Paediatric Respiratory - Liam

Question 1

Acute asthma:

• severity

Answer 1

• Moderate
  
  • Peak flow >50%
  • Normal speech
• Severe
  
  • Peak flow 33-50%
  • Saturations <92%
• Life threatening
  
  • Peak flow < 33%
  • Silent chest
  • Cyanosis
  • Altered consciousness

Question 2

Acute asthma:

• management

Answer 2

• Oxygen
• Bronchodilators
• Steroids (predinisone)
• ANtibiotics if bacterial cause suspected

Question 3

Bronchodilators stepped approach for acute asthma

Answer 3

1. Inhaled salbutamol
2. Inhaled ipratropium bromide
3. IV magnesium sulphate
4. IV aminophylline

Question 4

Chronic asthma <5 years:

• medical management

Answer 4

1. SABA (salbutamol)
2. Add low dose corticosteroid or leukotrine antagonist
3. Add another option from step 2
4. Refer

Question 5

Chronic asthma 5-12 years:

• medical management

Answer 5

1. SABA (salbutamol)
2. Add low dose corticosteroid
3. Add LABA (salmeterol)
4. Increased corticosteroid to medium dose or trial leukotriene receptor antagnoist, oral theothylline or inhaled LAMA
5. Increased corticosteroid to high dose
6. Add oral steroid

Question 6

Bronchiolitis:

• age

Answer 6

<1 year

Question 7

Bronchiolitis:

• cause

Answer 7

RSV

Question 8

Bronchiolitis:

• management

Answer 8

Only supportive

Question 9

Pneumonia:

• cause

Answer 9

Streptococcus pneumonia (most common)

If atypical, mycoplasma pneumonia

RSV if viral

Question 10

Pneumonia:

• management

Answer 10

1. Amoxicillin (add macroside if atypical pneumonia)
2. Macrolide if penicillin allergy

Question 11

CF:

• presentation

Answer 11

• Newborn bloodspot test often diagnosed
• Meconium ileus (sticky first poo)

Question 12

CF:

• common coloniser

Answer 12

Staph aureus and pseudonomas

Question 13

CF:

• monitoring

Answer 13

• Every 6 months
  
  • Diabetes, osteoporosis, vit D, liver failure