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Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

How might we treat coryza in infants (particularly if causing feeding difficulties)?

A

Normal saline nasal drops and aspiration

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2
Q

What are the symptoms of streptococcal sore throat?

A

High fever, exudate on tonsils, cervical lymphadenopathy

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3
Q

What complications can streptococcal sore throat lead to?

A

Glomerulonephritis, scarlet fever, rheumatic fever.

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4
Q

What are the symptoms of scarlet fever?

A

Initial symptoms usually include a sore throat, headache and a high temperature (38.3C/101F or above), flushed cheeks and a swollen tongue.

A day or two later the characteristic pinkish rash appears. It usually occurs on the chest and abdomen before spreading to other areas of the body, such as the ears and neck.

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5
Q

What are the main 3 indications for tonsillectomy?

A
  1. Recurrent episodes of infection (which may affect growth)
  2. Quinsy
  3. ‘Kissing tonsils’ causing airway obstruction and sleep apnoea.
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6
Q

What is quinsy?

A

Retrotonsillar abscess (would see one tonsil enlarged more than the other).

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7
Q

What are the symptoms of otitis media?

A

Fever, ear pain, discharge (sometimes).

Infants: irritable, crying.

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8
Q

How do we treat otitis media?

A

Antibiotics (amoxicillin to cover streps and haemophilus) and paracetamol

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9
Q

What are the complications of otitis media?

A

Meningitis, acute mastoiditis

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10
Q

How do we treat serous otitis media (glue ear)?

A

Grommets (tympanostomy tube)

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11
Q

What are the symptoms of sinusitis?

A 
Green or yellow discharge from nose
Blocked nose
Pain and tenderness around the cheeks, eyes or forehead
Sinus headache
Fever
Toothache
Reduced sense of smell
Halitosis
Post nasal drip, 
Chronic cough.
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12
Q

Croup is most commonly caused by which virus?

A

Parainfluenza

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13
Q

What are the main symptoms of croup?

A

Difficulty breathing, cough, coryza, stridor, sore throat, fever.

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14
Q

How do we treat croup?

A

Dexamethasone plus symptomatic treatment (hydration and paracetamol).

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15
Q

What organism causes epiglottitis?

A

Haemophilus Influenzae

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16
Q

What can help you differentiate epiglottitis from croup?

A

Posture of the child- neck extended.

Child looks unwell and drooling.

17
Q

What is it important NOT to do in a child with suspected epiglottitis?

A

Examine the throat. This can cause cardiorespiratory arrest.

18
Q

How do we treat epiglottitis?

A

Antibiotics
Intubation (call anaesthetist)
Tracheostomy

19
Q

What is the commonest cause of persistent stridor in children?

A

Laryngomalacia (floppy larynx)

20
Q

What is the most common causative organism of bronchiolitis?

A

RSV

21
Q

What are the symptoms of bronchiolitis?

A

Wet cough, tachypnoea, poor feeding, respiratory distress, low grade fever

22
Q

What organism causes bronchiolitis obliterans?

A

Adenovirus

23
Q

What are the signs of bronchiolitis on auscultation?

A

Fine crackles and wheeze

24
Q

How do we treat bronchiolitis?

A

NG tube feeding or IV fluids.
O2
May need CPAP
May need intubation (have a low threshold for admission).

25
Q

Which children are at particular risk of RSV infection and should be given the RSV vaccine?

A

Those with CLD or cyanotic congenital heart disease.

26
Q

What is the main complication of pneumonia?

A

Empyema (needs draining).

27
Q

What can cause bronchiectasis?

A

Pneumonia, cystic fibrosis, measles, pertussis, immunodeficiency, ciliary dyskinesia.

28
Q

What would be seen on a CXR in a patient with CF?

A
  1. Hyperinflation
  2. Linear shadows (due to bronchial wall thickening)
  3. Cystic shadowing
  4. Patchy consolidation
29
Q

How do we diagnose CF?

A

Sweat test (Cl- >60mmol/L)

Newborn screen (Guthrie Card)

(May also be diagnosed in foetal period by hyperechoic, dilated bowel on USS)

30
Q

What are the common symptoms of CF in infancy?

A

Meconium ileus
Diarrhoea and failure to thrive (most common)
Recurrent resp infections

31
Q

What are the respiratory complications of CF?

A

Pneumothorax, cor pulmonale, bronchiectasis, allergic aspergillosis.

32
Q

How is CF managed?

A 
Drainage of secretions
Physiotherapy
Abx prophylaxis
Bronchodilators
Inhaled DNase (Pulmozyme) and hypertonic saline
RSV and flu vaccines
Regular sputum swabs
Pancreatic enzymes (Creon)
Multivitamins
High protein diet
Transplant

Paediatrics (10 decks)

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