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

Give 3 signs of respiratory distress in a child.

A
  1. Tachypnoea, RR 40-60.
  2. Subcostal and intercostal recession.
  3. Stridor.
  4. Tracheal tug.
  5. Cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What virus can cause croup?

A

Parainfluenza virus

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

Describe the epidemiology of croup.

A

Peak incidence at 6 months - 3 years

More common in autumn

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

What is croup?

A

Acute laryngotracheobronchitis - trachea, bronchi and larynx are all affected.

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

What are 4 features of croup?

A

stridor
barking cough (worse at night)
fever
coryzal symptoms

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

Clinical Knowledge Summaries (CKS) suggest using the following criteria to grade the severity of croup.

A

Mild:
Occasional barking cough
No audible stridor at rest
No or mild suprasternal and/or intercostal recession
The child is happy and is prepared to eat, drink, and play

Moderate:
Frequent barking cough
Easily audible stridor at rest
Suprasternal and sternal wall retraction at rest
No or little distress or agitation
The child can be placated and is interested in its surroundings

Severe:
Frequent barking cough
Prominent inspiratory (and occasionally, expiratory) stridor at rest
Marked sternal wall retractions
Significant distress and agitation, or lethargy or restlessness (a sign of hypoxaemia)
Tachycardia occurs with more severe obstructive symptoms and hypoxaemia

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

What are the criteria to admit a child with croup?

A

CKS suggest admitting any child with moderate or severe croup. Other features which should prompt admission include:
< 6 months of age
Known upper airway abnormalities
Uncertainty about diagnosis

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

What is the mx of croup?

A

A single dose of oral dexamethasone (0.15mg/kg)

Prednisolone is an alternative

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

What is the emergency tx of croup?

A

High-flow oxygen

Nebulised adrenaline

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

Give 3 signs of bronchiolitis.

A

Coryzal symptoms precede:

  1. dry cough
  2. increasing breathlessness
  3. wheezing, fine inspiratory crackles (not always present)
  4. feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What viruses can cause bronchiolitis?

A

RSV = main causative organism!

Also: rhinovirus, influenza, adenovirus, parainfluenza virus.

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

Describe the epidemiology of bronchiolitis.

A

< 1yr olds (90% are 1-9 months, with a peak incidence of 3-6 months).
Maternal IgG provides protection to newborns against RSV
Higher incidence in winter

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

Give 5 bacterial organisms that commonly cause pneumonia in children.

A
  1. Group B strep in neonates.
  2. S.pneumoniae.
  3. H.influenzae.
  4. K.pneumoniae.
  5. M.pnuemoniae.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give 5 signs of pneumonia in children.

A
  1. Fever.
  2. Difficulty in breathing
  3. Increased respiratory rate (best clinical sign)
  4. Cough.
  5. Poor feeding.
  6. Lethargy.
  7. Localised chest, abdominal and neck pain (feature of pleural irritation and suggests bacterial infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigations might you do in a child who you suspect has pneumonia?

A
  • CXR -> look for consolidation.
  • Blood cultures.

It is often difficult to get a sputum sample.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the treatment for a child with pneumonia.

A
  1. 1st line- Amoxicillin
  2. Macrolides eg Erythromycin may be added if there is no response to first line therapy
  3. Macrolides should be used if mycoplasma or chlamydia is suspected
  4. Pneumonia associated with influenza- Co-amoxiclav
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between wheeze and stridor?

A

Wheeze: polyphonic noise heard on expiration.
Stridor: monophonic high pitched noise heard on inspiration.

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

Describe the aetiology of recurrent wheeze.

A
  1. Persistent infantile wheeze.
  2. Viral episodic wheeze.
  3. Asthma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is persistent infantile wheeze normally associated with/exacerbated by?

A

Persistent infantile wheeze tends to affect the small airways. It is associated with parental smoking or post-viral infection.

20
Q

Are inhalers likely to help a child with persistent infantile wheeze?

A

No. Inhalers are unlikely to help; symptoms will improve as the child gets older.

21
Q

What is viral episodic wheeze normally associated with/exacerbated by?

A

It normally follows a URTI. The child will have no interval symptoms.

22
Q

Are inhalers likely to help a child with viral episodic wheeze?

A

Bronchodilators may help but there is no benefit from inhaled steroids.

Symptoms are likely to improve with age.

23
Q

How would you manage an acute exacerbation of asthma in a child?

A

Pg 292 of sunflower book

24
Q

Inhalers: name 2 ‘preventers’.

