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Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Antibiotics side effects

A 
Diarrhoea
Oral thrush 
Nappy rash 
Allergic reaction 
Multiresistance
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2
Q

What is rhinitis

A

irritation and inflammation of the mucous membrane inside the nose

Self limiting

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3
Q

What can rhinitis lead to?

A

Pneumonia
Bronchiolitis
Meningitis
Septicaemia

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4
Q

Otitis Media

A 
Ear infection
Self limiting
Primary viral infection 
Secondary infection with pneumococcus 
Erythema 
Bulging drum
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5
Q

Treatment for otitis media

A

Analgesia

Antibiotics (may work >24 hours)

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6
Q

Investigation for tonsillitis/ pharyngitis

A

Throat swab

To determine if viral or bacterial

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7
Q

Treatment for tonsillitis/ pharyngitis

A

Amoxicillin if bacterial !

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8
Q

Croup cause and presentation

Larygnotracheobronchitis

A

Cause- para flu 1
Lasts about 3 days

Presentation:
Child seems well,
Coryza ++
Stridor
Hoarse voice
“Barking” cough
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9
Q

Treatment for croup

A

Oral dexamethasone
Can give prednisolone

Severe nebulised adrenaline

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10
Q

Cause of epiglottitis

And presentation?

A

Cause- haemophillius influenzae type B

Presentation- very unwell, stridor, drooling, severe sore throat

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11
Q

Eiglottitis treatment

A

Intubation and antibiotics

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12
Q

Common bacterial agents in children LRTI

A 
Strep pneumoniae, 
Haemophilus influenzae,
Moraxella catarrhalis,
Mycoplasma pneumoniae, 
Chlamydia pneumoniae
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13
Q

Common viral infections in children causative agent

A 
RSV
Parainfluenza III
Influenza A and B
Adenovirus 
Rhinovirus
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14
Q

Bronchitis presentation

A

Loose rattly cough,
Post-tussive vomit- “glut”

No wheeze or creps

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15
Q

Common causative agent in bronchitis

A

Haemophilus/ pneumococcus

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16
Q

Treatment for bronchitis

A

Self limiting

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17
Q

What is happening to cause bacterial bronchitis

A

There is disturbed mucociliary clearance so clearance stops for about 4 weeks
Resulting in cough and rattle

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18
Q

Red flags in LRTI (7)

A 
Age <6months
Age >4 years
No relapse-remission
Static weight
Disrupts child’s life
Associated SOB (when coughing)
Acute admission 
Other co-morbidities
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19
Q

Presentation of bronchiolitis

A

Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze

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20
Q

Common causative agent of bronchiolitis?

A

RSV
Paraflu III
HMPV

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21
Q

Prognosis of bronchiolitis

A

Day 2-5 gradual gets worse
Day 5-7 remains stable
Day 7-14 gradual recovery

22
Q

Common age to be affected by bronchiolitis

A

3 months
Born in August-December

Overall typically less that 12 months

23
Q

Management of bronchiolitis

A

Maximal observation

Minimal intervention

24
Q

Investigations in bronchiolitis

A

Oxygen saturations

Nasopharyngeal aspirate

25
Q

General lower respiratory tract infection signs

A 
48 hours 
Fever,
SOB,
Cough, 
Grunting,
Reduced or bronchial breath sounds
26
Q

If a wheeze is present is the infection likely caused by a virus or bacteria

A

Virus

27
Q

When would you call a LRTI pneumonia

A

If signs are focal,
Crepitations,
High fever

28
Q

Treatment for community acquired pneumonia

A

Nothing if symptoms are mild
Oral amoxycillin first line
Oral macrolide second choice

IV if vomiting

29
Q

Pertussis presentation

A

Coughing fits
Vomiting
Colour change of child (red)

30
Q

First line in all URTI and LRTI treatment

A

Oxygenation,
Hydration,
Nutrition

31
Q

When would you treat otitis media with antibiotics and which one if so?

A

If aged under 2 and has bilateral OM

Oral amoyxcillin

32
Q

What key words are associated with asthma definitions

A

Wheeze
Variability
Responds to treatment

33
Q

What causes asthma

A 
Host response to environment
Infection 
Physiology abnormal before symptoms
Genes- ADAM33 ORMDL3
Primary epithelial abnormality
34
Q

What are the 5 ways asthma pathways to asthma

A 
1- infant onset
2- childhood onset
3- adult onset
4- exertional asthma
5- occupational asthma
35
Q

Investigations for asthma (but not diagnostic)

A

Peak flow
Spirometry
Exhaled nitric oxide
Response to corticosteroids

36
Q

Symptoms/signs of asthma

A

Wheeze,
SOB at rest (“sooking” in of ribs)
Dry cough (nocturnal and exertional)
Responds to treatment

37
Q

Risk factors for asthma

A

Eczema
Hayfever
Food allergies

38
Q

What age range is resp symptoms more likely to be asthma

A

Over 5 more likely asthma

Under 18 months most likely infection

39
Q

Differential diagnosis for asthma under 5 years

A 
Congenital 
CF
PCD
Bronchitis 
Foreign body

Primary ciliary dyskinesia

40
Q

Differential diagnosis for asthma over 5 years

A

Dysfunctional breathing
Vocal cord dysfunction
Habitual cough
Pertussis

41
Q

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 to measure asthma control

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

Initial treatment of asthma

A

Low dose Inhaled corticosteroid

Review after 2 months

44
Q

Classes of medications used in asthma

A 
Short acting beta agonists
Inhaled corticosteroids
Long acting beta agonists
Leukotriene receptor antagonists
Theophyllines
Oral steroids
45
Q

How does treatment for asthma in children differ from adults

A 
Max dose ICS 800micrograms for <12 years
No oral B2 tablet
LTRA first line preventer in <5y
No LAMAs
Only 2 biologicals
46
Q

Step 2 of treatment of asthma

And when to go onto stage 2

A

Regular preventer- low dose ICS (or LTRA in <5y)

when?
-diagnostic test
-B2 agonist >2 days a week
Symptomatic 3 times a week or more or waking one night a week

47
Q

Adverse effects of ICS

A 
Height suppression
Oral candidiasis
Adrenocortical suppression 
Hypertension 
Cataracts
48
Q

Step 3 of treatment of asthma

A

add on LABA or LTRA (leukotriene receptor anatagonist (montelukast) was

49
Q

Step 4 of asthma treatment

A

Refer to specialist
Increase ICE
Add 4th drug eg theophylline

50
Q

Other non-medical management for asthma

A

Stop tobacco smoke exposure

Remove environmental triggers

51
Q

How to treat someone with acute asthma

A

Mild:
SABA via spacer
Or SABA via spacer and prednisolone

Moderate:
SABA via nebuliser + prednisolone
SABA + ipratropium via nebuliser + prednisolone

Severe:
IV salbutamol
IV aminophylline
IV magnesium 
IV hydrocortisone 
Intubate and ventilate

Paediatrics (17 decks)

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