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Phase 3A - Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

(47 cards)

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1
Q

What is a wheeze

A

Polyphonic expiratory noise originating from lower airways

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2
Q

what conditions cause a wheeze

A 
Asthma 
CF 
Bronchiolitis 
Pneumonia 
Extrinic allergic allveolitis
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3
Q

what does a focal wheeze indicate

A

focal airway obstruction

  • Inhaled foreign body
  • Tumour
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4
Q

what is a stridor

A

High pitched inspiratory noise originating from turbulent airflow through partially obstructed upper airway

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5
Q

what conditions cause a stridor

A 
Inhaled foreign bodies 
croup 
epiglottitis 
laryngomalacia 
bacterial trachetitis 
anaphalxis
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6
Q

BRONCHIOLOITIS

When is bronchiolitis common and in what age group

A

common in winter

children < 1 year

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7
Q

BRONCHIOLOITIS

what are the causes of bronchiolitis

A

RSV
Parainfluenza
adenovirus

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8
Q

BRONCHIOLOITIS

what are the risk factors from bronchiolitis

A 
passive smoke 
prematurity 
low birth weight 
immunocompromised 
congeital ehart disease 
Downs
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9
Q

BRONCHIOLOITIS

How does bronchiolitis present

A 
Coryzal sx - 1 to 3 days 
- mild fever 
wheeze 
breathlesness 
poor feeding
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10
Q

BRONCHIOLOITIS

What are the clinical signs of bronchiolitis

A 
signs of respiratory distress 
Fine end inspiratory crackles 
Hyperinflation 
wheeze 
stridor 
cyanosis 
tachycardia
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11
Q

BRONCHIOLOITIS

what are the investigations for bronchiolitis

A

Pulse oximetry

PCR analysis of nasal secretions

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12
Q

BRONCHIOLOITIS

What is the management fo bronchiolitis

A

Supportice
Hymidified O2
NG feeds
Fluids

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13
Q

BRONCHIOLOITIS

What is the prevention for nrochiolitis

A

Palvizumab
Monthly vaccinations for patients with: CF / Premature / chronic lung disease / immunocompromised / congenital heart defects

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14
Q

PNEUMONIA

What are the causes of pneumonia

A 
Bacterial - older children 
strep pneumonia 
Group B strep - Neonates 
S. aureus 
Mycoplasma pneumonia

Viruses - common in < 2y/o
RSV
H.Influenzae

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15
Q

PNEUMONIA

Which age group is Group B strep pneumonia more common in

A

Neonates

Pre vaccinated infants

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16
Q

PNEUMONIA

What features indicate pneumonia caused by s.aureus

A

CXR findings of pneumatoceles - round air filled cavities

consolidation of multiple lobes

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17
Q

PNEUMONIA

What features inidcate pneumnia caused by mycoplasma pneumonia - atypical

A

Erythem multiforme - red circular rash

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18
Q

PNEUMONIA

what is the presentation of pneumonia

A 
cough - wet / productuve 
high fever - >38.5 
lethargy 
poor feeding 
pain 
- Localised to chest / abdominal / neck – Pleurel irritation 
- Suggests bacterial infection
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19
Q

PNEUMONIA

what are the clincial signs of a pneumonia infection

Study These Flashcards
A 
tachycardia / tachypnoea 
respiratory distress 
Aucultation 
- bronchial breath sounds 
- End inspiratory coarse crackles 
Dullness to percussion
20
Q

PNEUMONIA

Investigatiosn for pneumonia

Study These Flashcards
A 
sputum cultures / throat swabs 
- bacterial culture and PCR
CBG 
- monitor metabolic acidosis 
- monitor blood lactate 
CXR
21
Q

PNEUMONIA

What is the criteria for admission

Study These Flashcards
A

O2 < 92%

Signs of respiratory distress

22
Q

PNEUMONIA

What is the management of pneumonia

Study These Flashcards
A

Abx
Neonates - Broad spectrum

others
1st line - Amoxicillin
2nd line - Erythromycin

23
Q

PNEUMONIA

what should you suspect if a child gets unwell after a period of improvement following a pneumonia dx

