Wheeze and stridor

Question 1

list 6 things that may cause a stridor?

Answer 1

• croup- (laryngotracheobronchitis)
• inhaled foreign body
• tracheitis
• abscesses
• anaphylaxis
• epiglottitis

Question 2

name two symptoms that define cystic fibrosis?

what gene is mutated to cause it?

Answer 2

• thick mucus secretions
• high salt content of sweat
• CFTR gene (F508)

Question 3

what investigations would you perform for CF?

Answer 3

• Guthrie Test

- sweat test (pilocarpine iontophoresis tests amount of chlorine in sweat)

Question 4

what kind of clinical features do you get with CF? (9)

Answer 4

• meconium ileus
• chronic cough
• diarrhoea
• pancreatitis
• rectal prolapse
• diabetes
• osteoporosis
• congenital absence of vas deferens
• resp signs

Question 5

What is the management of CF?

split into respiratory and nutritional

Answer 5

• chest physio
• sputum samples + prophylactic abx
• saline nebulisers
• bronchodilators LABA + SABA
• pancreatic enzyme (creon), high fat and protein diet

Question 6

how often should they be seen for review and what should they be reviewed for? (CF)

Answer 6

• CXR
• DEXA scan
• BM
• liver US,
• sputum
• vitD

Question 7

what are the complications of CF?

Answer 7

• respiratory failure
• emotional problems
• DM
• portal hypertension
• hepatic cirrhosis
• cor pulmonale
• infertility

Question 8

below what age should you be cautious about diagnosing asthma?

what does a unilateral wheeze suggest?

Answer 8

• age 2

- foreign body inhalation

Question 9

apart from foreign body inhalation and asthma what else can cause wheeze? (3)

Answer 9

• bronchiolitis
• viral induced wheeze (wheezy bronchitis)
• cardiac failure

Question 10

name conditions that cause stridor and what age they are associated with? (4)

Answer 10

• croup (6-24 months)
• epiglottitis (2-7 years)
• foreign body (9-18 months)
• subglottic stenosis (0-6 months)