Respiratory Flashcards
What is Pneumonia?
When is it most common?
Pneumonia is an infection in the lungs. It can be mild or serious.
Pneumonia is generally more common in children younger than 5 years old.
What are the most common causative organisms for pneumonia?
Streptococcus pneumoniae
Mycoplasma pneumonia. This often causes a mild form of the illness called walking pneumonia.
Group B streptococcus
Staphylococcus aureus
Respiratory syncytial virus (RSV)
What are the symptoms of pneumonia?
What is the difference between bacterial and viral pneumonia?
Cough that produces mucus
Cough pain
Vomiting or diarrhea
Loss of appetite
Tiredness (fatigue)
Fever
Difference
Bacterial happens quicker than viral
What investigations can you do for pneumonia?
Chest X-ray
Blood tests - CO2 and O2
Sputum culture - causative organism
Pulse oximetry
What are the treatment options for pneumonia?
-
Bacterial - Oral for mild to moderate cases
- Amoxicillin
- Clarithromycin, erythromcyin (pregnancy), doxycycline
-
IV if severely unwell
- Co-amoxiclav with erythromycin
- Benzylpenicillin
- Mycoplasma pneumonia - erythromycin
What is Croup?
What age is most common for croup?
Inflammation of the layrnx and trachea
6 months to 3 years
At what age is croup most common?
6 months - 3 years
What is the most common causative organism of croup?
Parainfluenza virus
Respiratory syncytial virus (RSV)
What are the symptoms of croup?
Starts with runny nose, sore throat, fever and cough
Barking seal cough
Horse voice
What are the investigations for croup?
- Mainly diagnosed clinically
-
Chest x-rays
- Tapering below the vocal chords
- Steeple sign
What is the emergency treatment for croup?
High flow oxygen
Nebulised adrenaline
What is the management for croup?
Single dose oral dexamethasone
What is Asthma?
Asthma is ongoing inflammation
What is the cause of asthma?
A reaction to an allergen or trigger
Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
Respiratory infections, such as the common cold
Physical activity
Cold air
Air pollutants and irritants, such as smoke
Certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs
Strong emotions and stress
What are the symptoms of asthma?
Cough
Wheezing, a high-pitched, whistle-like sound when exhaling
Trouble breathing or shortness of breath
A tight, uncomfortable feeling in the chest
What are the investigations for asthma?
IN PEADS
Spirometry - FEV1/FVC <70%
Bronchodilator reversibility - Show improvement
Peak expiratory flow (PEF) - Monitor variability
Chest X-ray
What is the treatment for asthma people aged 5-16?
- SABA
- SABA + paediatric low-dose ICS
- SABA + paediatric low-dose ICS + leukotriene receptor antagonist (LTRA)
- SABA + paediatric low-dose ICS + long-acting beta agonist (LABA)
- SABA + MART low-dose ICS
- SABA + MART moderate-dose ICS
- SABA + one of the following options:
- increase ICS to paediatric high-dose, either as part of a fixed-dose regime or as a MART
- a trial of an additional drug (for example theophylline)
- seeking advice from a healthcare professional with expertise in asthma
What is the treatment for asthma people aged under 5?
1) SABA
2) SABA + an 8-week trial of paediatric MODERATE-dose inhaled corticosteroid (ICS)
3) SABA + paediatric low-dose ICS + leukotriene receptor antagonist (LTRA)
4) Stop the LTRA and refer to an paediatric asthma specialist
What is the treatment of an acute exaccerbation asthma attack in the GP?
Bronchodilator therapy
- Give a beta-2 agonist via a spacer (for a child < 3 years use a close-fitting mask)
- give 1 puff every 30-60 seconds up to a maximum of 10 puffs
- if symptoms are not controlled repeat beta-2 agonist and refer to hospital
Steroid therapy
- Should be given to all children with an asthma exacerbation
- treatment should be given for 3-5 days
What is a MART?
A form of combined ICS and LABA treatment in which a single inhaler