Respiratory Disorders

Question 1

coommon cold, sore throat, acute otitis media and sinusitis are all refered to as:

Answer 1

URTI

Question 2

The common cold is the most common infection in childhood. True or False

Answer 2

True

Question 3

What are the pathogens involved in coryza

Answer 3

rhinovirus, coronavirus and RSV

Question 4

Antibiotics are necessary to treat the common cold. True or False

Answer 4

False

Question 5

What is the most common pathogen involved in pharyngitis and tonsillitis?

Answer 5

Adenovirus

Grp A beta hemolytic strep in older children

Question 6

CF in bacterial vs Viral Tonsillitis

Answer 6

marked headach apathy and tonsillar exudates abdominal pain are more common with bacterial

Question 7

Treatment of bacterial pharyngitis

Answer 7

pen V or erythromycin for 10 days

Question 8

Which drug causes widespread maculopapular rash if used to treat pharyngitis due to mono

Answer 8

Amoxicillin

Question 9

Group A strep puts a patient at risk for:

Answer 9

Scarlet fever

Question 10

7 yr old pt with fever that precedes headache and tonsillitis two days after. On exam there is a sandpaper llike rash with flushed cheeks and perioral sparing. The pt has a white and coated tongue which is mildly swollen. How is this pt treated?

Answer 10

This pt has Scarlet fever that is caused by GAS. Rx is pen v or erythromycin.

Question 11

What is this pt with fever and rash at risk for?

Answer 11

acute glomerulonephritis

Question 12

Which age group is acute otitis media more common in?

Answer 12

6-12 mo

Question 13

why are children more proned to ear infections?

Answer 13

because their eustachian tube is shorter and more horizontal.

Question 14

A 8 month old infant presents to the ED irritable and with a fever. What is the most important thing to do on examination?

Answer 14

examine the ear to check for ear infection

Question 15

What is seen on examination of the ear?

Answer 15

erythematous bulging with loss of normal light reflex

Question 16

Glue ear describes what

Answer 16

otitis media with effusion ear drum is dull and retracted

Question 17

Antibiotics are first line treatment for ear in fections. trie or false?

Answer 17

False. Antibiotics are not first line but are used if the infection does not resolve within 2-3 days

Question 18

otitis media is the most common cause of conductive hearing loss in children. True or false

Answer 18

true. it can interfere with speech development and result in learning difficulties

Question 19

how is glue ear treated?

Answer 19

grommet insertion

Question 20

Define Stridor

Answer 20

harsh inspiratory sound due to partial obstruction of the lower part of the upper airway

Question 21

central cyanosis drooling or reduced level of consciousness are suggestive of what?

Answer 21

impending airway collapse

Question 22

What is the most reliable measure of hypoxaemia

Answer 22

pulse ox

Question 23

hypoxaemia is an early ssign of upper airway obstruction true or false

Answer 23

false it is a late sign of obstruction

Question 24

A spatula can be used to examine the throat of a pt with stridor. True or False

Answer 24

Spatulas should NOT be used to examine pt with stridor bc it may precipitate complete airway collapse

Question 25

What is the most common cause of acute stridor?

Answer 25

Croup

Question 26

A two yr old boy presents to the ED with coryzal symptoms,and a fever which measured 38C. He has a severe cough and appears unwell. on examination there is chest wall retraction. There is marked stridor and he has a hoarse voice. How is this patient treated?

Answer 26

This patient has Croup and is most likely caused by the parainfluenza virus. Oral dexa,pred or nebulised steroids like budesonide should relieve symptoms. IF severe , neb epinehrine should be given with oxyge.

Question 27

Intense swelling of the epiglottis and the surounding tissue assoc with septicaemia is know as

Answer 27

Epiglottitis

Question 28

Epiglottititis is a caused by the influenza virus. True or falsie

Answer 28

False it is caused by h influenzae type B.

Question 29

5 yo girl develops severe sore throat drooling of saliva a high fever and increasing difficulty breathing over 8 hrs. The child is refusing to eat and has soft inspiratory stridor. How should this child be treated?

Answer 29

This child should be admitted to the the PIcu.Senior anaesthetist ENT and pediatrician should be briefed and the child intubatted under general anaesthesia.Tube could be removed after 24 hrs. Antibiotics should be given for 3-5 days e.g. cefuroxime

Question 30

A patient presents with high fever , has a toxic look and loud harsh stridor. what is the diagnosis

Answer 30

bacterial tracheitis

Question 31

differential for chronic stridor

Answer 31

laryngmalacia

vascular ring

Question 32

what is the most common severe infection of infancy ( under 1 year old)

Answer 32

Bronchiolitis

Question 33

RSV is the responsible pathogen in what infection

Answer 33

Bronchiolitis

Question 34

Severe bronchiolitis causative agents

Answer 34

human metapneumovirus and RSV

Question 35

A 3 month old boy presents to the ED with a dry wheezy cough difficulty fedding on examinationpt is tachypnoeaic and tachycardic. There are chest wall and subcostal recessions. On auscultation there is fine end inspiratory crackles. A high pitched end expiratory wheeze is appreciated. SpO2 is 90%.How should this patient be managed?

Answer 35

This pt should be admitted.GIven IVfluids and humidified oxygen. NG or orogastric tube shoul be inserted. Consider CPAP or mech vent if condition does not improve. Infection control measures should be used when attending to such patients.

Question 36

What prophylactic measure is used in preterm infants to decrease risk of Bronchiolitis?

Answer 36

IM palivizumab given on a monthly basis