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MD 3 - Paeds > Respiratory > Flashcards

Flashcards in Respiratory Deck (46):
1

what are some congenital respiratory disorders that can present with cyanosis hours after birth

pulmonary hypoplasia
persistant pulmonary hypertension of the newborn
surfactant deficiency
meconium aspiration
diaphragmatic hernia

2

most common organisms to cause pneumonia in a neonate

group B strep
gram negative enteric bacteria

3

classic age for croup

2 years
Range - 6months-6years

4

describe the childhood presentation of CF

- suppurative lung disease
- recurrent chest infections
- nasal polyps
- haemoptysis
- DIOS
- rectal prolapse
- multifocal biliary cirrhosis

5

describe the neonatal presentation of CF

- meconium ileus
- prolonged jaundice
- antenatal bowel perforation

6

treatment of critical asthma

- oxygen
- continuous ventolin
- nebulised atrovent
- methyl prednisolone
- consider aminophylline and MgSO4
- consider intubation/BiPAP/CPAP

7

most common organisms to cause pneumonia in a pre-schoooler

respiratory viruses
non typeable haemophilus influenzae

8

stepwise approach to asthma management

1. SABA
2. SABA + low dose ICS
3. SABA + high dose ICS OR low dose ICS + LABA
4. SABA + high dose ICS + LABA

9

genetics of CF

autosomal recessive condition
Defect in CFTR gene on chromosome 7 - codes for apical chloride channel on epithelial and mucosal surfaces

10

when should you admit a baby with bronchiolitis

- underlying comorbidities such as CHD
- requiring supplemental oxygen
- poor feeding
- episodes of apnoeas/cyanosis
- moderate-severe respiratory distress

11

how many hours does a child have to be wheeze free after ventolin before they can be discharged

3-4 hours

12

how many puffs of ventolin do you give a child with an asthma attack

- 6 years = 12 puffs, 4 breaths

13

epidemiology of CF affected and carriers

1:2500 - affected
1:25 - carriers

14

which signs of Xray are specific for bronchiectasis

- tram tracking (parallel narrow lines radiating form the hilum)
- cystic spaces
- honeycomb like structures

15

clinical presentation of subglottic stenosis

biphasic stridor

16

clinical features of laryngomalacia

noising breathing when crying or upset but absent when settled or sleeping

17

treatment of protracted bacterial bronchitis

prolonged (4 weeks) of oral antibiotics

18

treatment of laryngomalacia

self resolving - usually by 12 months

19

what causes croup

viral mucosal inflammation of the upper airway, larynx, trachea and bronchi

20

AB for severe pneumonia in a child >3 months

flucloxacillin + 3rd gen cephalosporin

21

describe the infant presentation of CF

- pancreatic insufficiency causing steatorrhoea and FTT
- anaemia, hypoporteinaemia
- hyponatraemia, hypochloraemia, metabolic alkalosis

22

what is protracted bacterial bronchitis

persistent infection of the conducting airways

23

most common organisms to cause pneumonia in an older child

strep pneumo
mycoplasma pneumoniae
chlamydia pneumoniae

24

which signs of HRCT are specific for bronchiecatsis

dilated bronchi with thickened walls where diameter of bronchus > diameter of accompanying artery

25

treatment of severe asthma

- oxygen
- 6-12 puffs of ventolin MDI with spacer 3 times in first hour
- 2 or 4 puffs of atrovent 3 times in first hour
- oral prednisolone
- admission to hospital

26

treatment of moderate asthma

- 6-12 puffs of ventolin MDI with spaces 3 times in first hour
- oral prednisolone
- observe for at least 1 hour

27

which organism most frequently causes empyema in childhood

strep pneumo

28

peak severity of bronchiolitis is typically which day

day 2-3

29

describe how sweat testing for CF works

use pilocarpine and electrodes to induce sweating on the arm - measure the concentration of chloride that is excreted in sweat

30

risk factors for severity of bronchiolitis

- less than 6 weeks
- ex prem
- CHD
- neurological conditions
- chronic respiratory illness
- PHTN

31

what does the CF mutation cause (at a cell level)

causes abnormalities in the transport of chloride across epithelial and mucosal surfaces causing a relative dehydration of airway secretions causing impaired mucociliary transport and airway obstruction. Also causes abnormal pancreatic enzymes

32

definition of bronchiectasis

abnormal and irreversible dilatation of the bronchi

33

most common viral cause of bronchiolitis

RSV

34

management of mild pneumonia in a child >3 months

oral amoxycillin for 7 days

35

principles of management of croup

MINIMAL HANDLING
- mild-moderate: prednisolone
- severe: nebulised adrenaline and IM/IV dexamethasone

36

2 causes of nasal polypa

CF
allergy

37

clinical presentation of primary ciliary dyskinesia

- sinusitis/rhinitis
- chronic suppurative lung disease
- otitis media
- male infertility
- dextrocardia in 50%

38

clinical features of croup

- barking cough
- inspiratory stridor
- increased WOB
- peaks at night 2-3

39

when should you tell your patient to go to hospital with asthma

if you need more than one set of 6/12 puffs in an hour or more than 3 times in a day

40

3 causes of gum hypertrophy

drugs
leukaemia
gingivitis

41

describe the pathogenesis of protracted bacterial bronchitis

predisposing viral infection --> impaired mucociliary clearance --> infection of bronchi with bacteria --> biofilm formation

42

AB for moderate pneumonia in a child that suggests mycoplasma pneumoniae

oral roxithromycin for 10 days

43

describe the newborn screening of CF

heel prick on day 2-4 of life - measures serum trypsinogen
- those levels above 99th percentile --> gene mutation testing
- 2 mutations --> CF clinic
- 1 mutation --> sweat testing

44

what is primary ciliary dyskinesia

genetic condition that causes ultrastructural and function defects of the cilia leading to impaired mucociliary clearance

45

which organism in particulary is associated with deterioration in LF of a CF patient

pseudomonas aeruginosa

46

treatment of mild asthma

6-12 puffs of ventolin MDI with spacer