aminophylline in unresponsive severe or life threatening attacks

year 2 - child health (20 decks)

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