Paeds Resp

Question 1

Indication for, and dose of, steroids in croup:

Answer 1

ALL.

MILD/MOD:
Dexamethasone 0.15mg/kg single dose
Prednisolone 1mg/kg daily for 2 days

SEVERE:
Dexamethasone 0.6mg/kg PO/IM/IV (max 12mg)

Question 2

Indication for adrenaline in croup:

Answer 2

PERSISTENT stridor at rest (=severe croup)

Question 3

Discharge criteria for croup:

Answer 3

Mild or moderate
Stridor free at rest
30mins post steroid
4 hours post adrenaline (and no repeat doses)
Social env

Question 4

Age that gets croup:

Answer 4

6mo to 6 years

Uncommon below 6mo, very uncommon below 3mo.

If <6mo, seriously consider alternative Dx
- Foreign body, bact. tracheitis, epiglottis, quinsy, retrophary abscess.

Question 5

Cystic fibrosis:

Answer 5

Defect of Na/Cl exchange channel
Thick secretions in:
-Lung
-Pancreas
-Liver
-Intestines
-Reproductive

Sweat test Dx (chloride level)

ED PRESENTATIONS:
- Pneumonia- Pseudomonas, gram negs, aspergillosis
—> *often resistant
—> Neb saline for secretions

• Pneumothorax
• Pancreatitis (and insufficiency- Creon)
• Malabsorption
• Electrolyte disturbance
  —> hypoK, hypoCl, metabolic alkalosis