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Paediatrics > Paediatric respiratory > Flashcards

Paediatric respiratory Flashcards

1
Q

Define rhinitis

A
  • Irritation of the lining of the nose
  • Very common
  • Winter months
  • Self-limiting
  • Can be prodrome to pneumonia, bronchiolitis, meningitis and septicaemia
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2
Q

Define otitis media

A
  • Common self-limiting infection of the middl ear
  • Caused by primary URTI
  • Spontaneous rupture of ear drugs
  • Bulging red ear drugs
  • Don’t need antibiotics
  • May require analgesia
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3
Q

Define tonsillitis/ pharyngitis

A
  • Can be viral or bacterial
  • Do throat swab
  • Nothing or 10 days penicillin
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4
Q

Define croup

A
  • Commonly parainfluenza 1
  • Lasts 1-3 days
  • Laryngotracheobronchitis
  • Presents with stridor, hoarse voice and barking cough
  • Treat with oral dexamethasone
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5
Q

Define epiglottitis

A
  • Influenzae type B
  • Rare
  • Toxic
  • Causes stridor and drooling
  • May require intubation and antibiotics
  • AIR RAIDS
    • Airways closed
    • Increased pulse
    • Restlessness
    • Retraction
    • Anxious
    • Inspiratory stridor
    • Drooling
      *
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6
Q

Define tracheitis

A
  • Swollen tracheal wall, narrowed lumen, luminal debris
  • Croup that doesn’t get better
  • Fever, sick cold
  • Staph or strep infection
  • Treat with augment → combo of amoxicillin and clavulanate
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7
Q

Define bronchitis

A
  • Endobrochial infection
  • Loose rattly cough with URTI
  • Post-tussive vomit
  • Chest free of wheeze and crepe
  • Haemophilus/ pneumococcus
  • Self-limiting
  • Reassure and don’t not treat
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8
Q

Cause of bacterial bronchitis

A
  • Disturbed mucociliary clearance → minor airway malaria and RSV/ adenovirus
  • Lack of social inhibitor
  • Infections secondary
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9
Q

Respiratory tract infection red flags

A
  • Age less than 6 months or more than 4 year s
  • Static weight
  • Disruption to child’s life
  • Associated SOB
  • Acute nature
  • Other comorbidities
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10
Q

Define bronchiolitis

A
  • LRTI of infants
  • Usually RSV
  • Nasal stuffiness, tachypnoea, poor feeding
  • Crackles and wheeze
  • Less than 12 months
  • One off
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11
Q

Management of bronchiolitis

A
  • Maximal observation and minimal intervention
  • NG aspiration
  • Do not need CXR, blood and culture
  • Medication also not required
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12
Q

Criteria for bronchiolitis

A
  • Fever for 48 hours and above 38.5
  • SOB, cough, grunting
  • Wheeze
  • Reduced or bronchial breath sounds
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13
Q

Define pneumonia

A
  • Inflammation of the lungs/ interstitium causing infiltrate and consolidation
  • Typically → fever, cough, dyspnoea, chest pain
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14
Q

Red flags of pneumonia

A
  • Focal signs
  • Crepitus
  • High fever
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15
Q

Management of pneumonia

A
  • Nothing if mild
  • Oral amoxicillin if bacterial Oral macrolide second choice
  • IV if vomitting
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16
Q

Empyema

A
  • Pus in lungs
  • Complication of pneumonia
  • Infection in pleural space
  • Chest pain and realllllly unwell
  • Antibiotics with drainage
17
Q

Define pertussis

A
  • Whooping cough
  • Highly contagious
  • Caused by bordetella pertussis
  • Controllable, violent coughing, difficulty breathing
  • Causes vomitting
  • Reduced by vaccination
18
Q

Treat or not to treat

A
  • Bronchiolitis → don’t
  • Bronchitis → don’t
  • Empymea → yes, IV antibiotics
  • Croup → don;t
  • Acute LRTI → not always, sometimes amoxicillin
  • Otitis media - don’t
  • Pharyngitis/ tonsillitis → not always, sometimes penicillin
19
Q

Definition of Asthma

A
  • Syndrome of increased tracheobronchial responsiveness to stimuli
  • Triad: paroxysmal dyspnoea, wheeze and cough
  • Mild to severe
  • Causes obstruction
20
Q

Clinical features of asthma

A
  • Panting
  • Chronic
  • Wheeze, cough, SOB
  • Multiple triggers → exercise, pollen, URTI, cold weather
  • Variable/ reversible
  • Responds to medication
  • History of eczema, hay fever, atopy
21
Q

Differences from adult asthma

A
  • More commonly in boys
  • More severe
22
Q

Triggers of asthma

A
  • URTI
  • Exercise
  • Allergen
  • Cold air
  • Emotions
  • Menstruation
23
Q

Criteria for asthma

A
  • Wheeze
  • SOB at rest
  • Familial asthma
  • Responds to treatment
24
Q

Differentials for asthma

A
  • Viral induced wheeze
  • Foreign boy
  • Cystic fibrosis
  • Immune deficiency
  • Ciliary dyskinesia
  • Aspiration → GORD
  • Tracheobronchomalacia
25
Q

Difference between asthma and viral induced wheeze

A
  • Not really separate → different shades of same colour
  • VIW
    • Presents before age of 3
    • No history of atopy
    • Viral infection
  • Mx same as asthma
26
Q

Goals in asthma management

A
  • Minimise symtoms
  • Minimal need for reliever medications
  • No attacks
  • No limitation to physical activity
  • FEV1:FVC >80%
27
Q

How to measure control of asthma

A
  • SANE
    • Short acting beta agonist/ week
    • Absence from school/ nursery
    • Nocturnal symptoms/ weeks
    • Exerction symptoms/ week
28
Q

Management pathway for asthma

A
  • Short-acting beta agonist
  • Low does ICS
  • Long-acting beta agonist
  • Leuktotriene receptor antagonists
  • Theophyllines
  • Oral steroids
29
Q

Classes of medications in asthma

A
  • SABA
30
Q

Adverse effects of ICS

A
  • Height suppression
  • Oral candidiasis
  • Adrenocortical suppression
31
Q

Other management of asthma

A
  • Stop smoke exposure
  • Remove environmental triggers → cats, dogs, mite
32
Q

Management acute asthma exacerbation

A
  • Mild disease
    • SABA via spacer
    • Saba via spacer and prednisolone
  • Moderate disease
    • SABA via nebuliser + prednisolone
    • SABA + ipratropium + prednisolone
  • Severe
    • IV salbutamol
    • IV aminophylinne
    • IV magnesium nebuliser
    • IV hydrocortisone
    • Intubate and ventile
33
Q

What to look out for in acute asthma attack

A
  • Increased respiratory rate
  • Work of breathing
  • Increased heart rate
  • Reduce oxygen saturations
  • Ability to complete sentences
  • Air entry

Paediatrics (10 decks)

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