Respiratory Flashcards
What is the most common viral cause of pneumonia in young children?
RSV
What is a common cause of pneumonia in all ages?
TB
What is a cause of pneumonia in newborns?
Group B strep
What is the presentation of pneumonia?
Fever, SOB, wet and productive cough, nasal flaring, tachypnoea, wheeze, hyperinflation, lethargy, delerium
What is shown on CXR in pneumonia?
Consolidation, cavities, fluid and air
When is the pneumococcal vaccine given?
12 weeks, 1 year and over 65
What does the pneumococcal vaccine protect against?
Sepsis, meningitis and pneumonia
What is croup?
Acute laryngotracheobronchitis
What is the usual age range of croup?
6 months to 6 years
What is the most common cause of croup?
Parainfluenza virus
What is the presentation of croup?
Harsh barking cough, stridor, fever, rhinorrhoea
What is the hospital treatment for croup?
0.15mg/kg dexamethasone single dose, nebulised adrenaline, oxygen as required, keep the child calm
What is the clinical rating score for croup?
Westley Severity Score
What is asthma?
Inflammatory, reversible airway disease with varying obstruction whereby airways are hypersensitive and respond to allergens by constricting
What is the presentation of chronic asthma?
Episodic symptoms, diurnal variation, dry cough, bilateral widespread polyphonic wheeze, SOB
Name some triggers of asthma
House dust mites, cold weather, exercise, pet hair, peanuts, smoke, pollution
What are the spirometry results for asthma?
FEV1/ FVC < 80% predicted
What are the reliever and preventer inhalers?
Reliever is SABA and preventer is ICS
Name 3 features of life-threatening asthma?
Silent chest, poor respiratory effort, exhaustion, cyanosis
Name 3 features of severe asthma?
Too breathless to feed or talk, use of accessory muscles and audible wheeze
Name 3 features of mild/ moderate asthma?
No or minimal accessory muscle use, feeding well, talking in full sentences
What is the PEFR of life-threatening asthma?
Under 33%
What is the PEFR of severe asthma?
33-50%
What is bronchioloitis?
Inflammation and infection of bronchioles due to RSV droplet spread
What is the presentation of bronchiolitis?
Coryzal symptoms, dyspnoea, tachypnoea, apnoeas, mild fever, poor feeding
Name features of respiratory distress
Accessory muscle use, inter and subcostal recessions, nasal flaring, head bobbing, tracheal tug, cyanosis, abnormal airway sounds
What is palivizumab?
A monoclonal antibody given to high risk babies for bronchiolitis such as premature or CHD
What is cystic fibrosis?
AR genetic condition with defects in chloride ion channel protein making secretions throughout the body thick and sticky
What is the presentation of CF?
Chronic cough, thick sputum, steatorrhoea, meconium ileus, abdominal pain, finger clubbing, salty skin, nasal polyps, crackles, rectal prolapse
What are the diagnostic tests for CF?
Gold is sweat test
Heel prick test measuring trypsin
Faecal elastase
Genetic testing for CFTR gene
What are the common colonisers for CF?
Staph aureus and pseudomnas aeruginosa (MC)
What is the management of CF?
CREON to replace lipase
ADEK vitamins
Fluclox as prophylaxis
Salbutamol nebulised
Chest physio
Exercise
Fertility treatment
What is acute epiglottitis?
Inflammation and swelling of the epiglottis typically due to Hib and causes quieter stridor than croup but is now rare due to Hib vaccination
What is the presentation of acute epiglottitis?
4 D’s = dyspnoea, dysphagia, drooling, dysphonia (hot potato voice)
Sore throat, fever, stridor, tripod position
What does the X-ray of acute epiglotttis show?
Thumb sign
When is the Hib vaccination given?
8, 12, 16 weeks and 1 year
Give some causes of wheeze in a child
Viral induced wheeze, asthma
What class of drugs are the relievers?
B2 agonists - salbutamol, ipratropium bromide
What are the possible side effects of inhaled steroids
Adrenal suppression, slowed growth, oral thrush
Give some examples of upper RTI
Rhinitis, otiits media, tonsilitis, laryngitis
Give some lower RTI
Croup, epiglottitis, pneumonia, bronchiolitis
A child in A+E is diagnosed with Croup. What medication should you give them?
Steroids - dexamethasone or prednisolone
List 3 diseases caused by Hib
Epiglottis, pneumonia and meningitis
What is the difference between viral induced wheeze and bronchiolitis?
Bronchiolitis is a specific inflammatory condition affecting the bronchioles, primarily seen in infants and young children, and is often associated with severe respiratory symptoms. Viral-induced wheeze, on the other hand, refers to wheezing associated with viral infections but may not involve the same level of inflammation in the bronchioles and can affect a wider age range
What is a virally induced wheeze?
Acute wheezy illness caused by viral infection (commonly RSV or rhinovirus) causing inflammation and oedema in the airways.
What causes whooping cough?
Bordetella pertussis (gram negative)
When is whooping cough vaccination given?
2, 3, 4 months and booster at 3 years 4 months
When is the inspiratory whoop seen in whooping cugh?
3-6 weeks later in the paroxysmal phase
What is the presentation of whooping cough?
Cough worse at night, whoop, low grade fever, sore throat, spasmodic coughing episodes that can lead to vomiting, coryzal symptoms in the first catarrhal phase
What is the management of whooping cough?
Clarithromycin (macrolide antibiotics)
What is RDS?
Affects premature babies born before sufficient production of surfactant (before 32 weeks) leading to lung collapse due to high surface tension so it is harder for alveoli and lungs to expand
What is the management of RDS?
High risk mothers are given dexamethasone, endotracheal surfactant and CPAP
