Resp Paediatrics

Question 1

common side effects of antibiotics in children

Answer 1

• diarrhoea
• oral thrush
• nappy rash
• allergic reaction
• multi-resistance

Question 2

management of child presenting with tonsillitis/ pharyngitis

Answer 2

• throat swab
• nothing or 10 days penicillin
• don’t give amoxycillin

Question 3

presentation of croup

Answer 3

• common
• well
• coryza ++
• stridor
• hoarse voice
• barking cough

Question 4

presentation of epiglottitis

Answer 4

• rare
• toxic
• stridor
• drooling

Question 5

management of epiglotittis

Answer 5

intubation and antibiotics

Question 6

management of croup

Answer 6

oral dexamethasone

Question 7

principles of management LRTI

Answer 7

• make a diagnosis
• assess the patient (oxygenation, hydration, nutrition)
• treat vs not treat

Question 8

potential diagnosis for this clinical presentation:

• loose rattly cough
• post-tussive vomit
• chest free of wheeze/ creps
• most self limiting
• child well
• parents worried

Answer 8

bronchitis

Question 9

potential diagnosis for this clinical presentation:

• nasal stuffiness
• tachypnoea
• poor feeding
• crackers +/- wheeze
• <12 months old
• one off (not recurrent)

Answer 9

bronchiolitis

Question 10

management of bronchiolitis

Answer 10

• max observation

- min intervention

Question 11

management of community acquired pneumonia if mild symptoms

Answer 11

nothing

Question 12

first line management of community acquired pneumonia

Answer 12

oral amoxycillin

Question 13

second line management of community acquired pneumonia

Answer 13

oral macrolide

Question 14

when would you give IV antibiotics for pneumonia

Answer 14

if patient vomitting

Question 15

management of bilateral media under 2 years old

Answer 15

oral amoxycillin

Question 16

key components of asthma

Answer 16

• wheeze
• variability
• responds to treatment
• SOB@rest

Question 17

if a patient is short of breath at rest, what is likely percentage of functioning lung

Answer 17

<30%

Question 18

differential diagnosis for asthma, onset under 5 years

Answer 18

• congenital
• CF
• PCD
• bronchitis
• foreign body

Question 19

differential diagnosis for asthma, onset >5years

Answer 19

• dysfunctional breathing
• vocal cord dysfunction
• habitual cough
• pertussis

Question 20

wee poem about asthma?

Answer 20

if you think its asthma
but you’re not sure
give a short course of inhaled steroids
and see if you have a cure

Question 21

goals of asthma treatment

Answer 21

• minimal symptoms during day and night
• minimal need for reliever medication
• no attacks (exacerbations)
• no limitation of physical activity
• normal lung function

Question 22

how to measure asthma control/ questions to ask

Answer 22

SANE
S - Short acting beta agonists/week
A - absence school/ nursery
N - Nocturnal symptoms/ week
E - exertional symptoms/ week

Question 23

potential causes of not well controlled asthma

Answer 23

• not taking treatment
• not taking treatment correctly
• not asthma
• other

Question 24

classes of medication used in asthma

Answer 24

• SABA
• inhaled corticosteroids
• LABA
• leukotriene receptor antagonists
• theophyllines
• oral steroids

Question 25

when would you prescribe a preventer inhaler

Answer 25

- B2 agonists >2/7 - symptomatic more 3/7+ - waking 1/7 nights

Question 26

first add on preventer

Answer 26

LABA

Question 27

management asthma attack

Answer 27

- IV salbutamol - IV aminophylline - IV magnesium - IV hydrocortisone - intubate and ventilate

Question 28

initial management for suspected asthma presentation

Answer 28

- allergy testing - trial of SABA - trial of low dose ICS - peak flow reliable - reduced spirometry