Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Paediatrics Specialty > Respiratory > Flashcards

Respiratory Flashcards

1
Q

When in children is asthma worse?

A

Early morning and at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

At what age generally are children investigated using spirometry?

A

> 5 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In terms of spirometry, what degree of reversibility should bronchodilator therapy cause in a child with asthma?

A

> 12% increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which asthma treatments are generally not used in

A. Children <5 years
B. Children aged 5-12 years

A

A. LABA

B. Montelukast (leukotriene antagonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give 3 side effects of long-term steroid inhalers

A
  1. Oral thrush (candida)
  2. Sore throat/hoarse voice
  3. glaucoma

NB: side effects are rare and only occur in very high doses over a long period of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How should you advise parents regarding cleaning spacers?

A

Clean with warm, soapy water (fairy liquid is very effective) and rinse.

Leave to dry (do not wipe as it will create static which causes the dry to to stick to the spacer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When are children’s asthma management monitored with PEFR?

A

> 5 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

After ABCDE, what is the pharmacological management of an acute asthma attack in a child with:

A. mild-moderate asthma attack
B. Severe asthma attack

A

Mild-moderate:
Burst therapy
3x 10 puffs of salbutamol (MDI with spacer)
Wean from hourly to 4-hourly

Severe:
3x 10 puffs of salbutamol (MDI with spacer) hourly
IV magnesium sulphate
IV aminophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common cause of pneumonia in neonates?

A

Organisms from maternal genital tract: e.g. GBS (Group B Strep), E.coli, Chlamydia trachomatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common cause of pneumonia in infants?

A

Bacterial (60%):

  • Strep. pneumoniae
  • Staph. aureus
  • Haemophilus influenzae

Viral (40%)

  • Parainfluenza
  • Influenza
  • Adenovirus
  • RSV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common cause of pneumonia in older children and adolescents?

A

Bacterial (60%):

  • Strep. pneumoniae
  • Staph. aureus
  • Haemophilus influenzae

Viral (40%)

  • Parainfluenza
  • Influenza
  • Adenovirus
  • RSV

Atypical organisms:

  • Mycoplasma pneumonia
  • Chlamydia pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common cause of aspiration pneumonia?

A

Enteric gram -ve bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the most common causes of pneumonia in immunocompromised children?

A

Viral:

  • CMV
  • Varicella zoster virus VZV
  • Herpes zoster virus HZV
  • measles and adenovirus

Bacterial:

  • Pneumocystis carinii
  • TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When does sputum usually appear rusty?

A

Strep. pneumoniae infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give 3 clinical signs of consolidation

A
  1. Reduced breath sounds
  2. Dullness to percussion
  3. Increased tactile/ vocal remits
  4. Bronchial breathing
  5. Coarse crepitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give 3 signs of respiratory distress

A
  1. Cyanosis
  2. Grunting
  3. Nasal flaring
  4. Marked tachypnoea
  5. Intercostal and suprasternal recession
  6. Subcostal recession
  7. Abdominal breathing
  8. Tripod positioning
  9. Reduced oxygen saturations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does focal consolidation on a CXR suggest?

A

Bacterial pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does a diffuse consolidation on a CXR suggest?

A

Viral bronchopneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

For suspected pneumonia, for which causes would the following investigations be useful?

A. Urine culture
B. Blood film
C. Immunofluorescence

A

A. Legionnaires antigen (in urine)
B. Mycoplasma - RBC agglutination
C. RSV on nasopharyngeal exudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the first line management of pneumonia in children?

A

Oral amoxicillin or erythromycin (if penicillin allergic)

If severe, IV cefuroxime +/- erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the antibiotic treatment for aspiration pneumonia?

A

Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most common cause of bronchiolitis?

A

RSV

Other causes: adenovirus, parainfluenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

At what age does bronchiolitis usually occur?

A

2 - 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When is the peak incidence of bronchiolitis?