A

ICS act as ‘preventers’ e.g. beclomethasone, budenoside.

25
Q

Inhalers: name 2 ‘relievers’.

A

Beta agonists e.g. salbutamol.

Muscarinic antagonists e.g. ipratropium bromide.

26
Q

Give 3 long term risks of systemic steroids.

A
  1. Adrenal suppression.
  2. Growth suppression.
  3. Osteoporosis.
27
Q

Why might asthma treatment fail in children?

A
  1. Poor adherence.
  2. Wrong diagnosis.
  3. Environmental factors.
  4. Choice of drug.
  5. Bad disease.
28
Q

Name 3 URTI.

A
  1. Rhinitis.
  2. Otitis media.
  3. Pharyngitis.
  4. Tonsillitis.
  5. Laryngitis.
29
Q

Name 3 LRTI.

A
  1. Bronchitis.
  2. Croup.
  3. Epiglottitis (bacterial).
  4. Tracheitis.
  5. Bronchiolitis.
  6. Pneumonia.
30
Q

Would you expect a patient with bronchitis or with bronchiolitis to be hypoxic and tachypnoeic? Explain why.

A

Bronchiolitis.

Bronchiolitis affects the respiratory portion of the airway, where gas exchange takes place therefore you may see hypoxia and tachypnoea.

Bronchitis affects the conducting portion of the airway and so is unlikely to have these effects.

31
Q

Give 3 signs of bronchitis in children.

A
  1. Chronic cough.
  2. Cough worst at night.
  3. No fever.
32
Q

Name 4 LRTI that could be caused by RSV.

A
  1. Acute bronchiolitis.
  2. Wheezy bronchitis.
  3. Asthma exacerbation.
  4. Pneumonia.
  5. Croup.
33
Q

Why are infants more susceptible to descending infection?

A

Infants have a poor innate immune response

34
Q

Name a bacteria that causes acute epiglottitis.

A

H.influenzae B.

Acute epiglottitis is a severe acute illness.

35
Q

Give 5 signs of acute epiglottitis.

A
  1. High fever in an ill, toxic-looking child
  2. Intensely painful throat
  3. Dribbling.
  4. Huge inflamed epiglottis that blocks the oesophagus and trachea-> soft inspiratory stridor
  5. Sitting immobile, upright, with an open mouth to optimise the airway
36
Q

Name 2 respiratory illnesses that can present with stridor.

A
  1. Croup - often a louder stridor.

2. Acute epiglottitis - often a quieter stridor due to inflamed epiglottis blocking oesophagus and trachea.

37
Q

Describe the immediate management for acute epiglottitis.

A

Secure the airway - anaesthetist, ENT surgeon.

38
Q

What is pneumonia?

A

Inflammation of the lung parenchyma with congestion

39
Q

Describe the diagnostic criteria for pneumonia in children.

A
  • If <3: pyrexial, chest recession and RR>50 = pneumonia.

- If older and the child has a history of breathing difficulties, cough and increased RR = pneumonia.

40
Q

Describe the treatment of pneumonia.

A
  • Amoxicillin is first-line for all children with pneumonia
  • Macrolides may be added if there is no response to first line therapy
  • Macrolides should be used if mycoplasma or chlamydia is suspected
  • In pneumonia associated with influenza, co-amoxiclav is recommended
41
Q

What antibiotics might you use in a child with pneumonia caused by mycoplasma pneumoniae?

A

Mycoplasma pneumoniae is intracellular and so amoxicillin won’t work therefore give macrolides e.g. clindamycin, erythromyocin.

42
Q

What is a unilateral pleural effusion suggestive of?

A

Infection e.g. parapneumonic or empyema.

43
Q

What is a bilateral pleural effusion suggestive of?

A

Fluid overload e.g. HF or nephrotic syndrome.

44
Q

What are the moderate, severe and life threatening features of asthma?

A 
Moderate: 
PEFR 50-75% best or predicted 
Speech normal 
RR < 25 / min 
Pulse < 110 bpm 
Severe: 
PEFR 33 - 50% best or predicted 
Can't complete sentences 
RR > 25/min
Pulse > 110 bpm 
Life-threatening: 
PEFR < 33% best or predicted 
Oxygen sats < 92% 
Silent chest, cyanosis or feeble respiratory effort Bradycardia, dysrhythmia or hypotension 
Exhaustion, confusion or coma
45
Q

List 2 causes of pulmonary hypoplasia.

A
  1. oligohydramnios

2. congenital diaphragmatic hernia

Paediatrics (21 decks)

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