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Paediatrics > Respiratory #2 > Flashcards

Respiratory #2 Flashcards

1
Q

What is the pathophysiology of respiratory distress syndrome?

A

Surfactant deficiency- phospholipids & proteins excreted by type 2 pneumocytes
Leads to alveolar collapse during expiration
Increased Surface tension & RR
Hypoxia & exhaustion
Compounded by poor muscle bulk & elastic ribcage in prem’s

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2
Q

When is respiratory distress syndrome usually seen?

A

50% at 32weeks

>90% <28weeks

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3
Q

What are the RFs for respiratory distress syndrome?

A 
Prematurity!
LSCS
Hypothermia
Acidosis
Meconium aspiration
Maternal DM
FHx
Congenital pneumonia
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4
Q

What are the signs & symptoms of respiratory distress syndrome?

A 
Cyanosis: Within 4hr of birth
Inc RR
Chest indrawing
Grunting within 4h
Untreated: Worsens 48-72hrs
Resolves: 5-7days
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5
Q

How is respiratory distress syndrome investigated?

A

CXR: Bilateral, diffuse ground glass-atelectasis
ABG
Sats
ECHO

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6
Q

How is respiratory distress syndrome managed?

A

Delivery room care & resus
Warm IV 10% Dextrose
Oxygen, nasal CPAP, Ventilation
Replace surfactant: Curosurf bolus down ETT, second dose 8-12h later
Abx: Penicillin & Gentamicin until pneumonia excluded
Nutrition

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7
Q

How is respiratory distress syndrome prevented?

A

Betamethasone/Dexamethasone 2doses 12hourly 1-7days before delivery
Max benefit 24hrs
Lasts 7days
Prevent hypothermia & acidosis (inhibits surfactant production)

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8
Q

What is a breath holding attack?

A

Infants and toddlers (6-18m)
Stimuli causes child to become anoxic
Due to vagal stimulation

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9
Q

What are the causes of breath holding attacks?

A

Noxious stimuli: Pain, shock, fear

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10
Q

What are the signs & symptoms of breath holding attacks?

A 
Short cry followed by:
Sudden 
Pale
Limp
Loss of consciousness
Tonic-clonic jerking
Eyes roll back
Call for help if >5mins
Blue breathing: Cry builds up until the child collapses at the end of expiration
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11
Q

How are breath holding attacks managed?

A

No investigations or treatment required
Most grow out of it
Reassure parents and child
Place in a safe place after trigger e.g on a mattress

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12
Q

What are the causes of infectious mononucleosis?

A

90% EBV

Cytomegalovirus

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13
Q

What are the signs & symptoms of infectious mononucleosis?

A 
Symptoms last 2-3weeks may last for 3months
Prodrome: Headache, chills, fever
Jaundice
Splenomegaly
Lethargy/malaise
Tonsillitis
Tender lymphadenopathy
Pharyngitis
Erythematous macular rash
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14
Q

How is infectious mononucleosis investigated?

A

Monospot test: ImmunoC adults & >12yrs
Bloods: LFTs, thrombocytopenia
Lymphocytosis >10% atypical lymphocytes on film

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15
Q

Who does infectious mononucleosis usually affect?

A

15-24years

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16
Q

How is infectious mononucleosis treated?

A

Symptomatic-Analgesia (Paracetamol/Ibuprofen)
Avoid contact sports
No OH-
Avoid Amoxicillin- Maculopapular RASH

17
Q

What are the complications of infectious mononucleosis?

A 
Hepatitis
Splenic rupture
Meningitis
Encephalitis
Guillain-Barre
18
Q

What objects are most commonly inhaled?

A 
Grapes
Nuts
Sweets
Coins
Marbles
Toys
19
Q

What age is foreign body aspiration most common?

A

1-2years

20
Q

What are the signs & symptoms of foreign body aspiration?

A

Larynx: Hoarseness, Cough, Dyspnoea, Stridor, Haemoptysis, Wheezing, Cyanosis, Apnoea
Trachea: Pneumonia
Oesophagus: Drooling, Vomiting, Dysphagia, Dyspnoea, Resp failure

21
Q

How is inhaled foreign body diagnosed?

A

Monophonic wheeze

Absent sounds on one side

22
Q

How is an inhaled foreign body investigated?

A

CXR

ABG

23
Q

How is an inhaled foreign body treated?

A 
ABCDE
Encourage coughing
If visible remove foreign body
5 Back blows
5 Abdominal thrusts
Unconscious: Oxygen &amp; rigid bronchoscopy
24
Q

What are the signs & symptoms of TB?

A

Primary infection: Asymptomatic

Re-activation: Cough, haemoptysis, fever, night sweats, dyspnoea, anorexia

25
Q

How is TB investigated?

A

Mantoux: 2-4days
Heaf: 5-7days

26
Q

How is TB treated?

A

Anti-TB meds for 6months (4drugs for 2m then 2drugs for 4m)

Rifampicin, Isoniazid, Ethambutol, Pyrazinamide

Paediatrics (26 decks)

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