Respiratory Flashcards
What is asthma?
Airway inflammation mediated by immune system
widespread narrowing of airways, increased airway activity
What are the risk factors for asthma?
Genetics- atopy
Smoking- mother and/or grandmother smoking during pregnancy
What is the presentation of asthma?
Wheeze Cough- dry, worse in morning and at night SOB Chest tightness Sputum
How is asthma diagnosed in <5s?
Clinically
How is asthma diagnosed in 5-16yo?
Spirometry with bronchodilator reversibility test
FeNO test if non diagnostic
What are the diagnostic criteria for asthma?
Wheeze
Responds to treatment
What are the steps for chronic management of asthma in <5s?
- SABA
- SABA + ICS
- SABA + ICS + LTRA
What are the steps of chronic asthma management in >5s?
- SABA
- SABA + ICS
- SABA + ICS + LTRA
- SABA + ICS + LABA +/- LTRA
- Long term oral steroids
What is the management of acute asthma?
Oxygen through non rebreather salbutamol neb hydrocortisone 100mg/pred 40mg Ipratropium neb theophylline- small print, rarely used magnesium sulphate
What is laryngomalacia?
Supraglottic Larynx causes partial airway obstruction
Most common cause of chronic stridor in children
What is the presentation of laryngomalacia?
Inspiratory stridor- intermittent, can cause difficulty feeding
Omega shaped glottis
What is the management of laryngomalacia?
Usually self limiting
Severe distress= tracheostomy
What is respiratory distress syndrome?
Inadequate surfactant leading to high surface tension within alveoli –> atelectasis
Who is RDS seen in?
50% infants born 26-28 weeks
25% born 30-31 weeks
What is the presentation of RDS?
Tachypnoea
Intercostal recession
Expiratory grunting
Cynosis
What investigations for done for RDS?
CXR- groin glass appearance with indistinct heart border
What is the prevention of RDS?
Maternal corticosteroids if premature labour likely
What is the management of RDS?
Oxygen
Assisted ventilation- CPAP preferably
Exogenous surfactant via ET tube
What are the complications of RDS?
Pneumothorax
Infection
Pulmonary haemorrhage
Chronic lung disease of prematurity
What is the presentation of chronic lung disease of prematurity?
Low sats Increased work of breathing Poor feeding and weight gain Crackles and wheeze Increased susceptibility to infection
How is chronic lung disease of prematurity diagnosed?
Characteristic CXR
Requires oxygen therapy after 36 weeks
