Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Where are all the infections (resp tract)?

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

Rhinitis

Where?

Features?

Prodrome to what other illnesses?

A

The nose

Self-limiting condition that occurs in the winter months.

Runny nose normally lasts 16 days

  • Pneumonia, bronchiolitis
  • Meningitis
  • Septicaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does otitis media erythema appear?

A

Bulging tympanic membrane

Normally lasts 9 days

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

Features of Otitis Media?

Causation?

What are complications?

Rx?

A
  • Common, self-limiting
  • Not “a bit pink”
  • Primary viral infection
  • Secondary infection with Pneumococcus/ H’flu
  • Spontaneous rupture of drum
  • Rx: Antibiotic treatment usually does not help so give analgesics and wait it out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do we Dx Tonsillitis/pharyngitis?

A
  • Sore throat
  • Normally lasts 7 days
  • Viral or bacterial?
  • Do a throat swab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tonsillitis/pharyngitis

Rx if viral?

Rx if bacterial?

A
  • Either nothing (viral) or 10 days penicillin (bacterial)
  • Don’t give amoxycillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which two URTI are very similar and must be differntiated?

A

Croup and Epiglottitis

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

How can we differentiate between croup (LTB) and epiglottitis?

A

Croup:

  • Para’flu 1
  • Common
  • Child is well
  • Coryza++, stridor, hoarse voice, “barking” cough
  • Normally lasts 3 days

Epiglottitis:

  • H. influenzae
  • Rare
  • Toxic
  • Stridor + drooling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rx for croup?

Rx for epiglottitis?

A
  • Croup = oral dexamethasone
  • Epiglottitis = intubation and antibs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are common agents for bacterial LRTI?

A
  • Strep pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydia pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are common agents for viral LRTI?

A
  • RSV, parainfluenza III, influenza A and B, adenovirus, rhinovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do we assess a patient with LRTI?

A
  • Make a diagnosis (easy)
  • Assess the patient (easy)
    • Oxygenation, hydration, nutritional
  • To treat or not to treat (grey area)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is bronchitis?

A

Infection of the main airways of the lung - the bronchi.

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

SSx of bronchitis?

A
  • Common ++++
  • Loose rattly cough
  • Post-tussive vomit - “glut”
  • Chest free of wheeze/creps
  • Haemophilus/Pneumococcus
  • Mostly self-limiting
  • Child VERY well, parent worried
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mechanism of bacterial bronchitis?

A
  • Disturbed mucociliary clearance
    • Minor airway malacia
    • RSV/adenovirus
  • Bacterial overgrowth is secondary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are red flags for LRTI?

A
  • Age <6 mo, >4yr
  • Static weight
  • Disrupts child’s life
  • Associated SOB (when not coughing)
  • Acute admission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Rx for persistent bacterial bronchitis?

A
  • Reasure parents
  • Do not treat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bronchiolitis: What is it?

A

Infection of the smal airways of the lungs - bronchioles

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

Bronchiolitis: features? SSx?

A
  • Affects 30-40% of all infants
  • Usually RSV, others include paraflu III, HMPV
  • Nasal stuffiness, tachypnoea, poor feeding
  • Crackles +/- wheeze
  • Normally lasts 16 days!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Who does bronchiolitis occur in?

A
  • <12 months
  • One off (not recurring)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Rx for bronchiolitis?

A
  • Maximal observation
  • Minimal intervention - there is no proven medications to work
22
Q

Ix for bronchiolitis?

A
  • Naspharyngeal aspirate (NPA)
  • Oxygen saturations (severity)
23
Q

What is pneumonia?

A

Lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid

24
Q

SSx for pneumonia?

A
  • Fever
  • SOB
  • Grunting
  • Cough
  • Reduced breath sounds
  • Consolidation/fluid on xray

Also only refer to it as pneumonia if signs are focal, creps and high fever. Otherwise refer to it as LRTI.

25
Q

Rx for pneumonia?

A
  • Investigations
    • CXR and inflammatory makers NOT “routine”
  • Management
    • Nothing if symptoms are mild
    • (always offer to review if things get worse!)
    • Oral Amoxycillin first line
    • Oral Macrolide second choice
    • Only for IV if vomiting
26
Q

When is IV vs oral antibiotics used in pneumonia?

A

Oral antibiotics “win” 2:1

√Shorter hospital stay

√Cheaper

XFever for a few more hours

27
Q

What is pertussis?

A

WhoOping cough

28
Q

What can prevent pertussis?

A
  • Vaccination reduces risk
  • Vaccination reduces severity
29
Q

SSx of pertussis?

