Respiratory

Question 1

Give 4 signs of respiratory distress in infants/children

Answer 1

• Tracheal tug
• Recessions
• Nasal flaring
• Head bobbing

Question 2

What is Harrison’s sulcus and what does it indicate?

Answer 2

Bilateral depression of chest wall present at costal margins where diaphragm inserts

Sign of chronic asthma

Question 3

Give 4 differentials for an acute cough

Answer 3

• Upper respiratory tract infection
• Croup
• Bronchiolitis
• Acute exacerbation of asthma

Question 4

Give 4 differentials for an chronic cough

Answer 4

• Asthma
• Infection
• GORD
• Cystic fibrosis

Question 5

Give 3 differentials for acute stridor

Answer 5

• Inhaled foreign body
• Acute epiglottis
• Croup

Question 6

Which virus usually causes croup and give 2 symptoms

Answer 6

Parainfluenza virus

Hoarse voice and barking cough

Question 7

How can croup be treated?

Answer 7

Oral Dexamethozone

Nebulised adrenaline if severe

Question 8

Give 2 viral and 2 bacterial causes of pneumonia

Answer 8

V: RSV + influenza

B: S. pneumonia + Group B strep. (neonates)

Question 9

What is bronchiolitis and what is the main causative virus?

Answer 9

Acute LRTI with inflammation of small airways mainly due to RSV

Question 10

Give 4 signs and symptoms of bronchiolitis

Answer 10

Cough
Dyspnoea
Hyperinflation
Fine creps

Question 11

Give 2 treatment options for bronchiolitis

Answer 11

02 if hypoxic

NG feeds

Question 12

Give 4 triggers for asthma

Answer 12

Cold weather
Smoking
Exercise
Pets

Question 13

Give 3 symptoms of asthma

Answer 13

SOB
Chest tightness
Wheeze

Question 14

Briefly outline the 5 treatment steps in asthma

Answer 14

1. SABA
2. Preventer and ICS
3. LABA, increase steriod
4. LTRA
5. Steroid tablet

Question 15

Define cystic fibrosis

Answer 15

AR disorder, mutation in CFTR gene on chromosome 7

Question 16

How do thickened secretions occur in CF?

Answer 16

CFTR should allow Cl ions out of mucosal cells into lumen but if defective = thickened secretions

Question 17

Give 5 possible complications/symptoms of CF

Answer 17

1. Cough
2. Nasal polyps
3. Pancreatic insufficiency
4. Liver cirrhosis
5. Steatorrhoea

Question 18

How are newborns screened for CF?

Answer 18

Immunoreactive Trypsin on blood spot, if raised then blood sent for genetic testing

Question 19

What 3 things in children are indications for sweat testing and genetic investigations with regards to CF?

Answer 19

Meconium Ileus

Recurrent chest infections

FTT

Question 20

Give 4 management steps in CF

Answer 20

1. Daily physio
2. Prophylactic Fluclox.
3. Creon
4. Fat soluble vitamin supplements

Question 21

What is the management of an infective exacerbation of CF?

Answer 21

o Double dose of prophylactic ABX

o Planned 2nd line ABX

o May require admission for IV ABX