Study These Flashcards
A

Empeyema - check via CXR

24
Q

VIRAL INDUCED WHEEZE

What are children who present with a VIW at higher risk of developing

25
VIRAL INDUCED WHEEZE | What are the risk factor for VIW
Maternal smoking | prematurity
26
VIRAL INDUCED WHEEZE | How does a VIW present
Evidence of viral illness - fever - cough - coryzal sx S.O.B Signs of respiratory distress Expiratory wheeze
27
VIRAL INDUCED WHEEZE | What factors differentiate VIW from asthma
VIW: Present before 3 y/o No atopic hx only occurs during viral infections
28
CYSTIC FIBROSIS | what is the pathophysiology of CF
Mutation in CFTR in chromosome 7 Cl- increased secretions Increased Na+ absorption Leads to H20 absorption into cells, thickened secretions and mucus stasis chnaces in mucus prediposes to infection
29
CYSTIC FIBROSIS | What is the most common mutation in CF
Delta-F508
30
CYSTIC FIBROSIS | What is the presentation of CF - Respiratory
``` chronic cough osinusitis nasal polyps breathlesness haemoptysis ```
31
CYSTIC FIBROSIS | What is the presentation of CF - GI
``` Cholesterol gallstones Meconium ileus - Abdo distension - Vomiting Steatorrhoea Pancreatitis failure to thrive ```
32
CYSTIC FIBROSIS | What is the presentation of CF - Other
``` salty taste to child pubertal delay secondary amenorrhoea infertilty failure to thrive recurrent resp infections pancreatitis ```
33
CYSTIC FIBROSIS | What are the signs of CF
``` Low weight or height on growth charts Hyperinflations of chest – air trapping Nasal polyps Clubbing Crackles and wheeze – auscultation Abdominal distension ```
34
CYSTIC FIBROSIS
- Blood spot testing - Gutherie card - Sweat test (GOLD STANDARD) >60mmol/L - Genetic testing CVS / Amniocentesis Faecal elastase CXR Lung fucntion
35
CYSTIC FIBROSIS | Describe the gutherie card test
Newborn blood spot - Looks for immunoreactive trypsinogen - conducted between days 5 - 9
36
CYSTIC FIBROSIS | Describe the sweat test
DIANGNSOTIC TEST > 60mmol/L Pitfalls - false positive rates common
37
CYSTIC FIBROSIS | Describe the faecal elastase test
evidence of abnormal pancreatic exocrine fucntion
38
CYSTIC FIBROSIS | what are the charecteristics of a CF patient on CXR
Hyperinflation Increased anterior-posterior diameter Bronchial dilation Cysts / linear shadows / infiltrates
39
CYSTIC FIBROSIS | What is the symptomatic management of CF?
``` Stop smoking vaccinations - pneumococcal - flu - varicella ``` Symptomatic relief - Beta 2 agonists - ICS
40
CYSTIC FIBROSIS | What is the pulmonary management of CF
``` chest physiotherpay excercise mucoactive agents - rhDNase alpha - Hypertonic saline Amiloride Lung trasnplant ```
41
CYSTIC FIBROSIS | WHat is the MOA of rhDNase alpha
breaks down DNA to reduce viscocity of mucus and promotes sputum clerance
42
CYSTIC FIBROSIS | What is the MOA of hypertonic saline
osmotic action that hydrates airway secretions and promotes clerance
43
CYSTIC FIBROSIS | What is the MOA of amiloride
Inhibits Na+ transport
44
CYSTIC FIBROSIS | What is the management of infection
Prophylactic flucloxacillin - Protects against s.aureus from ages 3 - 6 Vaccinations
45
``` CYSTIC FIBROSIS What if the extra pulmonary management of CF - Nutrition - Fertility - Heaptobiliary ```
``` Nutrition - Increase portion size - High calorie diet - Supplements - PERT (CREON tablets) replace lipase ``` Fertility - testicualr sperm extraction Hepatobiliary - Liver transplant
46
CYSTIC FIBROSIS | What is the impact of bacterial colonisers of a CF patient
damage of bronchial walls bronchiectasis abscess formation
47
CYSTIC FIBROSIS | What are the common microbial colonisers
``` S.Aurues Haemophilius influnzae Klebsiells penumonia E.Coli Psydomonas aeruginosa ```

Phase 3A - Paediatrics (1 decks)

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