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Flashcards in Respiratory System Deck (22):
1

With regards to 'signs' of respiratory distress, which three components can they be broken down into?

Effort
Efficacy
Effect

2

Name five signs related to 'Effort' within respiratory distress?

Child's positioning
Use of accessory muscles - (intercostal and subcostal recession)
Nasal flaring
Grunting
Increased respiratory rate

3

Name four signs related to 'Efficacy' within respiratory distress?

Chest expansion
O2 sats
Air entry
Auscultation

4

Name four signs related to 'Effect' within respiratory distress?

Heart rate
Skin colour (initially pale - late stage = cyanosed)
Confusion
Decreased AVPU

5

What is the typical range of respiratory rate for an infant 0-2 months?

40 - 60

6

What is the typical range of respiratory rate for an infant 2 months - 1 year?

30 -50

7

What is the typical range of respiratory rate for a pre school child?

20-40

8

What is the typical range of respiratory rate for an adult?

12 - 20

9

Name five signs of severe respiratory distress in an infant?

Drowsiness/unresponsiveness
Agitation
Increased respiratory effort (marked use of accessory muscles)
Cyanosis
Auscultation = SILENT chest

10

A 9 month old baby presents with a four day history of a dry cough with poor feeding, wheeze and breathlessness after initially having a runny nose. What is the most likely diagnosis?

Bronchiolitis

11

What is the most common causative agent for bronchiolitis?

RSV - 80% (endemic in winter months)

12

On examination of a baby with bronchiolitis, what are the most common findings?

Widespread wheeze
FINE inspiratory crackles
Tachypnoea
Intercostal and subcostal recession

13

In bronchiolitis, what finding may be more apparent to baby's under 4 months old?

Apnoea (temporary cessation of breathing - particularly in sleep)

14

How is bronchiolitis managed?

Supportive treatment - feed little and often

15

Name three indications for hospital admittance?

1. Poor feeding
2. Apnoea and signs of increased respiratory distress
3. Decreased O2 saturation

16

Name the most likely causative agent of pneumonia in newborns?

Group B strep

17

Name the three most likely causative agents of pneumonia in infants and toddlers?

RSV (C)
Strep. pneumoniae (C)
Haemophilus influenza
(staph aureus - rare but serious)

18

Name the four most likely causative agents of pneumonia in children 5+?

Strep. pneumoniae
Haemophilus influenza
Mycoplasma pneumoniae
Chlamydia pneumoniae

19

Which two agents are more commonly seen in children with underlying respiratory conditions (i.e. CF)?

Pseudomonas aeruginosa
Staph aureus

20

Name a sign that may possibly indicate a bacterial pneumonia over a viral?

Localised chest pain = pleuritic irritation = more likely bacterial cause

21

Describe three signs consistent with consolidation in children with pneumonia?

Dullness to percussion
Increased vocal resonance
COURSE crackles on auscultation

22

Name four steps in the management of pneumonia?

O2
Analgesia
Fluids
Amoxicillin - 1st line