A

Winter months (Nov-Feb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the clinical presentation of bronchiolitis?
It usually begins as an URTI with rhinorrhea and then: SOB, cough, wheeze and bilateral crepitations. Decreased feeding with irritability Signs of respiratory distress +/- apnoea Tachypnoea, fever and possible dehydration. Worse on day 5
26
What is croup usually caused by?
Viruses | Parainfluenza, RSV, rhinovirus, adenovirus
27
Who does croup most commonly affect?
6 months - 3 years
28
What are the clinical features of croup?
``` Barking cough Hoarse voice Low grade fever Stridor Decreased air entry but normal chest sounds Respiratory distress if moderate-severe ```
29
What is the management of croup?
Mild- managed at home with analgesia and fluid. Oral dexamethasone stat dose and reassurance. Moderate: Important to keep patient calm and be as uninvasive as possible. Admit for observations Oral dexamethasone Reassess - think could this be sepsis!! Could this be bacterial tracheitis- in which antibiotics would be required. ``` Severe: Nebulised adrenaline Dexamethasone High flow oxygen mask Call paediatrician, ENT and anaesthetists CATS/ PICU ```
30
What should you rule out/ consider when investigating croup?
1. Epiglottitis 2. Sepsis 3. Bacterial tracheitis
31
At what age are children more likely to get tonsillitis?
5-10 years and young adults
32
Which type of viral tonsillitis causes blisters in the mouth?
Coxsackie virus
33
What is the most common bacterial cause of tonsillitis?
Group A haemolytic streptococcus (group A strep)
34
When should you prescribe antibiotics in patients with suspected tonsillitis?
Systemic features secondary to acute sore throat Unilateral peritonisillits History of rheumatic fever Increased risk factor from acute infections e.g. diabetes mellitus 3 or more of the centor criteria
35
Which criteria is used in diagnosing bacterial tonsillitis?
Centor criteria: History of fever Tonsillar exudates No cough Tender anterior cervical lymphadenopathy
36
What advice should be given for non-pharmacological management of tonsillitis?
Salt water gargle | Antipyretics
37
In tonsillitis, where can the pain be referred to?
Ears
38
What is the treatment for bacterial tonsillitis? What should you NOT give?
Penicillin V Erythromycin/Clarithromycin if penicillin allergic You should not give Amoxicillin in case it is viral tonsillitis caused by EBV. (Causes rash)
39
Give 3 complications of tonsillitis
1. Acute otitis media 2. Peritonsillar abscess (quinsy) 3. Cervical abscess 4. Guttate psoriasis 5. Rheumatic fever (delayed) 6. Acute nephritis (delayed)
40
When should a child be referred for a tonsillectomy?
Recurrent attacks of tonsillitis Enlarged tonsils causing obstruction of the airway, which may be the cause of obstructive sleep apnoea Possible malignant disease of the tonsils
41
What is the most common cause of epiglottitis?
Haemophilus influenza B | Since the introduction of the Hib vaccine, streptococcus is becoming more common
42
Who does epiglottis usually affect?
2 - 5 years
43
What are the differentiating clinical features of epiglottitis?
``` Odynophagia (pain on swallowing) Hot potato voice Tripod position and sitting very still Stridor Drooling ```
44
What should you not in kids with suspected epiglottitis?
Examine the throat with a tongue depressor as this can cause obstruction of the airways. Need anaesthetists to manage airways first.
45
What is the management of epiglottitis?
IV fluids IV ampicillin Intubation/ tracheostomy if airways is compromised
46
When is a wheeze heard?
On expiration
47
What is transient early wheeze and what is it caused by?
In infancy, non-atopic infants can get intermittent wheeze, which usually disappears after the age of 3. It is commonly caused by RSV
48
What is a persistent wheeze?
IgE-associated wheeze; suggestive of asthma. | Lasting >4 weeks
49
What is stridor?
Upper airway obstruction | Turbulent airflow causing abnormal high pitched sound
50
What are the types of stridor?
Inspiratory: Extra-thoracic – nose, pharynx, larynx, trachea i.e. Above the vocal cords Common Biphasic stridor: (inspiratory AND expiratory) Subglottic or Glottic Expiratory stridor Intra-thoracic - Tracheal or bronchial obstruction Severe Upper Airway obstruction
51
List 3 causes of stridor
``` Croup Inhaled foreign body Anaphylaxis Bacterial tracheitis Epiglottitis ```
52
List 5 congenital cause of stridor
``` Laryngomalacia (soft larynx) Vocal cord dysfunction Subglottis stenosis Tracheomalacia Choanal atresia (back of nasal passage is blocked) ```
53
What is the pattern of infection in tracheitis?
Bacterial infection following a viral infection
54
What different types of abscess can children get and how do their clinical features differ?
Retropharyngeal abscess: <6 years, pain on neck hyperextension. Peritonsillar: Difficulty speaking Both presents with fever and dysphagia (difficulty swallowing)
55
When is laryngomalacia worst?
Lying supine Crying Feeding
56
What is the most common congenital anomaly of the nose?
Choanal atresia: failed recanalisation of the nasal fosse during fatal development
57
What is the most common cause of expiratory stridor?
Tracheomalacia
58
What mutation causes cystic fibrosis (CF)?
CFTR gene on chromosome 7. | Reduces conductance of chloride ions and increases viscosity of mucus secretions
59
Which tests are used for CF?
Chorionic villus sampling at 10 weeks Sweat test Guthrie test (heel prick) day 5-8
60
Give 3 signs of CF
Finger clubbing Cough with purulent sputum (recurrent infections despite adequate antibiotics) Crackles
61
What clinical features are associated with CF perinatally?
Bowel obstruction with meconium ileum Prolonged jaundice Failure to thrive Haemorrhagic disease of the newborn
62
In CF, what commonly do you have a congenital absence of ?
vas deferens aka. Congenital absence of the vas deferens (CAVD)
63
What is the management of CF?
``` Chest physiotherapy Prophylactic antibiotics Saline nebulisers SABA/ LABA Pancreatic enzymes (Creon) ```
64
What nutritional advice should you give to patients with CF?
High fat and high protein diet Vitamin supplements Pancreatic enzymes - Creon
65
Give 5 complications of CF
``` Respiratory failure Diabetes mellitus Portal hypertension Hepatic cirrhosis Infertility ```
66
What is the average life expectancy of a patient with CF?
~ 37years
67
What is TB caused by?
Mycobacterium tuberculosis
68
By what mode is TB spread?
Droplets
69
What are the risk factors of TB?
``` TB contact HIV South Asia travel Homelessness Drug users ```
70
What are the features of TB?
Night sweats fatigue weight loss and anorexia Purulent +/- bloodstained sputum
71
How can you diagnose latent TB?
Mantoux test
72
How do you manage TB?
Rifampicin Isoniazid Pyrazinamide Ethambutol
73
How long does whooping cough (pertussis) infection usually last for?
6 - 8 weeks Catarrhal phase followed by 2 weeks of cough
74
When is whooping cough most infectious?
Towards the end of the catarrhal phase/ during the paroxysmal coughing stage (1 - 2 weeks after onset of symptoms)
75
What is the presentation of whooping cough?
Catarrhal phase: Malaise, conjunctivitis, coryza symptoms, mild fever Paroxysmal coughing phase: Severe prolonged coughing Choking/gasping/flailing of extremities Cyanosis
76
How is whooping cough investigated?
Clinical examination Routine bloods Nasopharyngeal swabs
77
Give 3 complications of whooping cough
Pneumonia Apnoea Seizures Otitis media

Paediatrics Specialty (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions