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Paediatrics 👫👶🏼 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Viral infective agents for RTI

A 
Adenovirus
Influenza A, B
Para'flu I, III
RSV
Rhinovirus
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2
Q

Bacterial infective agents for RTI

A 
H. Influenzae
M. Catarrhalis 
(Mycoplasma)
(Staph aureus)
Streptococci
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3
Q

Rhinitis is a prodrome to

A

Pneumonia, bronchiolitis
Meningitis
Septicaemia

Because bacteria is in the nasal mucosa and rhinitis causes a change in environment

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4
Q

Presentation of otitis media

A

Red ear drum

Bulging

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5
Q

Treatment of otitis media

A

Spontaneous rupture resolves symptoms

Antibiotics don’t help - may be slightly quicker benefit but side effects likely diarrhoea or nappy rash

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6
Q

Treatment of tonsillitis/pharyngitis

A

Nothing or 10 days penicillin

NOT AMOXYCILLIN BECAUSE IF HAVE EBV WILL CAUSE WIDESPREAD RASH

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7
Q

Cause of croup

A

Commonly parainfluenza

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8
Q

Treatment of croup

A

Oral dexamethasone

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9
Q

Presentation of croup

A

Coryza++, stridor, hoarse voice, “barking” cough

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10
Q

Presentation of epiglottitis

A

Severely unwell

Toxic

Can’t swallow own saliva - drooling

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11
Q

Treatment of epiglottitis

A

Intubation and antibiotics

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12
Q

What causes epiglottitis

A

Haemophilus influenzae type B

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13
Q

Why is epiglottitis uncommon

A

Because most are vaccinated for haemophilus B

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14
Q

Tracheitis Presentation

A

Prolonged croup with a FEVER (Hasnt gone away in 12 hour with steroid)

Croup epiglottitis

Biphasic stridor

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15
Q

Treatment of tracheitis

A

Augmentin

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16
Q

Bronchitis

A

Loose rattly cough with URTI

Post-tussive vomit

Chest free of wheeze/creps

Child is very well (parent is worried)

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17
Q

Management of bronchitis

A

Do nothing

Will cause more bother with side effects of antibiotics

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18
Q

Bacterial bronchitis caused by

A

Pneumococcus and haemophilus

19
Q

Brionchiolitis Presentation

A

LRTI of infants (

20
Q

Cause of bronchiolitis

A

RSV

Paraflu III

HMPV

21
Q

Management of bronchiolitis

A

Maximal observation

  • Oxygenated
  • Hydrated
  • Nutrition

Minimal intervention

22
Q

Investigations for bronchiolitis

A

NPA

Oxygen saturations

23
Q

How does LRTI

A

48 hours, fever, SOB, cough, grunting

Reduced or bronchial breath sounds

May be wheeze

24
Q

Infective agents for LRTI

A

Viruses

Bacterial pneumococcus, mycoplasma, chlamydia

Mixed in

25
Q

Signs of pneumonia

A

Focal signs
Creps
High fever

26
Q

Treatment of LRTI

A

Nothing if symptoms are mild
(Always offer review)

Oral amoxycillin 1st line

Oral macrolide 2nd choice

Only IV if vomiting

27
Q

How common is pertussis

A

“Whooping cough”

This is common

Vaccination reduces risk and severity

28
Q

Pertussis appearance

A

Coughing fits

Vomiting and colour change (increased abdo pressure)

29
Q

Why use antibiotics in whooping cough

A

Prevents the spread - makes them less infectious

30
Q

Symptoms of empyema

What is it caused by

A

Chest pain and very unwell

Extension of pneumonia infection into pleural space

31
Q

Asthma is…

A

Wheeze
Cough
SOB

Triggered by exercise, URTI, allergen, cold weather

Reversible and responds to asthma treatment

32
Q

Aetiology of asthma

A
  1. Genes
  2. Inherently abnormal lungs
  3. Early onset atopy
  4. Later exposures
    - rhinovirus
    - exercise
    - smoking
33
Q

Symptoms of asthma

A

Wheeze

SOB at rest - “sooking” in of ribs

Cough - dry, nocturnal, exertional

Often atopy, parental asthma

34
Q

Asthma treatment

A

Inhaled corticosteroids for 2 months

  • if they respond they have asthma
  • if don’t they do not
35
Q

When is it not asthma

A

Isolated cough

  • bronchitis (2-3, wet cough)
  • pertussis
  • habitual cough (8-12, single louf cough)
  • tracheomalacia (lifelong loud cough)
36
Q

How to measure control of asthma

A

Short acting beta agonist/week
Absence school/nursery
Nocturnal symptoms/week
Exertional symptoms/week

37
Q

Treatment of asthma step 1

A

Short acting beta agonists

Spacer/MDI or dry powder inhaler

38
Q

Treatment of asthma stage 2

A

When using inhaled b2 agonist 3 times a week or more

Symptomatic 3+ times a week or waking 1 night a week

Low dose inhaled corticosterioids (or LTRA in

39
Q

Step 3 of asthma

A

Potentially increase steroid dose

Potentially add trial of leukotriene receptor antagonist or theophylline

40
Q

Step 4 for asthma treatment

A

4 increase high dose ICS

41
Q

Adverse effects of ICS

A

Height supression (0.5 to 1cm)

Oral candidiasis (if dont wash out mouth after use)

Adrenocortical suppression

42
Q

When is dry powder device indicated

A

> 8s

43
Q

What kind of steroids are used for acute vs management

A

Oral for acute

Chronic/maintenance use inhaled

44
Q

Microscopy of haemophilis influenzae

A

Gram negative rod

Paediatrics 👫👶🏼 (8 decks)

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