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Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Usual cause of bronchiolitis?

A

Respiratory syncytial virus (RSV)

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2
Q

Usual age for bronchiolitis?

A

Under 1 (most commonly under 6 months)

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3
Q

Presentation of bronchiolitis?

A 
Coryzal symtpoms
Dyspnoea
Tachypnoea
Poor feeding
Wheeze and crackles on auscultation
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4
Q

Signs of respiratory distress?

A 
Raised resp. rate
Accessory muscle involvement
Intercostal and subcostal recessions
Nasal flaring
Head bobbing
Tracheal tugging
Cyanosis
Abnormal airway noises
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5
Q

Abnormal airway noises?

A

Grunting
Wheezing
Stridor

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6
Q

Typical RSV course?

A

Coryzal symptoms
1-2 days chest symptoms
Day 3-4 usually worst
Lasts 7-10 days

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7
Q

Management of bronchiolitis?

A

Supportive management

  • intake
  • nasal suctioning
  • oxygen if needed
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8
Q

Palivizumab?

A

Monoclonal antibody against RSV given to ex-premature or congenital heart disease

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9
Q

Viral induced wheeze or asthma?

A

Viral induced wheeze more likely if:

  • Presenting under 3
  • No atopic history
  • Only occurs during viral infections
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10
Q

Presentation of viral induced wheeze?

A

Evidence of viral illness
SOB
Respiratory distress
Expiratory wheeze throughout the chest

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11
Q

Focal wheeze in children?

A

Think inhaled foreign body

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12
Q

Presentation in pneumonia?

A 
Cough (wet and productive)
High fever
Increased resp. effort
Tachypnoea
Tachycardia
Lethargy
Delirium
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13
Q

Signs in pneumonia?

A 
Derangement in basic obs. could indicate sepsis
Tachypnoea
Tachycardia
Hypoxia
Hypotension
Fever
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14
Q

Characteristic chest signs in pneumonia?

A

Bronchial breath sounds
Focal coarse crackles
Dullness to percussion

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15
Q

Bacterial causes of pneumonia?

A 
Strep. pneumoniae (most common)
Group A strep
Group B strep (pre vac)
Staph aureus
Haemophilus influenzae
Mycoplasma pneumonia
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16
Q

Investigations in pneumonia?

A

Sputum cultures and throat swabs
Blood cultures if sepsis suspected
Blood gas

17
Q

Management of pneumonia?

A

Nothing if symptoms are mild

1st: oral amoxicillin
2nd: oral macrolide
3rd: IV if vomiting

18
Q

Causes of croup?

A

Parainfluenza virus (classic)
Adenovirus
RSV

19
Q

Croup typically affects ages?

A

6 months - 2 years

20
Q

Treatment for croup

A

Oral dexamethasone

21
Q

Presentation of croup?

A 
Generally well
Barking cough
Stridor
Hoarse voice
Low grade fever
22
Q

Epiglottitis symptoms?

A

Sore throat and stridor
Drooling
Tripod position

23
Q

Investigations in epiglottitis?

A

Lateral x-ray of neck shows thumbprint sign (also to rule out foreign body)

24
Q

Treatment of epiglottitis?

A

Intubation if needed
IV ceftriaxone
Steroids (dexamethasone)

25
Q

When should you trial inhaled corticosteroids?

A

If quality of life affected by symptoms (no wheeze, no asthma)

26
Q

Asthma diagnosis?

A

Wheeze
Variability
Responds to treatment

27
Q

Presentation suggesting asthma?

A 
Wheeze and dry cough
SOB
Diurnal variability
Typical triggers
Family history of atopy
Other atopic conditions
28
Q

Presentation suggesting something other than asthma?

A

Wheeze only related to coughs and colds
Isolated or productive cough
Normal investigations
Unilateral wheeze

29
Q

Typical asthma triggers?

A 
Dust (HDM)
Animals
Cold
Exercise
Smoke
Food allergens
30
Q

Asthma treatment?

A

Inhaled corticosteroids for 2 months, then inhaler holiday for 2 months

31
Q

Step 2 (regular preventer) asthma treatment needed if?

A

Using SABA more than two days a week

Symptomatic three or more days a week or waking in the night

32
Q

Step 2?

A

Low dose inhaled corticosteroids (or LTRA in under 5s)

33
Q

Step 3?

A

Add long acting beta agonist or leukotriene receptor antagonist (Montelukast)

Paediatrics (7 decks)

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