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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
treatment of severe asthma
- 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
treatment of moderate asthma
- 6-12 puffs of ventolin MDI with spaces 3 times in first hour - oral prednisolone - observe for at least 1 hour
27
which organism most frequently causes empyema in childhood
strep pneumo
28
peak severity of bronchiolitis is typically which day
day 2-3
29
describe how sweat testing for CF works
use pilocarpine and electrodes to induce sweating on the arm - measure the concentration of chloride that is excreted in sweat
30
risk factors for severity of bronchiolitis
- less than 6 weeks - ex prem - CHD - neurological conditions - chronic respiratory illness - PHTN
31
what does the CF mutation cause (at a cell level)
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
definition of bronchiectasis
abnormal and irreversible dilatation of the bronchi
33
most common viral cause of bronchiolitis
RSV
34
management of mild pneumonia in a child >3 months
oral amoxycillin for 7 days
35
principles of management of croup
MINIMAL HANDLING - mild-moderate: prednisolone - severe: nebulised adrenaline and IM/IV dexamethasone
36
2 causes of nasal polypa
CF | allergy
37
clinical presentation of primary ciliary dyskinesia
- sinusitis/rhinitis - chronic suppurative lung disease - otitis media - male infertility - dextrocardia in 50%
38
clinical features of croup
- barking cough - inspiratory stridor - increased WOB - peaks at night 2-3
39
when should you tell your patient to go to hospital with asthma
if you need more than one set of 6/12 puffs in an hour or more than 3 times in a day
40
3 causes of gum hypertrophy
drugs leukaemia gingivitis
41
describe the pathogenesis of protracted bacterial bronchitis
predisposing viral infection --> impaired mucociliary clearance --> infection of bronchi with bacteria --> biofilm formation
42
AB for moderate pneumonia in a child that suggests mycoplasma pneumoniae
oral roxithromycin for 10 days
43
describe the newborn screening of CF
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
what is primary ciliary dyskinesia
genetic condition that causes ultrastructural and function defects of the cilia leading to impaired mucociliary clearance
45
which organism in particulary is associated with deterioration in LF of a CF patient
pseudomonas aeruginosa
46
treatment of mild asthma
6-12 puffs of ventolin MDI with spacer

MD 3 - Paeds (18 decks)

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