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paediatrics > respiratory disorders > Flashcards

respiratory disorders Flashcards

1
Q

types of URTI?

A
  • common cold
  • pharyngitis and tonsillitis (sore throat)
  • acute otitis media
  • sinusitis
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2
Q

common causes of tonsillitis?

A
  • group A B-haemolytic streptococci

- EBV

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3
Q

a) treatment of group A strep tonsillitis?

b) why?

A

a) 10 days of penicillin

b) to prevent rheumatic fever

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4
Q

features of tonsillitis?

A
  • red, swollen tonsils
  • may be white exudate
  • headache
  • apathy
  • abdominal pain
  • cervical lymphadenopathy
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5
Q

peak age for otitis media?

A

6-12 months

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6
Q

why are children prone to otitis media?

A

their eustachian tube is short, and horizontal

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7
Q

presentation of otitis media?

A
  • pain in ear
  • fever
  • bright red bulging tympanic membrane
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8
Q

pathogens that cause otitis media?

A
  • RSV
  • rhinovirus
  • H. influenzae
  • Moraxella catarrhalis
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9
Q

serious complications of otitis media?

A
  • mastoiditis

- meningitis

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10
Q

management of otitis media?

A
  • paracetamol or ibuprofen for pain relief
  • otherwise just wait
  • amoxicillin helps with severe pain
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11
Q

presentation of otitis media with effusion

A
  • asymptomatic, or slightly reduced hearing
  • eardrum looks dull and retracted
  • visible fluid in it
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12
Q

peak incidence of otitis media with effusion?

A

2.5-5 years old

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13
Q

management of otitis media with effusion?

A
  • nothing at all

- if hearing loss, grommets

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14
Q

main complication of otitis media with effusion?

A

conductive hearing loss

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15
Q

indications for tonsillectomy?

A
  • recurrent tonsillitis
  • NOT large tonsils alone
  • peritonsillar abscess
  • obstructive sleep apnoea
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16
Q

commonest cause of acute upper airway obstruction?

A

CROUP!!!!

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17
Q

rarer causes of acute upper airway obstruction?

A
  • epiglottitis
  • bacterial tracheitis
  • inhalation of smoke
  • trauma to throat
  • laryngeal foreign body
18
Q

signs of upper airway obstruction?

A
  • stridor (inspiration)
  • hoarse voice
  • barking cough
  • dyspnoea (varies)
19
Q

management of upper airway obstruction?

A
  • do NOT examine throat
  • look for signs of hypoxia
  • if there is resp failure, get urgent tracheal intubation
20
Q

commonest cause of croup?

A

parainfluenza virus?

21
Q

age for presentation of croup?

A

6 months - 6 years old

22
Q

peak age for croup?

A

2nd year of life

23
Q

which season is croup most common in?

A

autumn

24
Q

features of croup?

A
  • barking cough
  • harsh stridor
  • hoarse voice
  • prodrome of fever + coryza
  • symptoms worse at night
  • symptoms disappear at rest if mild croup
25
Q

management of croup?

A
  • inhaled warm, moist air

- oral steroids

26
Q

presentation of bacterial tracheitis?

A
  • high fever
  • toxic appearance
  • rapidly progressive obstruction
  • stridor, cough, resp distress
27
Q

causative organism in bacterial tracheitis?

A

staph aureus

28
Q

management of bacterial tracheitis?

A
  • do ABCDE
  • IV ceftriaxone and cloxacillin for 5 days
  • then oral co-amoxiclav for 7-10 days
29
Q

causative organism in acute epiglottitis?

A
  • H. influenzae b

- incidence really low now due to vaccination against Hib

30
Q

features of epiglottitis?

A
  • high fever (>38.5C) in toxic-looking child
  • painful throat, struggling to swallow (drooling)
  • soft inspiratory stridor
  • reluctant to speak
  • no cough
31
Q

management of acute epiglottitis?

A
  • treat it ASAP - every minute counts
  • intubation under GA
  • if this not possible, then tracheostomy
  • IV cefuroxime
  • rifampicin for all close contacts
32
Q

presentation of whooping cough?

A

1 week coryza, followed by:

  • paroxysmal cough, worse at night
  • may vom from coughing
  • older children whoop
  • infants have apnoea
  • red / blue in face during paroxysm
  • epistaxis
  • subconjunctival haemorrhage
33
Q

age for whooping cough?

A

<4 months, they have not been immunised yet

34
Q

management of whooping cough?

A
  • highly infectious, so child should be isolated

- erythromycin prophylaxis for unimmunised close contacts

35
Q

how is whooping cough diagnosed

A
  • culture of bordetella pertussis on per-nasal swab

- lymphocytosis on blood film

36
Q

age of presentation for bronchiolitis?

A

1-9 months, rare after 1 year old

37
Q

causative organism in bronchiolitis?

A

respiratory syncytial virus (RSV)

38
Q

features of bronchiolitis?

A

1 week coryza, followed by:

  • sharp, dry cough
  • increasing SOB
  • tachypnoea
  • tachycardia
  • recession
  • prominent sternum (hyperinflated chest)
  • difficulty feeding
  • cyanosis / pallor
  • expiratory and inspiratory wheeze
39
Q

investigations in bronchiolitis?

A
  • PCR of nasopharyngeal secretions
  • CXR (unusual) shows hyperinflated lungs
  • O2 sats (keep monitoring)
40
Q

management of bronchiolitis?

A
  • supportive
  • humidified O2 in nasal cannula
  • ventilation and fluids both as needed

paediatrics (10 decks)

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