Respiratory Emergency

Question 1

what is the most common cause of bronchiolitis in children

Answer 1

respiratory synctial virus

Question 2

how many wet nappies should a baby be having every 8-12 hrs

1. at least 3
2. at least 1
3. at least 5

Answer 2

2. at least 1 wet nappy 8-12 hrs

Question 3

What is bronchiolitis

1. acute infection of the upper resp tract
2. acute infection of lower resp tract

Answer 3

2. acute infection of lower resp tract

BRONCHIOLES

Question 4

what is the peak age incidence of bronchiolitis

1. 3-6 months
2. 9-12 months
3. 13-18 months

Answer 4

1. 3-6 months

Question 5

list 3 RFx for bronchiolitis

Answer 5

age: 3-6 months
comorbidity: congential heart disease, CF, premature

winter

Question 6

list 2 that increase the risk of developing bronchiolitis

Answer 6

congenital heart disease

cystic fibrosis

prematurity

Question 7

What 2 initial symptoms might a child with infection of resp syncytial virus present with

Answer 7

cough

cold like symptoms (runny/blocked nose)

Question 8

which part of the airways does RSV initially infect

1. upper
2. lower

Answer 8

upper

then progresses to lower resp tract (bronchioles)

Question 9

list 3 features of respiratory distress

Answer 9

intercostal/subcostal recession

tracheal tug

nasal flaring

accessory muscle use

Question 10

what is the classical finding finding when listening to a child with bronchiolitis

Answer 10

wheeze and crackles everywhere

Question 11

why do children with bronchiolitis have poor feeding

Answer 11

breathing through their mouth due to blocked nose

Question 12

what is the cut off value for feeding in a child that would suggest admission

1. <60%
2. <55%
3. <50%

Answer 12

3. <50%

Question 13

what would giving nebulsied bronchidialotors e.g. salbutamol not work in children

Answer 13

they dont have the receptors in their smooth muscle in the lung

no beta agonist/muscuranic receptors

Question 14

how can you fix the blocked in a child with bronchiolitis

Answer 14

nasal suctioning

Question 15

list 3 ways of administering O2 in a child with bronchiolitis

Answer 15

headbox

nasal cannula

CPAP

intubation/ventilation

Question 16

true/false

antibiotics, bronchodilators, saline nebulisers are not used in the management of bronchiolitis

Answer 16

true

Question 17

what is croup

1. inflammation of larynx and trachea only
2. inflammation of trachea and bronchi only
3. inflammation of the bronchi
4. inflammation of the larynx, trachea and bronchi

Answer 17

4. inflammation of the larynx, trachea and bronchi

laryngotracheobronchitis

Question 18

what is the most common cause of croup

1. RSV
2. parainfluenza virus

Answer 18

2. parainfluenza virus

Question 19

what are 3 RFx of croup

Answer 19

age (typically <3 yrs)

male

autumn/winter

previous intubation

Question 20

what condition does barking cough present in

Answer 20

croup

Question 21

when is barking cough usually worse

Answer 21

at night

Question 22

what is the name of the condition that present with episodes of wheezing induced by a upper resp tract viral infection

1. croup
2. bronchiolitis
3. laryngotracheobronolitis
4. viral induced wheeze

Answer 22

4. viral induced wheeze

Question 23

list 3 causes of viral induced wheeze

Answer 23

RSV
rhinovirus
influenza

Question 24

list a RFx for viral induced wheeze

Answer 24

age <5 yrs

viral infection

Question 25

list one differential for viral induced wheeze

Answer 25

asthma exacerbation

Question 26

how can you tell the difference between asthma exacerbation vs viral induced wheeze

Answer 26

in VIW: episodes of wheezing but well in between

asthma exacerbation: wheeze + resp symptoms throughout

Question 27

what is the most common cause of cardiac arrest in children

Answer 27

hypoxia

Question 28

what the 1st thing you do in a child who has arrested

Answer 28

5 rescue breaths
check pulse
compressions