Respi Flashcards
(90 cards)
1
Q
What are upper respiratory tract infections?
A
Pharyngitis, rhinitis, tonsilitis, otitis media
Commonly due to viruses, occasionally bacteria like Strep pyogenes.
2
Q
When should antibiotics be started for upper respiratory infections?
A
Persistent fever, severe otitis media, pharyngitis/tonsilitis with exudates, sinusitis with tenderness
Specific signs include enlarged lymph nodes and palatal petechiae.
3
Q
When should a patient be admitted for upper respiratory infections?
A
Poor fluid intake, signs of dehydration
4
Q
What are lower respiratory tract infections?
A
Bronchiolitis, pneumonia, TB, pertussis
5
Q
What is bronchiolitis?
A
Infection/inflammation at smaller airways (bronchioles)
Common respiratory illness affecting infants and toddlers.
6
Q
What is the common causative virus for bronchiolitis?
A
Respiratory syncytial virus (RSV)
7
Q
What are risk factors for bronchiolitis?
A
Preterm infant, congenital heart disease
8
Q
What are the signs and symptoms of bronchiolitis?
A
Mild coryzal symptoms, low-grade fever, shortness of breath, tachypnoea, respiratory distress, wheezy, inspiratory crackles
9
Q
What is the main treatment for bronchiolitis?
A
Supportive care including IV fluids, anti-pyretics, hypertonic saline neb, suctioning, oxygen therapy
10
Q
What are the complications of bronchiolitis?
A
Respiratory failure, secondary bacterial infection, pneumonia, dehydration
11
Q
What is asthma?
A
Chronic airway inflammation leading to increased airway responsiveness and recurrent episodes of wheezing, breathlessness, chest tightness, and coughing
12
Q
What is the triad of bronchial hyperactivity in asthma?
A
Mucosal oedema, bronchoconstriction, increased mucus production
13
Q
What are common risk factors for asthma?
A
URTI, allergens, smoking, cold air, exercise, emotional upset, chemical irritants
14
Q
What are the categories of pneumonia?
A
CAP/HAP, lobar/bronchopneumonia, viral/bacterial, typical/atypical
15
Q
What are common viral pathogens causing pneumonia?
A
RSV, adenovirus, influenza
16
Q
What are common bacterial pathogens in pneumonia for neonates?
A
GBS, E. coli, Klebsiella
17
Q
What are clinical features of pneumonia?
A
Fever, cough, tachypnoea, respiratory distress, wheeze and/or crackles
18
Q
What is the hospitalization criteria for pneumonia?
A
Children aged 3 months & below, fever >38.5°C, refusal to feed, fast breathing, associated systemic manifestations
19
Q
What are treatment options for pneumonia?
A
Antibiotics (e.g., benzyl-penicillin, ampicillin), oxygen supplementation, chest physiotherapy
20
Q
What are some signs of severe asthma exacerbation?
A
Drowsiness, cyanosis, tachypnea, tachycardia, pulsus paradoxus, unable to speak in full sentences
21
Q
What is the significance of Harrison’s sulci in asthma?
A
Indicates chronic respiratory disease
22
Q
A
23
Q
What are the classifications of severity of childhood asthma based on daytime symptoms?
A
Intermittent, Mild persistent, Moderate persistent, Severe persistent
These classifications help determine the management plan for asthma.
24
Q
What indicates the need for a SABA reliever more than 2 times a week?
A
Worsening asthma control
This is a sign of poorly controlled asthma.
25
What is the significance of nocturnal symptoms in asthma management?
Nocturnal symptoms indicate asthma severity and control
## Footnote
Awakening at night due to asthma can signify worsening control.
26
What is the criteria for well-controlled asthma in the past 4 weeks?
No daytime symptoms
## Footnote
Partially controlled asthma shows 1-2 symptoms, while uncontrolled shows 3-4.
27
What are common parameters to assess during an asthma exacerbation?
Breathlessness, activity limitation, respiratory rate, accessory muscle usage
## Footnote
These parameters help gauge the severity of the exacerbation.
28
What are the signs of severe acute asthma in infants?
Unable to speak, drowsy/confused, silent chest, poor respiratory effort
## Footnote
These signs indicate a life-threatening situation.
29
What is the definition of an asthma exacerbation?
A worsening of asthma symptoms requiring additional treatment
## Footnote
This can include increased frequency of symptoms and decreased peak flow.
30
What does PEFR stand for?
Peak Expiratory Flow Rate
## Footnote
PEFR is a measure of the maximum speed of expiration.
31
What is the FEV1/FVC ratio indicative of obstructive diseases?
FEV1/FVC ratio < 0.75
## Footnote
This ratio helps diagnose conditions like asthma or COPD.
32
What is the first step in managing acute asthma?
Initial assessment
## Footnote
This involves evaluating the severity and determining treatment options.
33
What are the components of chronic asthma management?
Reliever medications, preventer medications, anti-leukotrienes
## Footnote
These are essential for controlling asthma symptoms over time.
34
What type of inhaler is commonly used for reliever medication in asthma?