A
  • “Coughing fits”
  • Vomiting and colour change
30
Q

Give a run through of all the resp tract infections and how they are managed:

A
31
Q

What is asthma?

A

Clinical syndrome characterised by increased responsiveness of the tracheobronchial tree to a variety of stimuli - causing dyspnoea, wheezing and cough, which may vary from mild and almost undetectable to severe and unremitting.

32
Q

SSx for asthma?

A
  • Chronic
  • Wheeze, cough and SOB
  • Multiple triggers
    • URTI, exercise, allergen, cold weather, etc
33
Q

Dx for asthma?

A
  • Wheeze
  • Variability
  • Respond to treatment
34
Q

What are multiple hits causing asthma?

A
  1. Genes
  2. Inherently abnormal lungs
  3. Early onset atopy
  4. Later (env) exposures

Rhinovirus

Exercise

Smoking

35
Q

Ix for asthma?

A
  • All in the history!
  • Examination unhelpful
    • Unlikely to be wheezing
    • Stethoscope never important (often unhelpful)
  • •No asthma test in children
    • Peak flow random number generator
    • Allergy tests irrelevant
    • Spirometry lacks specificity
    • Exhaled nitric oxide unproven
36
Q

What are important SSx for asthma?

A

Wheeze

SOB at rest

•Significant resp difficulty

–<30% lung function

  • Airway obstruction
  • “Sooking” in of ribs with wheeze

Cough

  • Dry
  • Nocturnal (just after falling asleep)
  • Exertional
37
Q

What is the approach to wheeze?

A
  1. Assess if genuine: if not it’s stridor/rattle
  2. If genuine: Watch and see OR trial treatment, if responds to treatment
  3. Asthma.
38
Q

DDx for asthma? (onset under 5, onset over 5)

A

Under 5

  • Congenital
  • CF
  • PCD
  • Bronchitis
  • Foreign body

Over 5

  • Dysfunctional breathing
  • Vocal cord dysfunction
  • Habitual cough
  • Pertussis
39
Q

When is it not asthma?

A
  • Under 18 months, most likely infection
  • Over 5 years, most likely asthma
40
Q

What should be the approach for pre-school cough?

A
41
Q

What are the goals of asthma treatment?

A
  • “minimal” symptoms during day and night
  • minimal need for reliever medication
  • no attacks (exacerbations)
  • no limitation of physical activity
42
Q

How can we measure control of asthma symptoms?

A
  • Closed questions
  • SANE
  • Short acting beta agonist/week
  • Absence school/nursery
  • Nocturnal symptoms/week
  • Excertional symptoms/week
43
Q

What is the step up step down approach to asthma treatment?

A
  • Start on low dose ICS
    • Severe may respond to minimal treatment
  • Review after 2mo
    • No routine test to monitor progress (?)
    • Stepping up easier than down
44
Q

What are classes of asthma medications?

A
  • Short acting beta agonists
  • Inhaled corticosteroids (ICS)
  • Long acting beta agonists*
  • Leukotriene receptor antagonists*
  • Theophyllines*
  • Oral steroids
  • * “add ons”
45
Q

What is asthma ladder of treatment?

A
  1. Regular preventer - ICS
  2. Initial add on: preventer + LABA (if over 5) or LTRA (under 5)
  3. Additional add on therapies: if not respond to laba increase dose of ICS, if do respond to laba can also increase ICS, if not enough consider adding LTRA
  4. High dose ICS + SR theophylline
  5. Continuous use of oral steroids
46
Q

How does asthma management in paeds differ from adults?

A
  • Max dose ICS 800 microg (<12 yo)
  • No oral B2 tablet
  • LTRA first line preventer in <5s
  • No LAMAs
  • Only two biologicals
47
Q

At what point do we start regular preventer?

A
  • B2 agonists >two days a week
  • Symptomatic three times a week or more, or waking one night a week.
48
Q

What are adverse effects of ICS?

A
  • Height suppression (0.5-1cm)
  • ?Oral candidiasis
  • ?Adrenocortical suppression*
  • XHypertension
  • XCataracts
49
Q

What are two things to rmb about long acting beta agonist?

A
  • Do not use without ICS
  • Use as fixed dose inhaler
50
Q

How can we make it easier for children to inhale these medications?

A
  • MDI/spacer
  • Dry powder device
51
Q

Don’t use nebulisers

A

cool beans

52
Q

Other management for asthma?

A
  • Stop tobacco smoke exposure
  • Remove environmental triggers
    • Cat, Dog

Paediatrics (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions