Bronchiolitis
What are the symptoms, signs, investigations and management of Bronchiolitis?
Croup
What are the symptoms, signs, investigations and management of Croup?
CKS suggest admitting any child with moderate or severe croup. Other features which should prompt admission include:
- < 6 months of age
- known upper airway abnormalities (e.g. Laryngomalacia, Down’s syndrome)
- uncertainty about diagnosis (important differentials include acute epiglottitis, bacterial tracheitis, peritonsillar abscess and foreign body inhalation)
Management:
- CKS recommend giving a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
- prednisolone is an alternative if dexamethasone is not available
Emergency treatment:
- high-flow oxygen
- nebulised adrenaline
Croup vs Epiglottitis
How do you differntiate between Croup and Epiglottitis?
Include:
- Onset
- Preceding coryza
- Cough
- Able to drink?
- Dorrling saliva?
- Appearance
- Fever
- Stridor
- Voice, cry
Pneumonia
What are the symptoms, signs, investigations and managment Pneumonia?
Cystic fibrosis
What is the definition of, aetiology of, risk factors for and symptoms of Cystic Fibrosis?
Cystic fibrosis
What are the investigations and treatment of Cystic Fibrosis?
(last part of secondary care)
- Increased overnight gastronomy to acheive high dietary intake (>150% of normal).
- Fat soluble vitamin substance
- Regular ursodeoxycholic acid improves bile flow
- Intestinal obstruction- cleared by oral gastrografin
- All CF patients reviewed annually in a specialist centre to monitor for any compliactions
MDT (Very important)
- Physiotherapist
- Dietician
- Teachers
- Primary care team
- Specialist nurse
Larnygomalacia
What are the symptoms, signs, investigations and management Larnygomalacia?
Heart Failure
What are the symptoms, signs, investigations and managment of Heart Failure?
- Right heart failure signs (ankle oedema, sacral oedema and ascites) are rare in the western world except from long term Rheumatic heart disease
- In the first week of life, heart failure usually results from left heart obstruction. Which causes right to left shunting (via the arterial duct)
- Infants usually have left to right shunting, as the pulmonary vascular resitance falls there is an increase in left to right shunting increasing pulmonary blood flow but also causing pulmonary oedema and breathlessness.
- These symptoms can increase up to the age of about 3 months but then subside as the pulmonary vasucalr resistance increases to compensate.
- This leads to Eisenmenger syndrome if left untreated. This causes irreversibly raised pulmonary vasuclar resistance. The only treatment of this is a heart lung transplant.
Bronchiolitis
What are the symptoms, signs, investigations and management for Bronchiolitis (for Chronic Cough)?
Inhaled Foreign Body
What are the symptoms, signs, investigations and management for Inhaled Foreign Body?
Pneumonia
What are the symptoms, signs, investigations and management for Pneumonia (for Chronic Cough)?
Asthma
What are the symptoms, signs, investigations and management for Asthma (for Chronic Cough)?
Post–Nasal Drip/ Sinusitis
What are the symptoms, signs, investigations and management for Post–Nasal Drip/ Sinusitis?
Asthma
Outline the Emergancy treatment of Asthma
Gastro-oesophageal reflux (GORD)
What are the symptoms, signs, investigations and management for Gastro-oesophageal reflux?
Pulmonary TB
What are the symptoms, signs, investigations and management for Pulmonary TB?
Bronchiectasis
What are the symptoms, signs, investigations and management for Bronchiectasis?
Asthma
Outline the outpatient management of Asthma
Asthma
Outline the emergancy management of Asthma
Bronchiolitis
Outline the stepwise treatment of Bronchiolitis
Just for clarification the steps are:
- No support/ Little and often feeds
- Oxygen/NG feeds
- CPAP/IV feeds
- I&V
