Respiratory

Question 1

What causes Bronchiolitis most commonly

Answer 1

RSV

Question 2

What age is Bronchiolitis most common

Answer 2

Less than 1 year (6 months)

Question 3

Breath sounds heard in Bronchiolitis

Answer 3

Bilateral crackles and wheeze

Question 4

What MAB is used for kids at risk of Bronchiolitis

Answer 4

Palivizumab

Question 5

What does having Bronchiolitis predispose you to

Answer 5

Viral induced wheeze

Question 6

Disease course of Bronchiolitis

Answer 6

URTI with coryzal symptoms (prodrome) - then 1 in2 get chest symtpoms with worst on day 3/4

Question 7

Difference between pneumonia and Bronchiolitis

Answer 7

Pneumonia has temp >39 with focal crackles
Bronchiolitis temp <39 with widespread crackles and wheeze

Question 8

Treatment of acute asthma and viral induced wheeze

Answer 8

Inhaled or nebulised salbutamol and/or nebulised ipratropium bromide

If severe - o2 supplement to maintain 94-98
amniophylline, IV salbutamol and IV magnesium sulphate (senior guidance)

Question 9

Most common cause of croup

Answer 9

Parainfluenza

Question 10

Classic presentation of croup

Answer 10

Barking cough and stridor with a low grade fever

Question 11

Treatment of croup

Answer 11

Mild or moderate - dexamethasone 0.15mg/kg

If severe, nebulised adrenaline 5ml 1:1000 AND dexamethasone 0.6mg/kg up to 12mg

Question 12

Most common cause of epiglottitis

Answer 12

Haemophilus influenza type B (rare now due to vaccinations)

Question 13

Key points in managing epiglottits

Answer 13

Do not disturb child
Alert senior paeds consultant and anaesthesia

Can give dexamethasone

Question 14

What is the pathophysiology of laryngomalacia

Answer 14

Shortened aryepiglottic folds and soft tissue in supraglottic larynx makes it flop over airway- inspiratory stridor

Question 15

What pathogen causes whooping cough

Answer 15

BORDETELLA pertussis

Gram negative

Question 16

Presentation of whooping cough

Answer 16

2-3 days coryzal and low grade fever, followed by severe coughing fits with an insoirstory whoop

Worse at night

Infants may not have whooping cough, may have apnoeic episodes

Question 17

Diagnosis of whooping cough

Answer 17

Nasopharyngeal swab with PCR

Symptoms for more than 14 days:
Paroxysmal cough
Inspirstory whoop
Undiagnosed apnoeic episodes

Question 18

What resp disease in kids is a notifiabke disease

Answer 18

Pertussis

Question 19

Mx of pertussis

Answer 19

Simple supportive if over six months, not acutely unwell and no apnoeic episodes or severe coughing fits.

If any of above, oral macrolides like azithromycin or erithromyocin

Exclude from school for 21 days if supportive, 48 hours from abx onset if not

Question 20

What x ray sign seen in croup

Answer 20

Steeple sign on ant
Thumb sign on lateral