4th Year Respiratory

Question 1

examination signs

Answer 1

tracheal tug
subcostal recession
supraclavicular indrawing
nasal flaring
accessory muscle use
grunting

Question 2

what causes grunting in children?

Answer 2

infants close epiglottis to increase EEP to keep alveoli open

Question 3

what is peak flow related to in children

Answer 3

height

Question 4

types of inhalers

Answer 4

1. pressurised metered dose inhaler (pMDIs)
2. breath actuated inhalers (BAIs)
3. drug powdered inhalers (DPIs)

Question 5

examples of pMDIs

Answer 5

salbutamol
clenil modulate (beclomethasone)
seretide evohaler (salmeterol and fluticasone propionate)

Question 6

can you use pMDIs with a spacer?

Answer 6

yes

Question 7

how to use pMDIs with a spacer?

Answer 7

10 long and slow breaths in young children, 5 in older children

Question 8

how to use pMDIs without a spacer?

Answer 8

press canister once and breath in until lungs feel full and hold breath for 10 seconds

Question 9

how many puffs of a pMDIs be taken?

Answer 9

10, one a minute

Question 10

examples of breath actuated inhalers?

Answer 10

flutiform

salbutamol easi-breathe

Question 11

how do BAI work?

Answer 11

trigger by patient breath

Question 12

can BAI be used with a spacer?

Answer 12

no

Question 13

examples of drug powdered inhalers (DPIs)

Answer 13

turbohaler (8 and up) e.g. symbicort - budesonide and formoterol
accuhlaer (12 and up)
ellipta

Question 14

should you rinse your mouth after use of preventer?

Answer 14

yes

Question 15

can you suddenly stop taking preventer

Answer 15

no as contains steroids

Question 16

management of croup

Answer 16

• Severe= nebulised adrenaline + dex + oxygen
• Moderate= dex + adrenaline
• Mild= dex

Question 17

what is tachyitis

Answer 17

bacterial infection of the trachea

Question 18

what is larynogmalacia

Answer 18

floppy larynx in babies

Question 19

are <1 year olds more likely to have bronchiolitis or viral-induced wheeze?

Answer 19

bronchiolitis

Question 20

management of bronchiolitis

Answer 20

supportive feeding and oxygen
palivizumab (IgG)

repeated beta-agonist therapy will not help

Question 21

most likely cause of sepsis/ pneumonia in neonates?

Answer 21

GBS

Question 22

screening of CF

Answer 22

trypsinogen

Question 23

SIGN asthma pathway

Answer 23

SABA
ICS or LTRA <5
>5 add LABA or LTRA

Question 24

define status asthmaticus

Answer 24

respiratory failure due to asthmatic attack