Respiratory Lecture Flashcards
10 things you must exclude with a significant chronic cough
- post infectious
- chronic infection
- allergy
- environmental exposures
- aspiration syndromes
- chronic lung diseases
- foreign body
- cardiac failure
- habit cough
- medication
When is a chronic cough significant?
- > 8 weeks, present most days
- non-remitting
- keeps child awake
- productive, purulent, haemoptysis
Types of noisy breathing
- stertor
- snoring
- stridor
- wheeze
Characteristics of an extrathoracic obstruction
- worse on inspiration
- stertor/stridor
Characteristics of an intrathoracic obstruction
- worse on expiration
- wheeze
Define stridor
noisy breathing during inspiration arising from the laryngeal and sometimes proximal tracheal obstruction
Define stertor
noisy breathing arising from nasopharyngeal obstruction
Causes of acute stridor in infants
- croup
- diptheria
- candida
- CMV
- subglottic stenosis
- GORD
Causes of persistent stridor in infants and children
- congential abnormalities
- GORD
- vocal cord paralysis
- laryngeal papillomas
- vascular ring
Causes of acute stridor in children
- croup
- GOR
- foreign body
Basic treatment of croup
Adrenaline inhalations
Characteristic of wheeze in large/central airway obstruction
- monophonic throughout expiratory phase
- air trapping/ hyperinflation absent
Congenital causes of large airway obstruction
- tracheal stenosis/ complete rings
- vascular rings
- mediastinal tumours/ bronchogenic cysts
Acquired causes of large airway obstruction
- TB nodes
- foreign body
Characteristics of wheeze in small airway obstruction
end expiratory with forced expiratory effort
- bilateral air trapping/ hyperinflation present
Acute causes of small airway obstruction
- asthma
- bronchitis and viral-triggered wheeze
- acute aspiration/inhalation injury
Persistent causes of small airway obstruction
- chronic aspiration
- post infectious
- CF and PCD
- Cardiac failure
Bacterial causes of CAP in children
- S. pneumoniae
- H. influenzae
- S. aureus
- M. tb
Atypical bacterial causes of CAP in children
- M. pneumoniae
- C. trachomatis
- C. pneumoniae
Viral causes of CAP in children
- RSV
- Parainfluenza
- Adenovirus
- Influenza
- Rhinovirus
- Measles
Radiological signs of pneumonia
- airtrapping most common
- effusions
- atelectasis
- evidence of TB co-infection
First-line antibiotic for CAP
Ampicillin/ penicillin IV + aminoglycoside IV
