Respiratory Conditions Flashcards
What is a congenital diaphragmatic hernia?
Bowel protrudes through a hole in the diaphragm and ends up beside the lungs (usually the left lung) The loops of bowel are sitting in the hemithorax and cause lung and pulmonary vascultature underdevelopment.
What causes bronchiolitis?
Respiratory synctycial virus
Cold like illness in 1 9 month years old followed by a dry cough, increasing breathlessness, wheeze and feeding difficulties.
Bronchiolitis
What causes whooping cough?
Caused by the gram negative bacterium bordatella pertussis
What is the treatment for whooping cough?
Macrolides - erythromycin, clarithromycin, azithromycin
2 – 3 days of cold like symptoms, coughing bouts, inspiratory whoop
Whooping cough
Stridor, barking cough, hoarse voice mild fever and runny nose.
Croup
What causes croup?
Parainfluenza virus
What is the treatment for croup?
Oral prednisolone
Difficulty swallowing, drooling, fever, stridor, cyanosis. Septic and very unwell with fever.
Epiglottitis
What causes epiglottitis?
Haemophilus influenzae
What investigation do you order if you suspect epiglottitis?
Lateral cervical X Ray
What do you see on a lateral cervical X Ray for epiglottitis?
Thumbprint sign
What is the treatment for epiglottitis?
Endotracheal intubation
IV ceftriaxone
Steroids
Autosomal recessive inherited multisystem disease characterised by recurrent respiratory tract infections, pancreatic insufficiency, malabsoprtion and male infertility
Cystic fibrosis
What causes cystic fibrosis?
Defective CFTR gene on chromosome 7q. This endcodes for a cAMP dependant chlorine channel which regulates sodium and chlorine concentrations in exocrine secretions mainly in the lungs and pancreas. This loss of function mutation causes viscous secretions.
What is the most common mutation in CF?
F508
What is the investigation for a child who has a high probability of having asthma in order to confirm the diagnosis?
Start 6 weeks of inhaled corticosteroids (if the response is good then a diagnosis of asthma can be made)
Describe the management of asthma in children
Stage 1 : Inhaled beta agonists as required
Stage 2: Add in regular inhaled corticosteroids
Stage 3A: Regular inhaled steroids + LABA
Stage 3B: Add in leukotriene antagonists
Stage 4: High dose steroids
How do leukotriene receptor antagonists work?
Oppose the action of leukotrienes which are inflammatory mediators produced by the immune systme and promote bronchoconstriction, inflammation and mucus secretion.
What are examples of leukotriene receptor antagonists?
Montelukast
What is transient tachypnoea of the newborn?
A respiratory problem that occurs just after birth - consists of a period of rapid breathing and is likely to be due to amniotic fluid remaining in the lungs following birth.
How do you treat transient tachypnoea of the newborn?
Oxygen and antibiotics
A newborn baby has a respiratory rate of 70. You do a chest X ray and see hyperinflation of the lungs, flattening of the diaphram and fluid in the horizontal fissure of the right lung.
Transient tacchypnoea of the newborn.
Is transient tachypnoea of the newborn more common in babies born by vaginal delivery or C section?
C section
What is the treatment for an acute asthma attack in a child?
Oxygen Nebulised salbutamol Oral prednisolone IV salbutamol IV aminophylline IV magnesium
What are the most common causative organisms for pneumonia in neonates?
Group B Strep
E Coli
Klebsiella
Staph aureus
What are the most common causative organisms for pneumonia in infants?
Strep pneumoniae
Chlamydia
What are the most common causative organisms for pneumonia in school age children?
Strep pneumoniae Staph aureus Group A Strep Mycoplasma Legionella
What is the empirical treatment for community acquired pneumonia in children?
Non Severe: Amoxicillin for 7 days.Co Amoxiclav if less than 1. (Clarithromycin if allergic)
Severe: Co Amoxiclav IV. Add in clarithromycin if atypical pneumonia or pertussis.
