resp

Question 1

what is pulm hypoplasia

Answer 1

newborn with underdeveloped lungs

Question 2

causes pulm hypoplasia

Answer 2

oligohydramnios // congenital diaphragmatic hernia

Question 3

commonest cause resp distress in newborn period

Answer 3

Transient tachypnoea of the newborn (delayed reabsorption fluid in lungs)

Question 4

RF Transient tachypnoea of the newborn

Answer 4

C sections (air not squeezed out the lungs in birth canal)

Question 5

invx Transient tachypnoea of the newborn

Answer 5

CXR - hyperinflation + fluid in horizontal fissure

Question 6

mx Transient tachypnoea of the newborn

Answer 6

observation, supplementary O2, resolves 1-2 days

Question 7

what is Surfactant deficient lung disease

Answer 7

premature lungs and insufficient surfactant

Question 8

RF Surfactant deficient lung disease

Answer 8

male, diabetic mother, C section, 2nd twin

Question 9

CXR Surfactant deficient lung disease

Answer 9

glass ground + indistinct heart border

Question 10

symptoms Surfactant deficient lung disease

Answer 10

resp distress eg fast RR, intercostal recession, grunting, scyanosis

Question 11

mx Surfactant deficient lung disease

Answer 11

maternal steroids // oxygen // assisted ventilation

Question 12

what causes bronchiolitis

Answer 12

RSV (or myocplasma, adenovirus)

Question 13

age bronchiolitis

Answer 13

<1 year (common in winter)

Question 14

conditions bronchiolitis is dangerous in

Answer 14

premature, congenital heart disease, CF

Question 15

symptoms bronchiolitis

Answer 15

corzyal, mild fever, dry cough, SOB, wheeze + insp crackles, feeding difficulties

Question 16

immediate referral bronchiolitis

Answer 16

apnoea, looks unwell, resp distress (grunting, recession, RR >70), central cyanosis, sats <92

Question 17

invx bronchiolitis

Answer 17

nasopharnygeal immunofluorescence

Question 18

mx bronchiolitis

Answer 18

supportive, O2, NG tube

Question 19

organism pertussis (whooping cough)

Answer 19

bordetella pertussis (gram -ive)

Question 20

vaccine pertussis

Answer 20

2-4 months and 3-5 years // (pregnant women 16-32 weeks)

Question 21

symptoms pertussis

Answer 21

1-2 weeks URTI symtpoms // cough increases, worse at night and feeding, inspiratory whoop, apnoea, conjunctival haemorrhage, syncope (lasts 2-8 weeks) // eases over weeks to months

Question 22

diagnostic criteria whooping cough

Answer 22

acute cough 14 days + one of // paroxysmal cough // insp whoop // post coughing vomit // apnoea infants

Question 23

invx pertussis

Answer 23

nasal swab culture // PCR + serology

Question 24

mx pertussis

Answer 24

oral macrolide eg clarithro, azithromycin, erythromycin - if within 21 days symptoms

Question 25

public health mx pertussis

Answer 25

NOTIFIABLE disease // prophylactic abx for household // school exclusion until 48 hours starting abx

Question 26

complications pertussis

Answer 26

subconjunctival haemorrhage, pneymonia, bronchiectasis, seizure

Question 27

most common organism pneumonia children

Answer 27

s. pneumonia

Question 28

mx CAP kids

Answer 28

1 = amoxicillin // 2 = macrolides eg erythromycin, clarithryomycin

Question 29

mx chlamydia or mycoplasma pneumonia kids

Answer 29

macrolides

Question 30

mx pneumonia assoc with influenza kids

Answer 30

co-amox

Question 31

categories pre-school wheeze in kids

Answer 31

episodic viral wheeze eg URTI // multiple trigger wheeze eg URTI + smoke or allergens or exercise (risk of asthma)

Question 32

mx episodic viral pre-school wheeze

Answer 32

1 = SABA or SAMA via spacer // 2 = leukotriene (montelukast) +/- inhaled ICS

Question 33

mx multiple trigger pre-school wheeze

Answer 33

inhaled ICS or monteleukast 4-8 weeks

Question 34

asthma diagnosis kids 5-16

Answer 34

1 = sprirometry + bronchodilater revesribility // 2 = FeNO

Question 35

asthma diagnosis kids <5

Answer 35

clinical

Question 36

moderate asthma attack kids

Answer 36

O2 >92% // PEF >50%

Question 37

severe asthma attack criteria child

Answer 37

O2<92% // PEF 33-50% // SOB to feed or talk // >5 = HR 125, RR 30 // <5 = HR 140, RR 40 // accessory neck

Question 38

life-threatening asthma attack criteria child

Answer 38

O2 <92% // PEF <33% // silent chest, poor resp effort // agitated, altered LOC // cyanosis

Question 39

mx mild to moderate asthma attack kids

Answer 39

SABA via spacer, 1 puff every minute for 10 puffs --> hospital // all kids have steroids 3-5 days

Question 40

asthma mx kids 5-16

Answer 40

1 = SABA // 2 = SABA + ICS // 3= SABA + ICS + LTRA // 4 = SABA + ICS + LABA // 5 = SABA + maintenance and reliever therapy with ICS // 6 = SABA + MART moderate ICS // 7 = SABA + MART + high ICS OR theophylinne

Question 41

asthma mx kids <5

Answer 41

1 = SABA // 2 = SABA + moderate ICS (8 weeks) // 3 = SABA + low ICS + LTRA // 4 = stop LTRA + refer

Question 42

causes snoring kids

Answer 42

obese, nasal problem, tonsilitis, downs, hypothyroid