Respiratory Flashcards
Three things to manage in paeds no matter if bacterial or viral cause?
Oxygen
Hydration
Nutrition
->if all three are okay, it’s okay to watch and wait, time is on your side. Antibiotics can make problems worse.
Common side effects of antibiotics in chidlren?
Diarrhoea
Oral thush
Nappy thrush
Allergic reaction
Multi resistance
Rhinitis is very common. What are some conditions that can then develop from rhinitis?
Pneumonia, bronchiolitis.
Meningitis
Septicaemia
Otitis media symptoms?
Painful ear
Can be spontaneous rupture of the drum
Treatment of otitis media?
Usually self-limiting
Antibiotics often don’t help
Analgesia for pain
When would you give antibiotics for otisis media?
Child <2 and bilateral
If child is systemically unwell
Which antibiotic would you give for otitis media, IF antibiotics are indicated?
Amoxicillin
How do you determine the cause of tonsillitis/pharyngitis?
Throat swab
If strep throat, what is the treatment?
10 day penicillin
->otherwise, probs don’t need antibiotics
Which treatment should not be given for a sore throat?
Amoxicillin
->causes rash
Croup symptoms?
Barking cough
Stridor
->symptoms typically present at night
Treatment of croup?
Dexamethasone
Like in URTI, what are the three things to manage first in LTRI?
Nutrition
Oxygenation
Hydration
->all conditions actually
“Croup which doesn’t get better”?
Tracheitis
Symptoms of tracheitis?
Fever
Sick child
Really unwell
Treatment of tracheitis?
DOES need antibiotics.
->one paediatric condition which always needs antibiotics
What is more common bronchitis or bronchioitis?
Bronchitis
Symptoms of bronchitis?
Loose rattly cough, usually following a cold
Post-cough vomit/glut
Chest clear
Treatment of bronchitis?
No treatment required, mostly self-limiting
Reassure parents, cough is normal, 20% of children have the cough for two weeks, not juts in this condition, but it many resp conditions
Symptoms of bronchiolitis?
Only affects infants
Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze
Low grade fever
What tends to be the most common cause of bronchiolitis?
RSV
->now a RSV vaccine
How long do symptoms of bronchiolitis usually last?
50% have symptoms for at least 2wks
->no treatment though, no medications proven to work
General symptoms of LRTI?
48hrs symptoms
Fever >38.5
SOB
Cough
Grunting
Does a wheeze make a bacterial cause of a LRTI more or less likely?
Wheeze means bacterial cause is less likely
Benefits of oral antibiotics compared to IV?
Shorter hospital stay
Cheaper
No drip
->only negative is fever lasts longer
Why is bronchiolitis different to viral induced wheeze?
<12 months old
One off (NOT recurrent)
Typical history….
Difference between LRTI and bronchiolitis?
LRTI:
In all ages
More rapid onset of symptoms
Fever
Bronchiolitis:
Aged <12 months
3 days before reach peak
Fever rarely >38oC
Pertussis is known as?
Whooping cough
Pertussis is vaccinated against but is still common. What is the point of the vaccine?
Less severe
If you suspect asthma, how can it be confirmed?
Start low dose inhaled corticosteroids, will see improvement
Two months, won’t do harm to a child.
Trio of symptoms of asthma?
Wheeze
SOB
Cough
->all three need to be present
Five asthma syndromes that are all just diagnosed as asthma?
Infant onset
Childhood onset
Adult onset
Exertional onset
Occupation onset
Name some conditions which cause an isolated cough.
Bronchitis
Pertussis
Habitual cough
Habitual cough?
Cough out of habit, usually dry and loud
->strong FH asthma, they don’t do it when watching TV or asleep
Name some conditions which can cause noisy breathing.
Asthma
Bronchitis
Laryngomalacia
Tracheomalacia
Snoring
Goals of asthma treatment?
Minimal symptoms during day and night
Minimal need for reliever medication
No attacks (exacerbations)
No limitation of physical activity
What are some of the indications of poorly controlled asthma?
SABA >3 x /week
Absence from school/nursery
Nocturnal symptoms multiple times a week
Exertional symptoms multiple times a week
Which tests are recommended in asthma?
No tests.
Asthma preventer meds?
Inhaled corticosteroids (ICS)
Long acting beta agonists
Leukotriene receptor antagonists
Side effects of ICS?
Height suppression <1cm
Oral candidiasis*
-> prevent by brushing teeth after
Which drug must be taken alongside LABA?
ICS
->used as a fixed dose combined inhaler
What type of side effects can be seen in Leukotriene receptor antagonist meds?
Psychiatric side effects
->falling out of favour because of these
Summarise asthma treatment overview.
Low dose ICS
MART - but lecturer isn’t happy w this
If not with MART:
Add Leukotriene receptor antagonist
Then LABA combined inhaler
->so basically, guidelines say MART but apparently this isn’t good. This is a ladder, so only add the next if the previous does not provide good asthma control
What age group can have dry powder devices?
> 8yrs