MDI salbutamol (Ventolin/Asmol inhaler - Blue colour)
## Footnote
This is a short-acting beta-agonist used for quick relief.
35
Fill in the blank: The FEV1 increases by _______ after inhaling a bronchodilator.
200mL and >12% of baseline value
## Footnote
This indicates reversibility in airway obstruction.
36
What is a common treatment for moderate acute asthma?
Nebulized B2-agonist + O2 via face mask + oral prednisolone + Ipratropium Bromide
## Footnote
This combination helps in managing moderate exacerbations.
37
What are the signs of life-threatening asthma?
Cyanosis, inability to speak, drowsiness, poor respiratory effort
## Footnote
These signs necessitate immediate medical intervention.
38
What is the recommended action for severe acute asthma?
Neb ß2-agonist + oral prednisolone + O2 + IV hydrocortisone + SC Terbutaline + IV MgSO4
## Footnote
This aggressive treatment approach is critical for severe cases.
39
What is the most common serious genetic disorder of Caucasians?
Cystic fibrosis
## Footnote
Cystic fibrosis is a multi-system disorder affecting various organs.
40
What systems are affected by cystic fibrosis?
Lungs, pancreas, liver, gastrointestinal tract
## Footnote
Cystic fibrosis is a multi-system disorder that impacts several organs.
41
What type of disorder is cystic fibrosis?
Autosomal recessive (AR) disorder
## Footnote
It arises from a mutation in the CFTR gene.
42
What gene is mutated in cystic fibrosis?
Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)
## Footnote
This gene is located on the long arm of chromosome 7.
43
What is the pathophysiological mechanism of cystic fibrosis?
Defective CAMP-dependent chloride ion transport
## Footnote
This leads to increased viscosity of secretions, especially in the respiratory tract.
44
What is a key clinical feature of cystic fibrosis in newborns?
Meconium ileus
## Footnote
This condition is often diagnosed through newborn screening.
45
What are common respiratory symptoms in cystic fibrosis patients?
Recurrent productive cough, copious sputum, shortness of breath
## Footnote
Symptoms may include hyper secretion and changes in sputum odor.
46
What are some clinical signs of cystic fibrosis?
Clubbing, hypertrophic pulmonary osteoarthropathy (HPOA), hyperinflation, wheezing
## Footnote
These signs indicate respiratory complications.
47
What is the gold standard investigation for diagnosing cystic fibrosis?
Sweat test
## Footnote
A raised sweat chloride concentration (>60 mmol/L) confirms the diagnosis.
48
What is a common nutritional intervention for cystic fibrosis patients?
High calorie diet with fat-soluble vitamins A, D, E, and K
## Footnote
Nutritional support is crucial due to malabsorption.
49
What type of therapy is used to reduce the viscosity of secretions in cystic fibrosis?
Nebulized mucolytics such as DNase or hypertonic saline
## Footnote
These therapies help manage respiratory symptoms.
50
What is a common complication of cystic fibrosis in older children and adolescents?
Diabetes mellitus (DM)
## Footnote
Insulin therapy may be required for management.
51
What is the role of CFTR modulators in cystic fibrosis treatment?
CFTR potentiators like ivacaftor
## Footnote
These drugs help improve the function of the defective CFTR protein.
52
What surgical options are available for severe complications of cystic fibrosis?
Liver transplant, heart-lung transplant, bilateral lung transplant
## Footnote
These options are considered in end-stage disease with poor prognosis.
53
True or False: Cystic fibrosis is diagnosed only in adulthood.
False
## Footnote
Cystic fibrosis can be diagnosed in newborns and infants.
54
Fill in the blank: Cystic fibrosis is caused by a mutation in the ______ gene.
CFTR
## Footnote
This gene is crucial for chloride ion transport in epithelial cells.
55
What are some common gastrointestinal symptoms in infants with cystic fibrosis?
Prolonged neonatal jaundice, failure to thrive, malabsorption, steatorrhea
## Footnote
These symptoms arise due to pancreatic duct blockage.
56
What is the aetiology of Pertussis?
Bordetella pertussis
## Footnote
Pertussis is also known as Whooping cough.
57
What are the clinical features of Pertussis during the catarrhal stage?
Coryza symptoms (runny nose, conjunctivitis, malaise)
## Footnote
The catarrhal stage lasts for about 1 week.
58
During which stage of Pertussis does the inspiratory 'whoop' occur?
Paroxysmal stage
## Footnote
This stage lasts for 3-6 weeks.
59
What are some symptoms experienced during the paroxysmal stage of Pertussis?
* Inspiratory 'whoop'
* Worse at night
* Posttussive vomiting
* Apnea episodes
* Severe cough leading to bleeding
## Footnote
These symptoms may persist for several weeks.
60
What is the duration of the convalescent stage of Pertussis?
1-2 weeks
## Footnote
Symptoms gradually decrease during this stage.
61
What laboratory finding is significant in Pertussis?
Lymphocytosis >15,000 cells/mm3 or >10,000 cells/mm3
## Footnote
A full blood count (FBC) shows marked white cell count (WCC).
62
What is the recommended treatment for Pertussis?
