respiratory diseases

Question 1

what is bronchiolitis?

Answer 1

acute viral inflammatory injury of the bronchioles (usually in first winter)

Question 2

what causes bronchiolitis?

Answer 2

RSV

Question 3

what are the symptoms of bronchiolitis?

Answer 3

runny, snotty nose
dyspnoea
tachypnoea
poor feeding
mild fever
apnoeas

Question 4

what are the signs of bronchiolitis?

Answer 4

nasal flaring - sign of resp distress
wheeze and crackles on auscultation
inc work of breathing - tracheal tug, subcostal/intercostal recession
feeding difficulties

Question 5

what is the management of bronchiolitis?

Answer 5

supportive
oxygen (<92% O2)
NG tube

Question 6

what is croup?

Answer 6

upper resp tract infection causing oedema in the larynx - narrowed airway

Question 7

what causes croup?

Answer 7

parainfluenza virus

Question 8

how does croup clinically present?

Answer 8

inc work of breathing
barking cough, clusters of coughing episodes
hoarse voice
stridor
low grade fever

Question 9

what is the treatment of croup?

Answer 9

dexamethasone
severe = nebulised adrenaline

Question 10

what is acute asthma?

Answer 10

acute exacerbation of asthma characterised by rapid deterioration in the symptoms of asthma

Question 11

what are the symptoms of acute asthma?

Answer 11

progressively worsening shortness of breath
tachypnoea

Question 12

what are the signs of acute asthma?

Answer 12

signs of respiratory distress
expiratory wheeze on auscultation heard throughout the chest
the chest scan sound tight on auscultation with reduced air entry

Question 13

what are the features of moderate acute asthma?

Answer 13

peak flow >50% predicted
normal speech
no features

Question 14

what are the features if severe acute asthma?

Answer 14

peak flow <50% predicted
sats <92%
unable to complete sentences
signs of resp distress

Question 15

what is the respiratory rate in severe acute asthma?

Answer 15

> 40 in 1-5 years
30 in >5 years

Question 16

what is the heart rate in severe acute asthma?

Answer 16

> 140 in 1-5 years
125 in >5 years

Question 17

what are the features of life threatening acute asthma?

Answer 17

peak flow <33% predicted
sats <92%
exhaustion and poor respiratory effort
hypotension
silent chest
cyanosis
altered consciousness/confusion

Question 18

what is the treatment for mild acute asthma?

Answer 18

regular salbutamol inhalers via a spacer

Question 19

what is the management of moderate-severe acute asthma?

Answer 19

OSHITMAN
oxygen
salbutamol
hydrocortisone
ipratropium
theophylline
magnesium sulphate
an anaesthetist

Question 20

what is pneumonia?

Answer 20

infection of the lung tissue, causing inflammation of the lungs and sputum filling airways and alveoli

Question 21

what is the causative organisms of bacterial pneumonia?

Answer 21

strep. pneumonia - most common
group A and B strep
staph aureus
H. influenza

Question 22

what is the most causative organism of viral pneumonia?

Answer 22

RSV

Question 23

what are the symptoms of pneumonia?

Answer 23

cough (wet and productive)
high fever (>38.5)
tachypnoea
tachycardia
inc work of breathing
lethargy
delirium (acute confusion associated with infection)

Question 24

what are the signs of pneumonia?

Answer 24

bronchial breath sounds - harsh breath sounds equally loud on inspiration and expiration, caused by consolidation of lung tissue around airway
focal coarse crackles - air passing through sputum
dullness to percussion - due to lung tissue collapse and/or consolidation

Question 25

what investigations are used for pneumonia?

Answer 25

chest x-ray blood cultures if think sepsis

Question 26

what is the management of pneumonia?

Answer 26

amoxicillin erythromycin if penicillin allergic

Question 27

what is the causative organism of epiglottitis?

Answer 27

H. influenza

Question 28

what are the signs and symptoms of epiglottitis?

Answer 28

soft constant stridor sudden onset swollen epiglottis (thumb sign) drooling unable to swallow

Question 29

what is the management of epiglottitis?

Answer 29

immediate ENT help IV ceftriaxone + oxygen do not examine throat

Question 30

what are the difference between croup and epiglottitis?

Answer 30

croup - no drooling, able to swallow epiglottitis - drooling, unable to swallow

Question 31

what is the causative organism of whooping cough?

Answer 31

bordetella pertussis

Question 32

what are the signs and symptoms of whooping cough?

Answer 32

2-3 days of coryzal symptoms acute cough (>14 days) inspiratory whoop worse at night post coughing vomiting

Question 33

what is the management of whooping cough?

Answer 33

erythromycin, clarithromycin (macrolides)

Question 34

what is used to diagnose whooping cough?

Answer 34

nasal-swab

Question 35

what is the cause of cystic fibrosis?

Answer 35

CFTR chromosome 7 mutation

Question 36

what are the clinical signs and symptoms of cystic fibrosis?

Answer 36

failure to thrive recurrent chest infections malabsorption steatorrhea (fatty stool) meconium ileus (neonatal bowel obstruction)

Question 37

what would be seen in a sweat test in someone with CF?

Answer 37

inc chlorine