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MD 3 - Paeds > Respiratory > Flashcards

Respiratory Flashcards

1
Q

what are some congenital respiratory disorders that can present with cyanosis hours after birth

A 
pulmonary hypoplasia 
persistant pulmonary hypertension of the newborn
surfactant deficiency 
meconium aspiration
diaphragmatic hernia
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2
Q

most common organisms to cause pneumonia in a neonate

A

group B strep

gram negative enteric bacteria

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3
Q

classic age for croup

A

2 years

Range - 6months-6years

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4
Q

describe the childhood presentation of CF

A
  • suppurative lung disease
  • recurrent chest infections
  • nasal polyps
  • haemoptysis
  • DIOS
  • rectal prolapse
  • multifocal biliary cirrhosis
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5
Q

describe the neonatal presentation of CF

A
  • meconium ileus
  • prolonged jaundice
  • antenatal bowel perforation
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6
Q

treatment of critical asthma

A
  • oxygen
  • continuous ventolin
  • nebulised atrovent
  • methyl prednisolone
  • consider aminophylline and MgSO4
  • consider intubation/BiPAP/CPAP
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7
Q

most common organisms to cause pneumonia in a pre-schoooler

A

respiratory viruses

non typeable haemophilus influenzae

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8
Q

stepwise approach to asthma management

A
  1. SABA
  2. SABA + low dose ICS
  3. SABA + high dose ICS OR low dose ICS + LABA
  4. SABA + high dose ICS + LABA
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9
Q

genetics of CF

A

autosomal recessive condition

Defect in CFTR gene on chromosome 7 - codes for apical chloride channel on epithelial and mucosal surfaces

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10
Q

when should you admit a baby with bronchiolitis

A
  • underlying comorbidities such as CHD
  • requiring supplemental oxygen
  • poor feeding
  • episodes of apnoeas/cyanosis
  • moderate-severe respiratory distress
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11
Q

how many hours does a child have to be wheeze free after ventolin before they can be discharged

A

3-4 hours

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12
Q

how many puffs of ventolin do you give a child with an asthma attack

A
  • 6 years = 12 puffs, 4 breaths
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13
Q

epidemiology of CF affected and carriers

A

1: 2500 - affected
1: 25 - carriers

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14
Q

which signs of Xray are specific for bronchiectasis

A
  • tram tracking (parallel narrow lines radiating form the hilum)
  • cystic spaces
  • honeycomb like structures
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15
Q

clinical presentation of subglottic stenosis

A

biphasic stridor

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16
Q

clinical features of laryngomalacia

A

noising breathing when crying or upset but absent when settled or sleeping

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17
Q

treatment of protracted bacterial bronchitis

A

prolonged (4 weeks) of oral antibiotics

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18
Q

treatment of laryngomalacia

A

self resolving - usually by 12 months

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19
Q

what causes croup

A

viral mucosal inflammation of the upper airway, larynx, trachea and bronchi

20
Q

AB for severe pneumonia in a child >3 months

A

flucloxacillin + 3rd gen cephalosporin

21
Q

describe the infant presentation of CF

A
  • pancreatic insufficiency causing steatorrhoea and FTT
  • anaemia, hypoporteinaemia
  • hyponatraemia, hypochloraemia, metabolic alkalosis
22
Q

what is protracted bacterial bronchitis

A

persistent infection of the conducting airways

23
Q

most common organisms to cause pneumonia in an older child

A

strep pneumo
mycoplasma pneumoniae
chlamydia pneumoniae

24
Q

which signs of HRCT are specific for bronchiecatsis

A

dilated bronchi with thickened walls where diameter of bronchus > diameter of accompanying artery

25
Q

treatment of severe asthma

A
  • oxygen
  • 6-12 puffs of ventolin MDI with spacer 3 times in first hour
  • 2 or 4 puffs of atrovent 3 times in first hour
  • oral prednisolone
  • admission to hospital
26
Q

treatment of moderate asthma

A
  • 6-12 puffs of ventolin MDI with spaces 3 times in first hour
  • oral prednisolone
  • observe for at least 1 hour
27
Q

which organism most frequently causes empyema in childhood

A

strep pneumo

28
Q

peak severity of bronchiolitis is typically which day

A

day 2-3

29
Q

describe how sweat testing for CF works

A

use pilocarpine and electrodes to induce sweating on the arm - measure the concentration of chloride that is excreted in sweat

30
Q

risk factors for severity of bronchiolitis

A
  • less than 6 weeks
  • ex prem
  • CHD
  • neurological conditions
  • chronic respiratory illness
  • PHTN
31
Q

what does the CF mutation cause (at a cell level)

A

causes abnormalities in the transport of chloride across epithelial and mucosal surfaces causing a relative dehydration of airway secretions causing impaired mucociliary transport and airway obstruction. Also causes abnormal pancreatic enzymes

32
Q

definition of bronchiectasis

A

abnormal and irreversible dilatation of the bronchi

33
Q

most common viral cause of bronchiolitis

A

RSV

34
Q

management of mild pneumonia in a child >3 months

A

oral amoxycillin for 7 days

35
Q

principles of management of croup

A

MINIMAL HANDLING

  • mild-moderate: prednisolone
  • severe: nebulised adrenaline and IM/IV dexamethasone
36
Q

2 causes of nasal polypa

A

CF

allergy

37
Q

clinical presentation of primary ciliary dyskinesia

A
  • sinusitis/rhinitis
  • chronic suppurative lung disease
  • otitis media
  • male infertility
  • dextrocardia in 50%
38
Q

clinical features of croup

A
  • barking cough
  • inspiratory stridor
  • increased WOB
  • peaks at night 2-3
39
Q

when should you tell your patient to go to hospital with asthma

A

if you need more than one set of 6/12 puffs in an hour or more than 3 times in a day

40
Q

3 causes of gum hypertrophy

A

drugs
leukaemia
gingivitis

41
Q

describe the pathogenesis of protracted bacterial bronchitis

A

predisposing viral infection –> impaired mucociliary clearance –> infection of bronchi with bacteria –> biofilm formation

42
Q

AB for moderate pneumonia in a child that suggests mycoplasma pneumoniae

A

oral roxithromycin for 10 days

43
Q

describe the newborn screening of CF

A

heel prick on day 2-4 of life - measures serum trypsinogen

  • those levels above 99th percentile –> gene mutation testing
  • 2 mutations –> CF clinic
  • 1 mutation –> sweat testing
44
Q

what is primary ciliary dyskinesia

A

genetic condition that causes ultrastructural and function defects of the cilia leading to impaired mucociliary clearance

45
Q

which organism in particulary is associated with deterioration in LF of a CF patient

A

pseudomonas aeruginosa

46
Q

treatment of mild asthma

A

6-12 puffs of ventolin MDI with spacer

MD 3 - Paeds (18 decks)

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