* Antibiotics
* Supportive care
* Tonsillectomy
## Footnote
Erythromycin is commonly used as an antibiotic for treatment.
63
What are some common causative agents of respiratory infections?
* Adenovirus
* Coxsackievirus
* EBV
* HSV
* Group A strep
## Footnote
These agents can lead to conditions like acute pharyngitis.
64
What are some physical examination findings in bacterial infections? (Examination of the oral cavity)
* Erythematous pharynx
* Exudative tonsils
* Pharyngeal ulcers
* Swollen uvula
* Whitish spots
* Throat redness
## Footnote
These findings help differentiate between bacterial and viral infections.
65
What is the McIsaac score used for?
To assess the likelihood of strep pharyngitis
## Footnote
It includes criteria such as fever, tonsillar exudate, absence of cough, anterior cervical lymphadenopathy, and age.
66
What is the recommended antibiotic for treating strep pharyngitis?
Erythromycin for 14 days
## Footnote
Treatment duration is typically 2 weeks.
67
What complications can arise from Pertussis?
* CNS: Apnea, cerebral anoxia with convulsions, encephalopathy
* Respiratory: Pneumonia, epistaxis
* HEENT: Subconjunctival hemorrhage, otitis media
## Footnote
Young infants are particularly at risk for severe complications.
68
What preventive measure is recommended for Pertussis?
Vaccination (DTaP)
## Footnote
Close contacts should receive prophylactic antibiotics like azithromycin or erythromycin.
69
True or False: Symptoms of Pertussis can last up to 10-12 weeks.
True
## Footnote
This duration reflects the persistence of symptoms in untreated cases.
70
Fill in the blank: The typical age range for assessing strep pharyngitis using the McIsaac score is _______.
3-14 years
## Footnote
The score adjusts for age, affecting the overall assessment.
71
Croup / Acute Laryngotracheobronchitis:
- Most common cause of infectious acute upper airway obstruction.
- Result of viral (parainfluenza) inflammation of the larynx, trachea, and bronchi.
- Common in children between 6m-3y, peak at 2y, more in females.
72
Clinical Features: Croup / Acute Laryngotracheobronchitis:
- Low-grade fever, cough, and coryza for 12-72h, followed by barking cough and hoarseness.
- Inspiratory stridor (develops 1-3 days after coryza) – excited, rest or both.
- Respiratory distress.
73
Assessment of Severity:Croup / Acute Laryngotracheobronchitis:
- Mild: Stridor with excitement or at rest but no respiratory distress.
- Moderate: Stridor at rest with intercostal, subcostal, or sternal recession.
- Severe: Stridor at rest with marked recession, decreased air entry, altered level of consciousness.
74
Investigation & mx Croup / Acute Laryngotracheobronchitis:
- Neck X-ray: Subglottic narrowing (steeple sign).
- Mild: Dexamethasone, prednisolone, or nebulised budesonide.
- Moderate: Dexamethasone, nebulised budesonide, or nebulised adrenaline if no improvement.
- Severe: Nebulised adrenaline + dexamethasone + oxygen, intubate & ventilate if no improvement.
75
What is the most common cause of croup?
Viral (parainfluenza) infection causing inflammation of the larynx, trachea, and bronchi.
76
What is the typical age group affected by croup?
Children between 6 months to 3 years, most common at 2 years old.
77
What are the clinical features of croup?
Low-grade fever, cough, coryza for 12-72 hours, followed by a **barking** cough and hoarseness.
78
What are the severity assessments of croup?
Mild: Stridor with excitement, no distress. Moderate: Stridor at rest with retractions. Severe: Stridor at rest with marked retractions and altered consciousness.
79
What is the key investigation finding for croup?
Neck X-ray shows subglottic narrowing (steeple sign).
80
What is the management for mild croup?
Dexamethasone or prednisolone, or nebulised budesonide.
81
What is the management for moderate croup?
Dexamethasone and/or nebulised budesonide; if no improvement, nebulised adrenaline.
82
What is the management for severe croup?
Nebulised adrenaline + dexamethasone + oxygen; if no improvement, intubate and ventilate.
83
What is the most common cause of acute epiglottitis?
Haemophilus influenzae type B (HiB).
84
What age group is most commonly affected by acute epiglottitis?
Children between 2-7 years old.
85
What are the clinical features of acute epiglottitis?
(Epi-glue-titis--> glue kuat dkt throat)
Severe sore throat with dysphagia, drooling, hoarse voice, high-grade fever, toxic appearance, and dehydration.
86
What is the characteristic X-ray finding in acute epiglottitis?
Neck X-ray shows swollen epiglottis (thumb sign).
87
What is the management principle for acute epiglottitis?
Do not upset the child, admit urgently, secure ABC, give oxygen, and maintain airway.
88
What are the airway interventions for acute epiglottitis if oxygenation is not maintained?
Consider bag-valve mask; if still not maintained, refer to anesthesiologist and ENT for tracheostomy or ET intubation.
89
What are the antibiotic choices for acute epiglottitis?
IV amoxicillin/clavulanate (Augmentin).
90
What adjunctive treatment is given in acute epiglottitis?
IV dexamethasone to reduce airway inflammation.
