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Paeds - C.U > Cardio and Resp > Flashcards

Cardio and Resp Flashcards

(60 cards)

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1
Q

how many live births have CHD

A

1%

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2
Q

two genetic conditions associated with heart defects

A

Trisomy 21 and Turners syndrome

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3
Q

Acyanotic HD with shunts

A

ASD
VSD
PDA

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4
Q

Acyanotic HD without shunts

A

Coarction of the aorta

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5
Q

Cyanotic HD with shunts

A

Tetralogy of fallot

Transposition of great arteries

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6
Q

Cyanotic HD without shunts

A

Severe pulmonary stenosi
Tricuspid / pulmonary atresia
Hypoplastic left heart

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7
Q

Symptoms of congenital HD

A 
Problems breast feeding 
Failure to thrive 
Shortness of breath 
Syncope 
Squatting in older children 
Symptoms of cardiac failure - cyanosis, oedema, sweating, poor feeding
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8
Q

Signs of congenital HD

A 
Murmur
Tachycardia 
Tachypnoea 
Cyanosis - especially during feeding 
Clubbing
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9
Q

Complications in cogentila HD

A

Infective endocarditis
Paradoxical embolism
Polycythaemia
Pulmonary hypertension

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10
Q

Sign of ASD on examination

A

Parasternal heave in right ventricle

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11
Q

Signs of VSD on examination

A

Pan-systolic heart murmur - heard best at left sternal edge

Can be a parasternal heave

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12
Q

Signs of PDA on examination

A

Continuous machinery murmur below the left clavicle
Thrill
Bounding pulse

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13
Q

What can be used to close a PDA

A

Prostaglandin inhibitor - indometacin

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14
Q

Symptoms of coactation of the aorta

A

Headache / nose bleeds / intermittent claudication and cold legs

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15
Q

Signs of coarctation of the aorta

A

hypertension in the UL
Weak distal leg pulses
Maybe a systolic murmur over the upper back

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16
Q

Signs of heart failure in older children

A 
difficulties in weight gain 
tired 
SOB 
Chest pain and palpitations 
recurrent chest infections
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17
Q

Signs of heart failure in younger children

A

takes longer to complete feeds but seems hungry
may look puffy and sweaty
increasing resp difficulties
sudden weight gain - fluid retention

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18
Q

Investigations for heart failure in children

A

Clinical diagnosis

confirmed by US, echo, ECG and Echo

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19
Q

Acute management of HF in children

A

ABC
Stable - give diuretic
ACE inhibitor
Increase calorific intake

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20
Q

Most common cause of bronchiolitis

A

RSV infection

other- adenovirus and rhinovirus

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21
Q

Signs of respiratory distress

A 
Tachypnoea 
Head bobbing 
Tracheal tug 
Subcostal / intercostal recession 
abdominal movements to aid ventilation
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22
Q

Ddx in respiratory distress in a child

A 
Bronchiolitis 
Pneumona 
GI reflux with aspiration 
HF 
Pneumothorax 
Collapsed lung
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23
Q

Management of bronchiolitis

A

minimal handling
o2 and ventilation
hydration support
inhaled therapies

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24
Q

Mild croup

A

Mild – seal-like barking cough but no stridor or sternal/intercostal recession at rest.

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25
Moderate croup
Moderate – seal-like barking cough with stridor and sternal recession at rest; no agitation or lethargy.
26
Severe croup
Severe – seal-like barking cough with stridor and sternal/intercostal recession associated with agitation or lethargy.
27
When should a child with croup be admitted ?
Moderate, severe or impending respiratory failure
28
Mild croup but should still be admitted
<3m old inadequate fluid immunocompromised CHD significant
29
treatment of mild croup
supportive treatment
30
treatment of moderate croup
oral dex
31
treatment of severe croup
may require adrenaline, O2, involve ENT and anesthetics
32
incidence of CF
1,2000
33
Clinical features of CF
recurrent infections faltering growth nasal obstruction / polyps bowel obstruction
34
test used in new borns to detect CF
immune reactive trypsinogen
35
Gold standard test for CF
Sweat test
36
Long term monitoring required in CF
Serial CXR USS abdo Bone scans Monitor insulin function
37
Long term therapy in CF
Regular physiotherapy Monitor nutrition Prophylactic AB Nebulisers -help clear the lungs
38
Nutritional support in CF
Creon - pancreatic enzyme supplements | Micronutrient supplements
39
Complications of CF
``` Exocrine function of pancreas Diabetes Liver disease Infertility Early mortality ```
40
Ddx for asthma in <5 y/o
Viral induced wheeze
41
Causes of acute asthma
``` Viral URTI Change in enviro Allergen Exercise Strong emotional triggers ```
42
3rd line in asthma management <5 y/o >5 y/o
Leukotriene receptor agonist LABA
43
Mild croup treatment
Single dose of dex | Resolves within 48hrs
44
emergency croup treatment
oxygen and nebulised adrenaline
45
Peak incidence of bronchiolitis
3-6m
46
Most common cause of serious LRTI i < 1y
Bronchiolitis
47
What makes a bronchiolitis infection more severe
bronchopulmonary dysplasia (e.g. Premature), congenital heart disease or cystic fibrosis
48
Symptoms of bronchiolitis
coryzal symptoms (including mild fever) precede: dry cough increasing breathlessness wheezing, fine inspiratory crackles (not always present) feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission
49
Tetralogy of fallot is a combination of...
Ventricular septal defect (VSD) Pulmonary stenosis (PS) Right ventricular hypertrophy (RVH) Overriding aorta
50
Risk factors for cardiac congenital abnormalities
``` Maternal diabetes Rubella infection Foetal alcohol syndrome Downs syndrome VACTERL ```
51
Main cause of resp problems in neonates
Resp distress syndrome
52
Main cause of resp problems in infants
Bronchiolitis Pneumonia Croup
53
Main cause of resp problems in under 5
viral induced wheeze croup pneumonia
54
Main cause of resp problems in >5
asthma | pneumonia
55
Sings of resp distress
``` head bobbing nasal flaring tracheal tug IC recession Abdo recession ```
56
Length of typical bronchiolitis infection
9 days
57
bronchiolitis vs pneumonia
pneumonia - focal signs on resp exam and higher grade fever
58
Astham exacerbation in children - those with mild / moderate asthma
For children with mild to moderate acute asthma: Bronchodilator therapy give a beta-2 agonist via a spacer (for a child < 3 years use a close-fitting mask) give 1 puff every 30-60 seconds up to a maximum of 10 puffs if symptoms are not controlled repeat beta-2 agonist and refer to hospital Steroid therapy should be given to all children with an asthma exacerbation treatment should be given for 3-5 days 2 - 5 years 20 mg od 1-2 mg/kg od (max 40mg) > 5 years 30 - 40 mg od 1-2 mg/kg od (max 40mg)
59
Complication of kawasaki disease
coronary artery aneurysms - therefore should echo
60
Treatment of whooping cough
Azithromycin or clarithromycin within the 1st 21 days

Paeds - C.U (10 decks)

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