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4. Zero to Finals: Paeds > Paediatric Respiratory > Flashcards

Paediatric Respiratory Flashcards

1
Q

What are signs of respiratory distress in children?

A

Raised RR

Use of accessory muscles

Intercostal/subcostal recessions

Nasal flaring

Head bobbing

Tracheal tugging

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2
Q

What are causes of stridor?

A

Croup - stridor + barking cough

Acute epiglottitis - stridor, drooling, acutely unwell

Inhaled foreign body - choking

Laryngomalacia

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3
Q

What is the cause of bronchiolitis?

A

RSV (Respiratory syncytial virus)

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4
Q

How does bronchiolitis present?

A

Coryzal symptoms - runny nose, watery eyes, sneezing

Dry cough

Mild fever

Wheeze

Dyspnoea

Tachypnoea

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5
Q

When should a child with bronchiolitis be admitted?

A

Under 3 months

Pre-existing health condition

Clinical dehydration

RR > 70

Oxygen sats <92%

Apnoeas

Deep recessions

Head bobbing

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6
Q

How is bronchiolitis managed?

A

Supportive

Supplementary oxygen if required

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7
Q

Which children are at risk of severe bronchiolitis?

A

Bronchopulmonary dysplasia

Congenital heart disease

Cystic fibrosis

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8
Q

How to differentiate Asthma vs. Viral induced wheeze?

A

Viral induced wheeze..

Features of viral illness e.g. coryza, fever

Presents prior to 3 years

No atopy history

Only occurs during infections

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9
Q

How is viral induced wheeze managed?

A

1st line = Salbutamol

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10
Q

What is the stepwise management of Asthma in under 5’s?

A
  1. SABA (e.g. Salbutamol)
  2. Low dose ICS or Montelukast
  3. Add other option
  4. Refer to specialist
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11
Q

What is the most common bacterial and viral cause of pneumonia in children?

A

Strep pneumoniae

RSV

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12
Q

How does pneumonia present?

A

Productive cough

Fever

Tachypnoea

Tachycardia

Hypotension

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13
Q

How is pneumonia managed in children?

A

1st line = Amoxicillin

2nd line = Macrolide (Clarithromycin, Erythromycin, Azithromycin)

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14
Q

What is croup? What is the most common causative organism?

A

Upper respiratory tract infection which causes laryngeal oedema, leading to stridor

Most common = Parainfluenza virus

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15
Q

How does croup present?

A

Stridor

Barking cough

Low grade fever

Coryza

Increased work of breathing

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16
Q

When should a child with croup be admitted?

A

Stridor at rest

Recessions

Any significant distress

Tachycardia

17
Q

How is croup treated?

A

Single dose oral Dexamethasone

Oxygen if required

18
Q

What organism causes epiglottitis?

A

Haemophilus influenza type B

19
Q

How does epiglottitis present?

A

Acute onset

Sore throat

Stridor

Tripod position

High fever

Drooling of saliva

20
Q

What is seen on neck XR in epiglottitis?

A

Thumb sign

21
Q

How is epiglottitis managed?

A

IV Ceftriaxone

Oxygen

22
Q

What is Laryngomalacia?

A

Soft larynx

Larynx causes partial airway obstruction

Causes chronic stridor on inhalation

23
Q

How is Laryngomalacia managed?

A

Problem usually resolves as the larynx matures and grows

24
Q

What is whooping cough?

A

URTI caused by Bordatella pertussis

25
Q

How does whooping cough present?

A

Sats with coryza symptoms

Then - Severe coughing fits, worse at night

Inspiratory whoop at end of coughing fit

May be vomiting

May be apnoea attacks

26
Q

How is whooping cough treated?

A

Supportive care

In first 21 days - can use oral macrolide

27
Q

What do infants with bronchopulmonary dysplasia receive to reduce infections?

A

Monthly injection of Palivizumab

28
Q

What type of inheritance pattern does cystic fibrosis have?

A

Autosomal recessive

29
Q

What are the first signs of CF?

A

Meconium ileus

Prolonged jaundice

30
Q

What are features of CF?

A

Chronic cough

Thick sputum

Recurrent infections

Greasy stools

Finger clubbing

Pancreatic enzyme deficiency

31
Q

What are common colonisers in CF?

A

Staph aureus

Pseudomonas

32
Q

What is the gold standard diagnostic investigation for CF? What does it show?

A

Sweat test showing increased chloride levels

33
Q

How is CF managed?

A

Chest physio

High calorie idet

Pancreatic enzyme supplementation

Prophylactic flucloxacilin

34
Q

What are complications of CF?

A

Diabetes

Delayed puberty

Male infertility

Nasal polyps

35
Q

Why are males with CF often infertile?

A

Absence of the vas deferens

36
Q

What is primary ciliary dyskinesia?

A

Autosomal recessive condition

TRIA

Paranasal sinusitis

Bronchiectasis

Situs invertus

4. Zero to Finals: Paeds (15 decks)

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