Respiratory System 2 Flashcards
(21 cards)
What is the other name for croup?
Acute laryngotracheobronchitis
Define croup?
Mucosal inflammation with increased secretions - affecting the airways with oedema of the subglottic area - potentially life-threatening!
What is the main causative agent of croup?
Parainfluenza virus - 95%
What is the age range of children affected by croup - and what is the peak onset?
6months - 6 years
Peak = 2 years
Describe the classical presentation of croup?
Onset is insidious (over a few days with slow progression) initially coryza followed by stridor, wheeze and a classical ‘barking’ cough
What causative agent commonly causes epiglottis?
Haemophilias influenza B
Associated with septicaemia
What age bracket does epiglottitis often affect?
1 - 6 years
Describe 5 signs and 3 symptoms associated with epiglotitis?
Soft stridor Drooling slaiva Inability to drink Toxic appearance Child often leans forward NO cough High grade fever Sore throat
What should be avoided in children with suspected epiglotitis?
Attempts to lie the child flat
O/E of the throat
What is the typical finding on laryngoscopy of a child presenting with epiglotitis?
‘Cherry’ red swollen epiglotis
Define asthma?
Chronic inflammatory disorder of the airway with reversible airway obstruction and typical symptoms (diurnal variation)
Describe four symptoms associated with asthma?
Cough - recurrent and dry - worse at night/exercise
Wheeze - expiratory
SOB - triggers and exercise limitation
Chest tightness
Name six common triggers for asthma?
Smoking Exercise Pollen/dust Beta blockers Aspirin
On Hx and O/E of a child with asthma - what five relevant likelihoods are there?
Family and personal Hx of atopy Widespread wheeze on auscultation Acid reflux - 60% Unexplained peripheral blood eosinophillia Symptoms improve with treatment
O/E of a child with asthma - what three findings may be apparent with uncontrolled asthma?
Silent chest - SEVERE
Harrison’s sulcus
Barrel chest
What two things might CXR of a child with asthma show?
Air trapping (hyper-inflation) Collapse (mucous plugging)
Describe the management of a child under the age of five with asthma?
- Short acting B2 agonist
- Inhaled corticosteroid
- Monteleukast
- Refer
Describe the management of a child over the age of five with asthma?
- Short acting B2 agonist
- Inhaled corticosteroid
- Long acting B2 agonist (+Monteleukast/theophyline)
- Increase inhaled corticosteroid dose
- Oral steroids/ Refer
In an acute asthma attack - define what constitutes a ‘mild’ attack?
Peak flow = 50% or higher than normal
Breathlessness without distress
In an acute asthma attack - define four factors that constitute a ‘severe’ attack?
Peak flow = Less than 50% normal
Too breathless to talk/feed
RR higher than 50
HR higher than 130
Describe five factors that constitute a ‘life threatening’ asthma attack?
- Peak flow below 33%
- Silent chest
- Cyanosis
- Fatigue/confusion
- Decreased BP
