Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Respiratory Paediatrics > Flashcards

Respiratory Paediatrics Flashcards

1
Q

What are the risks of antibiotics in children?

A 
Diarrhoea
Oral thrush
Nappy rash
Allergic reaction
Multi resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the characteristics of rhinitis?

A

Very common
Most children affected by ~5-10 cases of rhinitis annually
Cases occur almost exclusively in the winter months
Usually a self limiting condition
Can also be a prodrome to a serious illness such as pneumonia, meningitis or septicaemia. Reviewal can be made if unsure as to diagnosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the characteristics of otitis media?

A 
Common 
Self-limiting infection of the ear
Can be primary viral infection or secondary to pneumococcal or haemophilus infection.
In severe cases the drum can rupture
Antibiotics usually do not help
Analgesia can be given to reduce earache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the characteristics of tonsillitis/pharyngitis?

A

Common
Very hard to tell whether the infection is viral or bacterial
Throat swabs can be taken but they take two days to come back.
Management options are either to do nothing or to give ten days of penicillin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why should amoxicillin not be given in tonsillitis?

A

Amoxycillin should never be given as EBV is a possible precipitant and amoxicillin will give a severe rash if EBV is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristics of croup?

A 
Commonly caused by parainfluenza type I
Common
Patient is systemically well
Coryza (common cold)
Stridor
Hoarse voice
 Barking cough
Treated with oral dexamethasone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the characteristics of epiglottitis?

A 
Caused by haemophilus influenza type B
Very rare but serious when does occur
Patient is toxic
Stridor
Drooling due to inflammation of throat being so severe that nothing can be swallowed- not even saliva
Managed by intubation and antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the common bacterial organisms associated with lower respiratory tract infections in children?

A 
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Mycoplasma pneumoniae
Chlamydia pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the common viral organisms associated with lower respiratory tract infections in children?

A 
RSV
Parainfluenza III
Influenza A and B
Adenovirus
Rhinovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the characteristics of bronchitis?

A 
Very common
Loose, rattly cough
Post-tussive vomit
Chest free of wheeze and creps
Haemophilus or pneumococcal causes common
Usually self-limiting
Child usually very well
Parent usually very worried
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the red flag signs of a more serious infection with bronchitis-like symptoms?

A 
Age <6 mo, >4yr
No relapse-remission
Static weight 
Disrupts child’s life
Associated SOB (when not coughing)
Acute admission
Other co-morbidities (neuro/gastro)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of bronchiolitis?

A

Lower respiratory tract infection of infants <12 months
Affects 30-40% of all infants
One off- not recurring
Usually respiratory syncytial virus (RSV)
Less commonly- parainfluenza III or human metapneumovirus (HMPV)
Associated with :
-Nasal stiffness
-Tachypnoea
-Poor feeding
Crackles common +/- wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the characteristic timeline of bronchiolitis?

A

Begins getting worse ~2 days after infection, with the condition worsening for ~3 days before stabilising for a couple of days before improving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is bronchiolitis investigated and managed?

A

Management of bronchiolitis is based around maximal observation with minimal intervention. Diagnosis is usually clinical and there are no medications that are proven to work in bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the general features of LRTIs in children?

A 
48hr duration
Fever >38.5
Dyspnoea
Cough
Grunting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is paediatric pneumonia investigated and managed?

A

CXR and inflammatory markers not routine in paediatrics
If symptoms are mild then give no treatment
If treatment is required then oral amoxicillin is first line and oral macrolide is second line

17
Q

When are IV antibiotics given in paediatric pneumonia?

A

ONLY when the patient is vomiting

18
Q

Why are oral antibiotics preferable to IV antibiotics in paediatric pneumonia?

A

Associated with a shorter hospital stay

Cheaper

19
Q

What are the characteristics of pertussis?

