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Year 4 Child Health > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is croup

A

laryngotracheobronchitis

inflammation of the upper airway usually due to parainfluenza viral infection

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2
Q

age group affected by croup

A

6mth - 3 yr

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3
Q

symptoms and signs of croup

A 
barking cough 
stridor 
dyspnoea 
fever 
cyanosis 
fatigue 
hoarse voice 
usually following having a cold
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4
Q

red flags / severe signs of croup

A 
cyanosis / grey / pale 
drooling 
altered mental state 
absent breath sounds / quieter than before 
fatigue 
resp distress
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5
Q

how can croup be classified

A

mild
moderate
severe
impending resp failure

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6
Q

management of croup

A

paracetamol, rehydrate
mild - PO DXM and rest at home + SAFETY NET
mod-severe - admit, and give supplementary O2 and steroids
PO DXM / neb budesonide / IM DXM

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7
Q

what is epiglottitis and what is the usual cause

A

inflammation and swelling of the epiglottis
HiB bacterial infection
other causes include: strep penumoniae, viral, trauma, smoking

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8
Q

age group affected by epiglottitis

A

2-6 yr

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9
Q

symptoms and signs of epiglottitis

A 
sore throat 
odynophagia + dysphagia 
stridor and breathing difficulties 
fever 
irritability 
hoarse voice 
decreased oral intake 
classic 'tripod' positioning 
drooling
cherry red epiglottis
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10
Q

RF for epiglottitis

A

non HiB vaccination

immunocompromised

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11
Q

management of epiglottitis

A

admit
ABCDE
secure the airway - O2 mask, intubation, tracheostomy
FBC, CRP, throat swab and culture, Xray/CT
IV antibiotics - ceftriaxone (chloramphenicol)

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12
Q

in paediatrics what must be done before administering chloramphenicol

A

check plasma levels

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13
Q

what is bronchiolitis

A

inflammation of the bronchioles

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14
Q

causes of bronchiolitis

A

respiratory syncytial virus RSV - most common
rhinovirus
parainfluenza virus

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15
Q

RF for bronchiolitis

A 
<6 wk 
premature 
immunocompromised 
other chronic conditions - neuro, cardiac, resp 
small for age
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16
Q

bronchiolitis is the most common infection in neonates and is usually self limiting, true or false

A

true

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17
Q

bronchiolitis is more common in children >2yo, true or false

A

false, it is more common in <2yo

asthma is more likely if >2yo

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18
Q

symptoms and signs of bronchiolitis

A 
tachypnoea 
fever 
increased work of breathing: nasal flaring, intercostal recession, tracheal tug, abdominal breathing 
wheeze 
crepitations
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19
Q

red flags for bronchiolitis

A 
apnoea or severe tachypnoea 
difficulty feeding 
cyanosis / grey 
grunting 
SaO2 < 92%
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20
Q

investigations are required to make a diagnosis of bronchiolitis, true or false

A

false, it is a clinical diagnosis

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21
Q

management of bronchiolitis

A

main principles: oxygenation and hydration as it is self limiting
mild - self limiting at home
mod - severe - admit, fluids, O2 support
impending resp failure - CPAP, NG feeding

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22
Q

antibiotics should be given in bronchiolitis, true or false

A

false!

23
Q

asthma triad

A

airway inflammation
airway hyper responsiveness
reversible airway obstruction

24
Q

pathology of asthma

A

bronchocontstriction
chronic airway inflammation
airway remodelling

BM thickening
submucosal collagen deposition
smooth muscle hypertrophy

25
Q

RF / triggers for asthma

A

FH
atopy - eczema, hayfever
exercise
nasal polyps

26
Q

symptoms and signs of asthma

A 
wheeze 
episodic symptoms 
diurnal variation - worse at night/early morning 
dry cough 
failure to thrive
27
Q

asthma has a dry/productive cough?

A

DRY non-productive cough

28
Q

management of asthma

A
  1. SABA - salbutamol
  2. SABA + very low dose ICS or LTRA if <5yo
  3. SABA + ICS + LABA/LTRA or LTRA if <5yo
  4. SABA + increase ICS dose + LABA/LTRA (remove if unhelpful)
29
Q

what are the PEFR ranges for severe and life threatening asthma

A

severe - 33-50%

life threatening <33%

30
Q

signs of life threatening asthma

A 
PEFR <33% 
apneoa 
silent chest 
exhaustion 
hypotension 
confusion 
cyanosis
31
Q

management of acute life threatening asthma

A 
high flow O2 if SaO2<94% with target 94-98%
SABA 
add ipratroium bromide to SABA 
consider adding MgSO4 
PO steroids - prednisolone 
CALL FOR HELP!
32
Q

what are pMDI

A

pressurised metered inhalers

33
Q

examples of pMDI

A

salbutamol
clenil modulite = beclometasone
seretide = fluticasone + salmeterol

34
Q

pMDI can be used with spacers, true or false

A

true

35
Q

technique for using pMDI

A

long slow deep breaths in and out of spacer

10 for younger children and 5 for older children

36
Q

examples of spacers

A

volumatic, aerochamber
yellow = masked
blue = unmasked

37
Q

who would use a masked spacer

A

preschool children

38
Q

what are breath actuated inhalers

A

triggered by the patient

39
Q

can breath actuated inhalers be used with a spacer

A

no

more convenient at school

40
Q

what is DPI

A

dry powdered inhalers

41
Q

examples of DPI and ages they can be used

A

turbohaler >=8yo
accuhaler >=12yo
ellipta

42
Q

DPI are pressurised devices, true or false

A

false, therefore you need to breathe hard and fast

43
Q

what is symbicort a mixture of

A

budesonide and formoterol

44
Q

what is seretide a mixture of

A

fluticasone and salmeterol

45
Q

what is clenil modulite

A

beclometasone

brown inhaler

46
Q

what is the blue inhaler

A

salbutamol

SABA

47
Q

inheritance pattern of CF

A

autosomal recessive

48
Q

what test is done for CF in the heel prick test

A

immune reactive trypsinogen IRT

49
Q

seretide inhaler is twice as potent as clenil, true or false

A

TRUE!

50
Q

which steroid is used as treatment in croup, prednisolone or dexamethasone

A

dexamethasone

51
Q

what are the 3 D’s for epiglottitis

A

drooling distress dysphagia

52
Q

xray feature of croup

A

steeple sign

53
Q

xray feature of epiglottitis

A

thumb print sign

Year 4 Child Health (22 decks)

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