MSRA: Respiratory Conditions

Question 1

What are the CXR findings in meconium aspiration syndrome?

Answer 1

Patchy infiltrates
Coarse streaking of both lungs

Question 2

Give two risk factors for respiratory distress syndrome (RDS)

Answer 2

Pre-term infants
Diabetic mothers (high BM impars surfactant production)

Question 3

Give one risk factor for transient tachypnoea of the newborn (TTN)

Answer 3

Delivery by Caesarean section

Question 4

What are the CXR findings in transient tachypnoea of the newborn (TTN)??

Answer 4

Hyperinflation and fluid in the horizontal fissure

Question 5

What is the cause of bronchiolitis?

Answer 5

Respiratory syncytial virus (RSV)

Question 6

At what age does the peak incidence of bronchiolitis occur?

Answer 6

3-6 months

Question 7

What is the presentation of bronchiolitis?

Answer 7

Corzyal symptoms with low grade fever
Followed by increased SOB and WIB, cough, feeding difficulties

Question 8

What is the cause of croup?

Answer 8

Parainfluenza virus

Question 9

At what age does the peak incidence of croup occur?

Answer 9

6 months to 6 years

Question 10

What is the presentation of croup?

Answer 10

Symptoms are worse at night
Inspiratory stridor, barking cough, fever, coryzal symptoms

Question 11

What is the management of croup?

Answer 11

Oral Dexamethasone (0.15mg/kg) to all children regardless of severity (NICE CKS)
Consider oxygen and nebulised adrenaline

Admit if <6 months, known airway structural abnormality or moderate/severe e.g. stridor at rest

Question 12

What is the cause of acute epiglottitis?

Answer 12

Haemophilus influenza type B (HIB)

Question 13

What is the presentation of acute epiglottitis?

Answer 13

Very acute onset over hours
High fever
Painful throat
Drooling of saliva
Stridor
No cough or coryza

Question 14

What is the cause of whooping cough?

Answer 14

Bordetella pertussis

Question 15

What are the features of whooping cough?

Answer 15

Coryza followed by coughing bouts, worse at night, may end with vomiting
Inspiratory whoop

Question 16

When can pregnant women receive the whooping cough vaccine?

Answer 16

16 to 32 weeks

Question 17

True or False:
Steroid therapy should be given to all children with an asthma exacerbation?

Answer 17

True

Question 18

What is the management of asthmatic less than 5 years with no improvement with LTRA?

Answer 18

Stop LTRA and refer to a specialist

Question 19

What is the management of asthmatic older than 5 years with no improvement with LTRA?

Answer 19

Stop LTRA and start LABA

Question 20

What is the management of whopping cough?

Answer 20

Macrolides (e.g. Azithromycin) if onset of symptoms in the preceeding 21 days

Question 21

What are the key differences between mild and moderate croup?

Answer 21

Mild = no stridor at rest, no or mild recession
Moderate = stridor at rest, recessions at rest