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Flashcards in Acute paeds case Deck (5)
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1

An 18mo child presents with a 3 day history of coughing and sneezing. 

Their mum said that she has not been feeding as often and is finding it harder to breath

Her 4yo sister has a cold.

On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations. 

 

What are the differentials

Viral induced wheeze

Pneumonia

Bronchiolitis

URTI 

2

An 18mo child presents with a 3 day history of coughing and sneezing. 

Their mum said that she has not been feeding as often and is finding it harder to breath

Her 4yo sister has a cold.

On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations. 

 

What is the diagnosis and why

Viral induced wheeze

 

She is too young for asthma

There are no crepitations so it's not bornchioloitis

Not an URTI as there is a wheeze 

 

3

An 18mo child presents with a 3 day history of coughing and sneezing. 

Their mum said that she has not been feeding as often and is finding it harder to breath

Her 4yo sister has a cold.

On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations. 

She is diagnosed with Viral induced wheeze (VIW)

 

What is the basic pathophysiology of a viral induced wheeze

Virus causes the bronchi to contract, so you get a lovely wheeze

4

An 18mo child presents with a 3 day history of coughing and sneezing. 

Their mum said that she has not been feeding as often and is finding it harder to breath

Her 4yo sister has a cold.

On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations. 

She is diagnosed with Viral induced wheeze (VIW)

 

How should she be managed

Get a senior's review

Start her on MDI salbutamol

Observe

5

An 18mo child presents with a 3 day history of coughing and sneezing. 

Their mum said that she has not been feeding as often and is finding it harder to breath

Her 4yo sister has a cold.

On exam, her O2 sats, HR and BP are all normal, but there is a bilateral wheeze but no crepitations. 

She is diagnosed with Viral induced wheeze (VIW)

She presents a few days later with tachycardia, tachypnoea and low O2 sats. 

 

How should she now be urgently managed

Oxygen

Nebulised salbutamol & oral steroids

IV fluids

Capillary/venous gas