Respiratory

Question 1

Three things to manage in paeds no matter if bacterial or viral cause?

Answer 1

Oxygen
Hydration
Nutrition

->if all three are okay, it’s okay to watch and wait, time is on your side. Antibiotics can make problems worse.

Question 2

Common side effects of antibiotics in chidlren?

Answer 2

Diarrhoea
Oral thush
Nappy thrush
Allergic reaction
Multi resistance

Question 3

Rhinitis is very common. What are some conditions that can then develop from rhinitis?

Answer 3

Pneumonia, bronchiolitis.
Meningitis
Septicaemia

Question 4

Otitis media symptoms?

Answer 4

Painful ear
Can be spontaneous rupture of the drum

Question 5

Treatment of otitis media?

Answer 5

Usually self-limiting
Antibiotics often don’t help

Analgesia for pain

Question 6

When would you give antibiotics for otisis media?

Answer 6

Child <2 and bilateral
If child is systemically unwell

Question 7

Which antibiotic would you give for otitis media, IF antibiotics are indicated?

Answer 7

Amoxicillin

Question 8

How do you determine the cause of tonsillitis/pharyngitis?

Answer 8

Throat swab

Question 9

If strep throat, what is the treatment?

Answer 9

10 day penicillin

->otherwise, probs don’t need antibiotics

Question 10

Which treatment should not be given for a sore throat?

Answer 10

Amoxicillin

->causes rash

Question 11

Croup symptoms?

Answer 11

Barking cough
Stridor

->symptoms typically present at night

Question 12

Treatment of croup?

Answer 12

Dexamethasone

Question 13

Like in URTI, what are the three things to manage first in LTRI?

Answer 13

Nutrition
Oxygenation
Hydration

->all conditions actually

Question 14

“Croup which doesn’t get better”?

Answer 14

Tracheitis

Question 15

Symptoms of tracheitis?

Answer 15

Fever
Sick child
Really unwell

Question 16

Treatment of tracheitis?

Answer 16

DOES need antibiotics.

->one paediatric condition which always needs antibiotics

Question 17

What is more common bronchitis or bronchioitis?

Answer 17

Bronchitis

Question 18

Symptoms of bronchitis?

Answer 18

Loose rattly cough, usually following a cold
Post-cough vomit/glut
Chest clear

Question 19

Treatment of bronchitis?

Answer 19

No treatment required, mostly self-limiting

Reassure parents, cough is normal, 20% of children have the cough for two weeks, not juts in this condition, but it many resp conditions

Question 20

Symptoms of bronchiolitis?

Answer 20

Only affects infants
Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze
Low grade fever

Question 21

What tends to be the most common cause of bronchiolitis?

Answer 21

RSV

->now a RSV vaccine

Question 22

How long do symptoms of bronchiolitis usually last?

Answer 22

50% have symptoms for at least 2wks

->no treatment though, no medications proven to work

Question 23

General symptoms of LRTI?

Answer 23

48hrs symptoms
Fever >38.5
SOB
Cough
Grunting

Question 24

Does a wheeze make a bacterial cause of a LRTI more or less likely?

Answer 24

Wheeze means bacterial cause is less likely

Question 25

Benefits of oral antibiotics compared to IV?

Answer 25

Shorter hospital stay Cheaper No drip ->only negative is fever lasts longer

Question 26

Why is bronchiolitis different to viral induced wheeze?

Answer 26

<12 months old One off (NOT recurrent) Typical history….

Question 27

Difference between LRTI and bronchiolitis?

Answer 27

LRTI: In all ages More rapid onset of symptoms Fever Bronchiolitis: Aged <12 months 3 days before reach peak Fever rarely >38oC

Question 28

Pertussis is known as?

Answer 28

Whooping cough

Question 30

Pertussis is vaccinated against but is still common. What is the point of the vaccine?

Answer 30

Less severe

Question 30

If you suspect asthma, how can it be confirmed?

Answer 30

Start low dose inhaled corticosteroids, will see improvement Two months, won't do harm to a child.

Question 31

Trio of symptoms of asthma?

Answer 31

Wheeze SOB Cough ->all three need to be present

Question 32

Five asthma syndromes that are all just diagnosed as asthma?

Answer 32

Infant onset Childhood onset Adult onset Exertional onset Occupation onset

Question 33

Name some conditions which cause an isolated cough.

Answer 33

Bronchitis Pertussis Habitual cough

Question 34

Habitual cough?

Answer 34

Cough out of habit, usually dry and loud ->strong FH asthma, they don't do it when watching TV or asleep

Question 35

Name some conditions which can cause noisy breathing.

Answer 35

Asthma Bronchitis Laryngomalacia Tracheomalacia Snoring

Question 36

Goals of asthma treatment?

Answer 36

Minimal symptoms during day and night Minimal need for reliever medication No attacks (exacerbations) No limitation of physical activity

Question 37

What are some of the indications of poorly controlled asthma?

Answer 37

SABA >3 x /week Absence from school/nursery Nocturnal symptoms multiple times a week Exertional symptoms multiple times a week

Question 39

Which tests are recommended in asthma?

Answer 39

No tests.

Question 40

Asthma preventer meds?

Answer 40

Inhaled corticosteroids (ICS) Long acting beta agonists Leukotriene receptor antagonists

Question 41

Side effects of ICS?

Answer 41

Height suppression <1cm Oral candidiasis* -> prevent by brushing teeth after

Question 42

Which drug must be taken alongside LABA?

Answer 42

ICS ->used as a fixed dose combined inhaler

Question 43

What type of side effects can be seen in Leukotriene receptor antagonist meds?

Answer 43

Psychiatric side effects ->falling out of favour because of these

Question 44

Summarise asthma treatment overview.

Answer 44

Low dose ICS MART - but lecturer isn't happy w this If not with MART: Add Leukotriene receptor antagonist Then LABA combined inhaler ->so basically, guidelines say MART but apparently this isn't good. This is a ladder, so only add the next if the previous does not provide good asthma control

Question 45

What age group can have dry powder devices?

Answer 45

>8yrs