Respiratory

Question 1

most common cause of bronchiolitis

Answer 1

RSV

peak incidence autumn + spring

Question 2

presentation of bronchiolitis

Answer 2

course crepitations
wheeze
tachypnoea
hypoxia

Question 3

what might a CXR show in bronchiolitis

Answer 3

hyperinflation / patchy infiltrative change

Question 4

what is given to infants at risk of bronchiolitis?

e.g. children with chronic lung disease

Answer 4

palivizumab (RSV monoclonal antibody)

- given monthly as primary prophylaxis during RSV season

Question 5

barking cough

Answer 5

croup

- viral laryngotracheal infection

Question 6

presentation of croup

Answer 6

stridor, barking cough, increased work of breathing

Question 7

tx croup

Answer 7

oral dexamethasone or nebulised budesonide

nebulised adrenaline if severe

Question 8

fever, stridor, drooling, minimal cough

Answer 8

epiglottitis

Question 9

tx epiglottitis

Answer 9

emergency - ENT/anaesthetic review to secure airway

IV antibiotics

Question 10

organism that causes epiglottis

Answer 10

haemophilus influenza B

- rare now due to Hib vaccine

Question 11

organism that causes whooping cough

Answer 11

bordatella pertussis

Question 12

features of viral induced wheeze

Answer 12

wheeze following cough/coryza

Question 13

tx viral induced wheeze

Answer 13

1. SABA - salbutamol

2. Leukotriene receptor antagonist - Montelukast

Question 14

what type of hypersensitivity is asthma

Answer 14

type 1 - IgE mediated

Question 15

asthma signs and symptoms

Answer 15

expiratory wheeze
reduced peak flow

cough- worse at night
wheeze
breathlessness
chest tightness

Question 16

spirometry results in asthma

Answer 16

FEV1 - reduced
FVC- normal
FEV1/FVC: <70%

Question 17

asthma pathway in children

Answer 17

SABA
SABA + ICS
SABA + ICS + Leukotriene receptor antagonist
SABA + ICS + LABA

Question 18

management of whooping cough

Answer 18

admit if under 6 months old

give clarithromycin if onset within 21 days

Question 19

presentation of whooping cough

Answer 19

2-3 days of coryza
bouts of coughing - usually worse at night / after feeding
inspiratory whoop
vomiting

Question 20

management of croup if steroids fail

Answer 20

oxygen + nebulised adrenaline

Question 21

what organism causes croup

Answer 21

parainfluenza

Question 22

most common cause of stridor in neonate

Answer 22

laryngomalacia

Question 23

features of a viral wheeze

Answer 23

wheeze present with an upper respiratory tract infection, absent the rest of the time

Question 24

management of a viral wheeze

Answer 24

1st line: salbutamol inhaler

2nd line: trial of montelukast / ICS