Resp distress

Question 1

common causes of cough

Answer 1

• pneumonia
• asthma
• URTI
• Bronchioloitis
• whooping cough
• FB
• bronchiectasis

Question 2

common causes of wheeze

Answer 2

• bronchiolitis
• asthma
• HF
• FB

Question 3

common causes of acute stridor

Answer 3

• croup
• anapylaxis
• FB
• epiglottitis

Question 4

common causes of chronic stridor

Answer 4

• laryngomalacia
• vocal cord palsy
• subglottic stenosis

Question 5

until what age are infants nasal breathers

Answer 5

6-12mo

Question 6

what are the differences in a kids airway

Answer 6

• smaller airways
• trachea more cartilagenous + soft
• narrowest point cricoid cartilage

Question 7

what are some signs of increased WOB

Answer 7

• tachypnoea
• tachycardia
• nasal flaring
• grunting
• tripod
• paradoxical breathing
• head bobbing
• accessory muscles

Question 8

what is a ddx for asthma in a child <3yrs

Answer 8

transient wheeze of infancy

Question 9

what is croup

Answer 9

AKA laryngotracheobronchitis

viral infection of larynx, trachea and bronchitis

Question 10

most common age for croup

Answer 10

6mo-5yrs

rare <3mo

Question 11

common organism of croup

Answer 11

parainfluena

Question 12

what is the typical course of croup

Answer 12

worse at night. peaks day 2/5

Question 13

sx of croup

Answer 13

• wheeze widespread
• increased WOB
• barking cough
• coryzal sx
• insp stridor

Question 14

mx of croup

Answer 14

mild-mod
prednisolone 1mg/kg for 2 nights
severe
neb adrenaline and Im/IV dexamethasone

Question 15

what is epiglottitis

Answer 15

bacterial infection of epiglottis

Question 16

age for epiglottitis

Answer 16

2-4yo

Question 17

organisms of epiglottitis

Answer 17

H. influenza, S. aureus, strep. pneumonie

Question 18

sx of epiglottitis

Answer 18

drooling 
febrile 
dysphagua 
leaning forward
not coughing or speaking

Question 19

mx of epiglottitis

Answer 19

ICU
intubated
IV Abs

Question 20

what is bacterial tracheitis + organisms

Answer 20

bacterial infection of trachea

Hif, staph, strep

Question 21

CF of bacterial tracheitis

Answer 21

toxic child

++ sore trachea

Question 22

dx and mx of bacterial tracheitits

Answer 22

direct visualisation with endoscopy

ABX

Question 23

what is bronchioloitis

Answer 23

viral LRTI

Question 24

age for bronchioloitis

Answer 24

<12mo

Question 25

organisms of bronchioloitis

Answer 25

RSV, metapneumovirus, influenza, parainfluenza

Question 26

progression of bronchioloitis

Answer 26

peak day 2-5. resolves 7-10 | cough can persist for 1mo

Question 27

CF of bronchioloitis

Answer 27

``` coryzal sx cough wheeze decreased feeding irritability apnoea ```

Question 28

mx of bronchioloitis

Answer 28

``` supportive paracetamol adn sucrose for comfort minimal handling breast feeding small amounts and frequently 2/3 maintence IVF o2 if sats <92% ```

Question 29

criteria for admission of pneumonia

Answer 29

<3yrs unwell extensive consolidation pleural effusion

Question 30

mx of mild asthma

Answer 30

- 1x puff salbutamol - reassess if effective can dc home - if non effective mx as moderate

Question 31

mx of moderate asthma

Answer 31

- o2 if sats <92% - 1x puff salbutamol every 20 mins for 1hr - PO prednisolone 2mg/kg then 1mg/kg for 2-3days

Question 32

mx of severe asthma

Answer 32

1. 02 if sats <92% 2. 1x puff salbutamol every 20 mins for 1hr 3. 1x puff ipatropium every 20 mins for 1hr 4. aminophylline 5. magnesium sulfate 6. PO prednisolone of IV methylprednisolone

Question 33

mx of critical asthma | SILENT CHEST

Answer 33

1. o2 2. nebulised salbutamol 3. nebulised ipatropium 4. IV CCS 5. magnesium sufate 6. aminophylline

Question 34

DC requirements after asthma attack

Answer 34

- eating and drinking well - no WOB - asthma action plan!!!!!! - correct inhaler technique - safety net - OPD or GP appt

Question 35

what is the long term asthma control

Answer 35

releiver - salbutamol preventor ICS first!!!! or montelukast before combo or LABA

Question 36

what are the indications for a preventor

Answer 36

sx when exercising 1+night/week waking up 1+/wk use of bronchodilator

Question 37

what is the correct technique for inhaler use`

Answer 37

should always use a spacer 1. remove cap from inhaler and shake well 2. insert inhaler into spacer 3. hold horizontally 4. form seal around spacer with lips 5. breathe out gently 6. press inhaler once and breathe in normally 3-4x 7. repeat if necessary to clean use warm water and detergent. do not rinse. let drip dry dont use paper towel or cloth

Question 38

what are the benefits of an asthma action plan

Answer 38

- D time away from schoo/work - D hospitalisations - D ED presentations - I lung function

Question 39

what is laryngomalacia

Answer 39

``` floppy larynx most common cause of congenital stridor most cases resolve by 1yr as larynx grows and cartilage rings harden can be exacerbated by URTI/LRTI often does not cause issues with feeding ```

Question 40

how can CF present in neonate, infant and older children

Answer 40

neonate - meconium ileus - inestional atresia - hepatitis/prolonged jaundice infant - rectal prolapse - FTT - malabsorption older children - recurrent chest infection - nasal polyp - liver disease - DM

Question 41

what organs does CF affect

Answer 41

lungs, pancreas, intestines, liver

Question 42

how is CF dx

Answer 42

sweat test | heel prick test in infancy