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3 - PAEDS > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Causative organism of bronchiolitis?

A

RSV - respiratory syncytial virus

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2
Q

Criteria for admitting a child with bronchiolitis?

A

Child <3 months
Inadequate feeding (<1/2) - or inadequate fluid intake
Saturations <92%
If RR >60

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3
Q

Causative organism of Croup?

A

Parainfluenza viruses, type 1 and 3

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4
Q

Clinical features of croups

A

Preceding coryza - over days –> severe, seal-bark cough
Inspiratory stridor, harsh voice
Worse at night
Mild fever

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5
Q

Scoring system used in croup? What it means

A

Westley Croup Scoring System

0-3 = mild
4-6 = moderate
>6 = severe
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6
Q

Management of croup?

A

Steroids - Dexamethasone 0.15-0.6 mg/Kg

+ Nebulised adrenaline + O2 if severe

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7
Q

Why is epiglottitis rare now?

A

Causative organism of Haemophilus Influenza type B - which is now vaccinated against

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8
Q

Clinical features of epiglottitis?

A

Onset over hours, with no preceding coryza
No cough present, pyrexic >38.5
Child odono/dysphagic - drooling saliva –> tripod position

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9
Q

Investigations in epiglottitis

A

DO NOT examine the throat - risk of obstruction

Refer for laryngoscopy or Lateral X-ray

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10
Q

Management of epiglottitis

A 
(Oral ?) / IV antibiotics
 - cefuroxime/cefotaxime
Can give some dexamethasone
Call anaesthetist to secure airway
Prophylactic rifampicin to household contacts
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11
Q

Most common causative organisms of pneumonia in children

A

Newborn - group B strep
Infants - RSV, strep
Children >5 - strep

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12
Q

What classifies tachypnoea in children?

A

0-5 months = >60
6-12 months = >50
>12 months = >40

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13
Q

What is the Centor criteria?

A

Indicates likelihood of bacterial tonsillitis:

Tonsillar exudate
No Cough
Tender cervical lymphadenopathy
Fever >38

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14
Q

Management of bacterial tonsillitis?

A 
Penicillin V (benzylpenicillin)
 ALT - erythromycin

Avoid amoxicillin - as if EBV infection is the cause - this can cause a wide maculopapular rash

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15
Q

Criteria for tonsillectomy

A

7 documented episodes in the previous year, OR
5+ episodes, each year for 2 years, OR
3+ episodes, each year for 3 years, OR
2 episodes of quinsy

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16
Q

Inheritance of cystic fibrosis and pathophysiology

A

Autosomal recessive - defect in CFTR gene

Responsible for sodium transport across epithelium

results in high sodium secretions

17
Q

Investigations in cystic fibrosis?

A

Detection antenatally and at birth - Guthrie blood assay
–> Immunoreactive trypsinogen (IRT)

Chloride sweat test - although clinical delayed presentation is rare

18
Q

Management of cystic fibrosis?

A 
Chest physio
Prophylactic Abx and regular sputum cultures
Pancreatic enzyme supplementation
High protein, high calorie diet
Calcium + Vitamin D supplementation
19
Q

Follow up care in cystic fibrosis?

A 
Managed by MDT - specialist CF centre
2x/year
Check LFT, Insulin and glucose
Counselling
fertility support for males - IVF
20
Q

Where is an inhaled foreign body most likely to lodge?

A

Right bronchus, in either middle or lower lobe

21
Q

Antibiotics in acute otitis media?

A

Amoxicillin

Organism usually HiB or Strep p

22
Q

Management of otitis media with effusion (OME)

A

Advise - face child when speaking, talk loud and slow
90% will resolve within a year

Surgery if Persistent bilateral OME for >3 months, or hearing loss >25-30 dB
—> Grommet insertion

23
Q

What is laryngomalacia

A

Soft, immature soft palette, collapsing on inspiration –> stridor

24
Q

What is choanal atresia?

A

Blockage of communication of nasal passage to pharynx

Bilateral can be severe, as babies are obligate nasal breathers

25
Q

Different types of TB?

A

Primary - disease embeds in hilar lymph nodes –> disseminates –> forms tubercles around body –> these become active/dormant

Miliary - TB infection of bloodstream –> severe

Secondary –> Activation of dormant TB, secondary to compromised immune system

26
Q

Investigations for TB?

A

Mantoux test (can get false +ve if they have had BCG)

> 10mm is +ve if no BCG
15mm is +ve if BCG

27
Q

Management of TB?

A

6 months of Isoniazid + Rifampicin

3 months, if latent disease detected, and patient asymptomatic

28
Q

Clinical course of whooping cough

A

1-2 weeks - catarrhal phase - highly infective
3-4 weeks - paroxysmal coughing
dry, hacking cough with whoop
so severe can cause vomiting, sub-conjunctival haemorrhages

29
Q

management of whooping cough

A

Abx - clarithromycin/azithromycin - however Abx shown not to alter clinical course

Keep off school for at least 21 days from onset of symptoms

3 - PAEDS (13 decks)

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