Respiratory Flashcards
(27 cards)
What is the admissions criteria for bronchiolitis?
<3 months pre-existing conditions such as CF or DS Oral intake <75% normal If RR >70 pO2 <92% Signs of resp distress or apnoea
What is the management of bronchiolitis?
Supportive with nasal suction.
If severe O2 and ventilatory support
What are the main types of ventilatory support?
- High flow humidified oxygen - Airvo (to give +ve expiratory pressure to maintain the airway and prevent collapse)
- Continuous Positive Airway Pressure (CPAP)
- Intubation and ventilation via endotracheal tube
What is the key feature of T2 Respiratory Failure?
Increased CO2, decreased O2.
What is the treatment for bronchiolitis?
Palivizumab
What are the three features that differentiate Viral Induced Wheeze from Asthma?
< 3y/o
no atopic history
only occurs during viral infections
What observations would be found in a viral induced wheeze?
Expiratory wheeze throughout chest (if focal, check for obstruction)
What is the guideline for severe asthma?
Peak flow < 50% predicted
Sats <92%
Can’t complete a sentence
High HR + RR
What is the guideline for life-threatening asthma?
Peak flow < 33% predicted Sats < 92% Hypotension Silent chest Cyanosis
What is the treatment for an asthma attack?
O2 -> bronchodilators (neb salbutamol) -> ipratproprium -> MgSO4
10 puffs every 2 hours
If steroids, prednisolone 1mg/kg for 3 days
What is the treatment for an emergency asthma attack?
3 B2B - 3 neb salbutamol + 3 neb ipratproprium bromide back to back
IV MgSO4
IV corticosteroid
What is the main cause of epiglottitis?
Haem. Influ B
What would be the radiological finding in epiglottitis?
Neck X-ray - thumb print
What are the treatment options for epiglottitis?
Secure airway - anaesthetists
IV Abx - Ceftriaxone
Steroids - dexamethasone
What are the signs of laryngomalacia?
Chronic stridor that worsens when feedings or lying down.
What are the signs of Chronic Lung Disease of Prematurity? (CLDP)
< 28 weeks gestations
RDS - need O2 or vent+intub at birth
Chest X-Ray changes
What can be done to minimise the risk of CLDP?
Give mother Betamethasone if signs of prematurity
Once born, CPAP baby
Caffeine to stimulate resp effort
What investigations need carried out for CLDP?
Sleep study
What gene mutation is tested for in CF?
CFTR gene
What are the three causes of symptoms in CF?
- thick pancreatic and biliary secretions (block the ducts and prevent digestive enzymes from entering the GI tract, pancreatic lipase)
- thick airway secretions
- absence of Vans Deferens
What is commonly the first sign of CF?
Meconium ileus
What are non-respiratory signs of CF?
Distension of abdomen Steatorrhoea Failure to thrive nasal polyps finger clubbing
What investigations can be done in CF?
Newborn spot test
Sweat test
Genetic testing
What is used in the Sweat Test?
Pilocarpine - make an area of skin sweat using electrodes and measure [Cl]- in sweat collected, if >60 possible CF diagnosis.
