respiratory

Question 1

when does respiratory bud arise from ventral surface of foregut

Answer 1

3-5wks

Question 2

when do distal airways develop

Answer 2

17-24wks

Question 3

when do alveoli develop and what phase

Answer 3

25wks - saccular phase

Question 4

when does surfacnt production occur

Answer 4

from 23wks

Question 5

what is stertor

Answer 5

intermittent upper airway obstruction due to loss of control of pharyngeal muscles

Question 6

causative organisms of pharyngitis in young vs older children

Answer 6

young - adenovirus, enterovirus, rhinovirus
older - group a beta-haemolytic streptococcus

Question 7

commone causative organism of tonsillitis

Answer 7

group a beta haemolytic strept
EBV

Question 7

abx for otitis media

Answer 7

amoxicillin

Question 7

most common age for acute otitis medial

Answer 7

6-12months

Question 7

portion of tonsillitis is bacterial?

Answer 7

1/3

Question 8

when is otitis media with effusion common

Answer 8

2-5 yrs

Question 9

most common conductive hearing loss in children

Answer 9

otitis media with effusion
manage with grommet insertion or adenoidectomy

Question 10

absolute indicate for tonsillectomy or adenodectomy

Answer 10

obstructive sleep apnoea

Question 11

croup: causes, age, season and treatemtn

Answer 11

parainfluenza 1
2yrs
autumn
oral dexamethasone - nebulised adrenaline - intubation

Question 12

risk of adrenaline

Answer 12

2hr after - rebound symptoms

Question 13

bacterial tracheitis

Answer 13

staph aureau
treat with iv abx and intubate and ventilate

Question 14

epiglottitis: causes, difference vs croup, treatment, prophylaxis for contacts

Answer 14

haemophilus influenza b
unwell with drooling
intubation and iv abx
prophylaxis: rifampicin

Question 15

whooping cough: causes, symptoms, investigations, treatemtn

Answer 15

bordetella pertussis
paroxysmal cough with whoop and vomiting or apnoea
investigation: nasal swab
management: erythromycin

Question 16

bronchiolitis

Answer 16

RSV
Dry cough, WOB, reduced feeding
humidified oxygen and help with feeding

Question 17

causes of pneumonia in
newborn
infants
>5

Answer 17

newborn - mothers genital tract (group b strep or gran -ve enterococci
infants - RSV, strep pneumonia, haemophilus
>5yrs - mycoplasma, strep pneumoniae and chlamydia pneumoniae

Question 18

asthma investigations

Answer 18

skin prick for allergens
PEFR
Spirometry

Question 19

asthma treatment

Answer 19

reliever
regular preventer
<5yrs add on LTRA (montelukast), >5yrs add inhaled LABA
Oral steroid or immunotherapy

Question 20

primary ciliary dyskinesia

Answer 20

congenital abnormalities in structure and function of cilia - recurrent infections- bronchiectasis
sympt: recurrent cough, purulent nasal discharge and ear infections
50% have Kartagener (dextrocardia and situ inversus)

Question 21

CF

Answer 21

Autosomal-recessive defect in CFTR gene on chromosome 7, commonly deletion of Phe 508
Results in:
- Chronic endobronchial infection with pseudomonas
- Meconium ileus (thick meconium produced)
- Pancreatic ducts become blocked by thick secretions –> enzyme deficiency & malabsorption
- Abnormal sweat gland function –> salty sweat (excess Na & Cl)

Question 22

What organisms cause chronic infection in cystic fibrosis - initially then subsequently?

Answer 22

Initially - Staph aureus & Haemophilus influenzae Later - Pseudomonas aeruginosa & Burkholderia

Question 23

How to diagnoses pancreatic insufficiency in CF

Answer 23

Low faecal elastase

Question 24

treatment for meconium ileus in CF

Answer 24

gastrograffin enema and surgery

Question 25

diagnosis of CF

Answer 25

Sweat test - high chloride

Question 26

diet in CF

Answer 26

High calorie supplement fat soluble vitamins

Question 27

treatment of chronic pseudomonas infection in CF

Answer 27

Nebulised abx daily (azithromycin-tobraycin mucolytic

Question 28

what is measured in CF heel prick test

Answer 28

immunoreactive trypsinogen (raised) if high -samples screened for CF mutation If 2 present - sweat test

Question 29

proportion of caucasians with cftr gene in uk

Answer 29

1 in 25

Question 30

fueature of mycoplasma pneumoniae

Answer 30

atypical - upper and lower RTI frequently resistant to penicillin

Question 31

prednisolone dose in children with asthma exacerbation

Answer 31

1-2mg/kg max 40mg

Question 32

which clinical feature is major determinant in cardiac risk stratification in noonan syndrome

Answer 32

degree of hypertrophic cardiomyopathy

Question 33

which virus is not likely to cause otitis media

Answer 33

echovirus

Question 34

what baceria commonly cause otitis media

Answer 34

strptococcus pneumoniae haemophilus moraxella catarrhalis

Question 35

most common extracranial complication of otitis media

Answer 35

mastoiditis

Question 36

marfan syndrome is assocaited with which gene mutation

Answer 36

fibrillin 1

Question 37

incidence of bronchiolitis

Answer 37

age 3-6 months

Question 38

percentace of children with bronchiolitis req admission

Answer 38

2-3%

Question 39

peak incidince of bronchiolitis

Answer 39

november-february

Question 40

genetics of noonan syndrome

Answer 40

autosomal dominant

Question 41

which bacteria is not associated with CF

Answer 41

Streptococcus pneumoniae

Question 42

organisms associated with CF

Answer 42

Staphylococcus haemophilus pseudomonas aspergillus burkholderia nontuberculous mycobacteria

Question 43

what can cause a false positive mantoux test

Answer 43

BCG injections

Question 44

what can cause a false positive sweat test

Answer 44

eczema

Question 45

types of pulmonary hypoplasia

Answer 45

primary secondary - most common