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Paeds 2.0 > Other infections + Asthma > Flashcards

Other infections + Asthma Flashcards

1
Q

what do you see normally on inspection of the eardrum?

A

light reflex

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2
Q

what do you see in otitis media on inspection of the eardrum?

A
  • absent light reflex
  • bulging eardrum
  • erythema
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3
Q

pathophysiology of OM?

A
  • primary viral infection
  • secondary bacterial infection with pneumococcus / H influenza
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4
Q

treatment of OM?

A

self-limiting

but treat if:

  • severe uni/bilateral pain if > 6 months for >48 hours
  • non-severe bilateral pain in 6-23months
  • non-severe bilateral pain in older children
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5
Q

complications of OM?

A

spontaneous rupture of eardrum

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6
Q

investiagation for tonsillitis?

A

throat swab

to determine if viral or bacterial

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7
Q

treatment of tonsillitis?

A
  • nothing (if viral)

or

  • penicillin for 10 days
    • DO NOT GIVE AMOX
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8
Q

what is croup?

A

laryngotracheobronchitis

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9
Q

peak age of croup?

A

common < 4

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10
Q

symptoms of croup?

A
  • stridor
  • coryza
  • barking cough
  • hoarse voice
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11
Q

main causative agent of croup?

A

parainfluenza virus

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12
Q

treatment of croup?

A

Oral dexamethsone or nebulised budenoside

nebulised adrenaline in severe cases

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13
Q

causative agent, symptoms and rx of epiglottitis?

A

agent - H Infleunza B

symptoms- high fever, stridor and drooling

Rx- IV antibiotics + intubation

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14
Q

what must you not do in a child w epiglottitis?

A

examine w a tongue depressor- may cause obstruction

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15
Q

tracheitis:

causative organisms

symptoms

treatment

A

staph or strep

symptoms: fever, rapidly progressive airway obstruction

Rx: Augmentin

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16
Q

pathophysiology of bacterial bronchitis?

treatment?

A

primary viral infection, which causes disturbance of mucociliary escalator & hence clearance

–> secondary bacterial infection

self-limiting

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17
Q

when is it pneumonia?

A
  • focal signs
  • crepitations
  • high fever
  • tachypnoea
  • SOB
  • off feed
  • cough
18
Q

treatment for pneumonia?

A

1st- Amoxicillin

2nd-Macrolide

macrolide 1st line in mycoplasma pneumonia

19
Q

aetiology of pertussis?

A

bronchitis caused by bordetella pertussis

20
Q

presentation of pertussis?

A

coryzal symptoms followed by episodic coughing fits that are very severe

loud inspiratory whoop when coughing ends

vomiting / fainting

21
Q

Mx of pertussis?

A
  • vaccine
  • Abx - erythromycin
22
Q

prognosis of pertussis?

A

resolves within 8 weeks –> several months

23
Q

complications of pertussis?

A
  • pneumonia
  • bronchiectasis
24
Q

outline key symptoms/features of asthma

A
  • wheeze
  • cough
    • dry
    • nocturnal
    • exertional
  • SOB
  • reversible
  • variable
25
Q

what is the characteristic feature of asthma?

A

repsonds to asthma treatment (reversible)

26
Q

outline some triggers of asthma?

A
  • exercise
  • cold weather
  • infections
27
Q

aetiology of asthma?

A

genetic + environmental

inherently abnormal lungs

early onset atopy

28
Q

DDx of asthma?

A
  • viral induced wheeze
    • variant of asthma
  • CF
  • foreign body
  • infection
29
Q

when is it most likely NOT Asthma?

A

if < 18 months–> most likely to be infection

30
Q

aims of asthma treatment?

A
  • minimise symptoms
  • no exacerbations
  • lung function to normal
    • FEV1 & PEFR >80%
31
Q

how do you measure control of asthma?

A
  • Short acting beta agonist use per week
  • Avoidance of school/nursery
  • Nocturnal symptoms per week
  • Exertional symptoms per week
32
Q

steps in asthma mx <5 years ?

A
  1. SABA
  2. inhaled corticosteroid or LRA
  3. add other option from 2
33
Q

steps in asthma management 5-12years?

A
  1. SABA
  2. inhaled corticosteroid
  3. LABA
  4. titrate up inhaled corticosteroid dose to medium
    • consider adding LRA/theophylline
  5. titrate up corticosteroid to high dose
34
Q

side effects of ICS?

A
  • height suppression (only up to 1cm when used for longer than 12 months)
  • oral candidiasis
  • adrenocortical suppression
35
Q

when is LABA given?

A

ONLY if concomitant use of ICS- cannot be taken without ICS

36
Q

compare Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI) effectiveness

A

MDI:

  • reaches 5% deposition on its own
  • reacher 20% deposition with spacer

DPI:

reaches 20% deposition on its own

37
Q

how to determine severity of an acute exacerbation of asthma?

A
38
Q

Mx of mild acute exacerbation of asthma

A

as an outpatient w regular salbutamol inhalers

39
Q

Mx of moderate /severe acute exacerbation of asthma

A
  • oxygen - if <94% sats
  • bronchodilators
    • salbutamol
    • ipratropium
    • mag sulphate
  • steroids
    • prednisolone
    • hydrocortisone
  • IV Abx if infection
40
Q

stepwise approach for moderate/severe exacerbations of asthma

A
  1. Salbutamol inhalers via a spacer device
  2. Nebulisers with salbutamol / ipratropium bromide
  3. Oral prednisone
  4. IV hydrocortisone
  5. IV magnesium sulphate
  6. IV salbutamol
  7. IV aminophylline

Paeds 2.0 (51 decks)

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