A

Pertussis/whooping cough is the most common cause of cough + vomiting in school aged children. Vaccination reduces risk and severity. It is associated with coughing fits, vomiting and colour change

20
Q

How are respiratory tract infections in children managed?

A

Generally, management of respiratory tract infections in children focuses on oxygenation, hydration and nutrition before antibiotics are thought about

21
Q

In what circumstances should antibiotics be considered in paediatric respiratory tract infection? Which antibiotic should be given for each?

A

Bilateral otitis media <2 years old- oral amoxicillin
Tonsillitis if known streptococcal cause- penicillin
LRTI/pneumonia if two day history of fever, cough and focal signs- oral amoxicillin

22
Q

What are the cardinal features of asthma?

A

Wheeze
Variability
Response to treatment

23
Q

What tests should asthma diagnosis involve?

A
  1. Spirometry
  2. BDR (bronchodilator responsiveness)
  3. FeNO (nitric oxide)
  4. Peak flow
24
Q

What are the characteristics of asthma?

A

Wheeze is essential for asthma diagnosis and it is important to clarify that what the parent reports as wheeze is actually wheeze. Other characteristics of asthma are:
•SOB at rest (indicative of 70% reduction in lung function)
•Cough- dry, nocturnal, exertional
•Parental history of asthma
•Personal history of eczema, hayfever or food allergies

25
Q

How should inhaled corticosteroids be trialled?

A

Initially, two months of inhaled corticosteroids should be given before giving a break to exclude any false positives

26
Q

What harm is associated with trialling ICS?

A

Cost
Hassle
Oral thrush
0.5-1.0cm reduction in final adult height

27
Q

What are the differential diagnoses for asthma that has onset <5 years of age?

A 
Congenital
Cystic fibrosis
Primary ciliary dyskinesia
Bronchitis
Foreign body
28
Q

What are the differential diagnoses for asthma that has onset >5 years of age?

A

Dysfunctional breathing
Vocal cord dysfunction
Habitual cough
Pertussis

29
Q

What are the goals of treatment of asthma?

A 
Minimal symptoms during day and night 
Minimal need for reliever medication 
No attacks (exacerbations) 
No limitation of physical activity 
Normal lung function (in practical terms fev1 and/or pef >80% predicted or best)
30
Q

How can control of asthma be monitored?

A

Control can be measured using the acronym SANE:
•Short acting beta agonist/week (>2 per week = poor control)
•Absence school/nursery
•Nocturnal symptoms/week (Weekly = poor control)
•Exertional symptoms/week

31
Q

What drug classes are used for standard regimes in asthma?

A

Inhaled corticosteroids

Short acting beta agonists

32
Q

What add on medications can be used in asthma?

A

Long acting beta agonists
Leukotriene receptor antagonists
Theophyllines

33
Q

When should a regular preventer for asthma be given?

A

Using beta agonists >2 days a week
Symptomatic >2 times a week
Waking with symptoms once weekly
Exacerbation of asthma in previous two years

34
Q

How is a regular preventer given initially?

A

Initially, a very low dose inhaled corticosteroid should be given as a preventer, apart from in under 5s when it should be a leukotriene receptor antagonist.

35
Q

What are the adverse effects of inhaled corticosteroids?

A

Height suppression of 0.5-1.0cm
Oral candidiasis (can be avoided)
Adrenocortical suppression

36
Q

How are add on preventers given?

A

Usually in the form of a LABA, but LTRA or additional ICS can also be given

37
Q

What is severe asthma?

A

Severe asthma affects ~5% of asthmatics at some point but the majority have behavioural or compliance issues rather than genuine severe disease

38
Q

What is the best inhaler type for lung deposition?

A

Metered dose inhalers WITH a spacer has same lung deposition as a dry powder inhaler. Dry powder inhalers cannot be given to anyone <8

39
Q

What non-medical management can be advised in asthma?

A

Stop second hand smoke exposure

Remove environmental triggers (ie pets)

Paediatrics (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions