respiratory Flashcards
respiratory consequences of CF
low volume thick airway secretions -> reduces airway clearance
results in bacterial colonisation and susceptibility to airway infections
pancreatic consequences of CF
thick pancreatic and biliary secretions that cause blockage of ducts -> lack of digestive enzymes in the GI tract
associated conditions of CF
pancreatitis
recurrent LRTI
failure to thrive
DM
male infertility
what is meconium ileus
sign of CF
thick and sticky meconium which gets stuck and obstructs the bowels
characterised by not passing meconium within 24hrs, abdo distension and vomiting
clinical presentation of CF - symptoms
chronic cough
thick sputum production
steatorrhoea
parent may say child tastes salty when they kiss them
poor weight and height gain
signs of CF
finger clubbing
crackles and wheezes on auscultation
abdo distention
investigations for CF
newborn blood spot testing
sweat test
genetic testing
what is offered to prevent staph aureus infection for children with CF from 3yrs to 6yrs
flucloxacillin
management for CF patient developing pseudomonas aeruginosa
eradication therapy with a course of oral/ IV abx and inhaled abx
management for CF
chest physio
exercise
high calorie diet
creon tablets to digest fats
what is bronchiolitis
LRTI commonly affecting babies in their first year of life - peak at 3-6months
most common cuase of bronchiolitis
RSV
risk factors of bronchiolitis
congenital heart disease
preterm
neuromuscular disorders
under 3months
clinical presentation for bronchiolitis
coryza
chest recessions
tachypnoea
poor feeding
fever
wheeze and crackles on auscultation
persistent cough
management for bronchiolitis
ng tube/ iv fluids
o2
what ventilatory support is given in bronchiolitis if supplementary o2 is not sufficient
high flow humidified o2
cpap
intubation and ventilation
signs of poor ventilation in cap gas
rising co2
falling ph
what is given to high risk babies to prevent bronchiolitis caused by RSV
palivizumab
given to babies who are ex prems and those with congenital heart disease
what is gastroenteritis
inflammation of stomach to the intestines
clinical presentation of gastroenteritis
sudden onset nausea and vomiting
sudden onset diarrhoea
dry mucous membranes
reduced uo
stomach pain
causes of gastroenteritis
mainly viral - rotavirus and norovirus
bacterial- campylobacter jejuni, e.coli
gastroenteritis management
rehydration - low osmolarity oral rehydration salt solution if child is at increased risk of dehydration
abx (only in some cases - not routinely given)
anti diarrhoeals and anti-emitics not recommended
investigations for gastroenteritis
stool culture and sensitivity - not routine but maybe be considered if systemically unwell, immunocompromised, contact with an affected person etc
at what age is croup common in
6months - 3yrs
what is croup
laryngotracheobronchitis causing mucosal inflammation and increased secretion which affect the airways
common cuase of croup
parainfluenza virus
clinical presentation of croup
sudden onset of barking cough
stridor
increased work of breathing
hoarse voice
fever
management for croup
oral dexamethasone
if too unwell for oral - inhaled budenoside or IM dexamethasone
o2
when is croup often worse
often worse and also starts at night
what is viral induced wheeze
acute wheezy illness caused by a viral infection
clinical presentation of viral induced wheeze
sob
signs of resp distress
expiratory wheeze throughout the chest
what are the 2 patterns of wheezing
transient early wheezing- virus associated wheeze
persistent and recurrent early wheezing- stimuli triggered wheeze
clinical presentation of asthma
wheeze
worse at night and early morning
triggers
positive response from asthma therapy
management for asthma
ICS and SABA
ICS and LTRA
ICS and LABA
