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Paediatrics > Respiratory Paediatrics > Flashcards

Respiratory Paediatrics Flashcards

1
Q

What are the side effects of antibiotics in children?

A 
Diarrhoea
Oral thrush
Nappy rash
Allergic reaction
Multi resistance
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2
Q

Rhinitis

A 
Very common
5-10 per year 
Self-limiting
Blocked/runny nose
Prodrome to other illnesses - pneumonia, bronchiolitis, meningitis, septicaemia
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3
Q

Otitis media

A

Common
Self-limiting
Typical duration - 1 week

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4
Q

What kind of infection causes otitis media?

A

Primary - viral

Secondary - pneumococcus/H’flu

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5
Q

What are the signs of otitis media?

A

Red ear
Painful
Discharge if perforation

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6
Q

How is otitis media treated?

A

Analgesia for pain relief

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7
Q

Tonsilitis/pharyngitis

A 
Common
Bacterial or viral
Typical duration - 1 week
Throat swab - 2 days
Either nothing or 10 days penicillin (if strep)
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8
Q

Croup

A

Common
Child is well
Typical duration - 3 days

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9
Q

What causes croup?

A

Para flu’1

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10
Q

What are the signs of croup?

A

Stridor
Hoarse voice
Barking cough

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11
Q

How is croup treated?

A

Oral dexamethasone

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12
Q

Epiglottitis

A

Medical emergency
Rare
Toxic

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13
Q

What is the cause of epiglottitis?

A

H/influenzae type B

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14
Q

What are the signs of epiglottitis?

A

Stridor
Drooling
Extremely painful

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15
Q

How is epiglottitis treated?

A

Intubation

Antibiotics

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16
Q

What are common agents in LRTIs?

A

Bacterial overgrowth - strep pneumoniae, haemophilus influenzae, moraxella catarrhalis, mycoplasma pneumoniae
Viral - RSV, para-influenza 2, influenza A and B, adenovirus, rhinovirus

17
Q

Bronchitis

A

Common
Mostly self-limiting
Relapsing remitting cycle - typically happens in Winter

18
Q

What causes bronchitis?

A

Haemophilus/pneumococcus

19
Q

What are the symptoms of bronchitis?

A

Loose rattly cough
Post-tussive vomit - ‘glut’, lots of mucous comes up
No wheeze or creps in the chest

20
Q

Bacterial bronchitis

A

Disturbed much-ciliary clearance
Lack of social inhibition
Bacterial overgrowth is secondary

21
Q

What are red flags in bronchitis?

A 
Age - <6 months, >4 years
No relapsing-remitting pattern
Static weight
Disrupts child's life
Associated SOB
Acute admission
Other co-morbidities
22
Q

Bronchiolitis

A

LRTI of infants
Usually RSV - Christmas time
Typical duration - 16 days

23
Q

What are the symptoms of bronchiolitis?

A

Blocked nose
Tachypnoea, SOB
Poor feeding
Chest - crackles and wheeze

24
Q

How is bronchiolitis managed?

A

If the patient is in the stabilising phase then do nothing

If the child is getting worse give antibiotics

25
Q

What are the symptoms of LRTI/pneumonia?

A 
Duration 48 hrs
Fever - >38.5
SOB
Cough
Grunting
Reduced or bronchial breathing
26
Q

When do you definitely call it pneumonia?

A

Signs are focal - ie in one area
Creps
High fever

27
Q

How is LRTI/pneumonia managed?

A

Nothing if symptoms are mild
1st - oral amoxycillin
2nd - oral macrolide

28
Q

Pertussis

A 
Common
Whooping cough
Vaccination reduces risk and severity
Coughing fits
Vomiting and colour change
29
Q

What is always first line treatment in a child?

A

Oxygenation, hydration, nutrition

30
Q

What is the epidemiology of childhood asthma?

A

1 million UK children

31
Q

What are the causes of childhood asthma?

A

Genes - 30-80%
Primary epithelial abnormality resulting in - eczema, asthma
Host response environment
Infection is important

32
Q

What are the symptoms of asthma?

A

Essential - wheeze, variability, responds to treatment
Wheeze - check noise with parents
SOB at rest
Cough

33
Q

How is asthma investigated?

A

None normally needed

Could no - peak flow, spirometry, exhaled nitric oxide

34
Q

How is asthma treated?

A

With a spacer ALWAYS
Watch and wait or trial ICS for 2 months
SABA - salbutamol
ICS - low dose
Initial add on - LABA (children >5), LTRA (children <5)
Additional add on’s - increase dose of ICS

35
Q

Severe asthma

A

50% psychological issues
50% compliance issues
Only minority have genuine severe disease

36
Q

How is control of asthma measured?

A 
SANE
Short acting beta agonist/week - if >2 then poor control
Absence school/nursery
Nocturnal symptoms/weel
Exertional symptoms/weel
37
Q

What are the differences in child asthma compared with adults?

A

Max dose ICS 800 micro (<12)
No oral B2 tablet
LTRA first line preventer in <5s
No LAMA

38
Q

What is the common age of bronchiolitis?

A

<12 months

39
Q

What are signs of respiratory distress?

A 
Raised respiratory rate
Use of accessory muscles of breathing (sternocleidomastoid, abdominal and intercostal muscles
Intercostal and subcostal recessions)
Nasal flaring
Head bobbing
Tracheal tugging
Cyanosis (due to low oxygen saturation)
Abnormal airway noises

Paediatrics (17 decks)

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