Respiratory

Question 1

Why does stridor occur in babies when they sleep?

this is a normal process

Answer 1

Laryngomalacia (soft larnyx) and floppy epiglottis narrows airway when sleeping

They will grow out of this as larynx and epiglottis hardens with age

Question 2

Why do babies present with sternal recession?

Answer 2

They have soft ribs so when they are working harder the sternum recesses

Question 3

What 3 things should be in your DD for stridor in a child?

Answer 3

Croup
Inhaled foreign body
Epiglottitis

Question 4

How old do you have to be before asthma can be diagnosed?

Answer 4

5/6

Question 5

At what age do children get bronchiolitis?

What is the most common cause?

Answer 5

<1yo - disease of babies

RSV (respiratory syncytial virus)

Question 6

What condition presents acutely with a barking cough and little systemic illness?

How is it managed?

What is the most common cause?

Answer 6

Croup

Single dose of prednisolone/dexamethasone

Parainfluenza virus

Question 7

What respiratory condition is more common in non-vaccinated kids?

Answer 7

Epiglottis - rare now because of vaccination

Question 8

Does bronchiolitis present with wheeze or stridor?

What can be heard on auscultation?

Answer 8

Wheeze (noise on breathing out)

Crackles (can sound a bit bubbly)

Question 9

What must NOT be done in epiglottitis?

What is the first thing you should do?

Answer 9

Look inside the throat - can cause the epiglottis to seize up

Urgently get a senior and anaesthetist

Question 10

How is bronchiolitis managed?

Answer 10

Supportively

Question 11

Bronchiolitis initially presents with coryzal symptoms and then some go on to develop more complex symptoms suggestive of respiratory distress.

How does this appear in a child? (try get 6/9)

Answer 11

• Raised RR
• Subcostal recession
• Cyanosis
• Head bobbing
• nasal flaring
• abnormal airway noises
• use of accessory muscles
• tracheal tugging
• intercostal recession