Respiratory

Question 1

BRONCHIOLITIS DF + CAUSES

PAEDIATRICS

Answer 1

Acute bronchiolar inflammation

Causes
- RSV (75-80%)
- Myscoplasma (bac), adenovirus
- ~ secondary to bacterial infectio
- More serious if bronchopulmonary dysplasia (e.g. premature), congenital heart disease or cystic fibrosis

Most common cause of LRI in <1yr, peak 3-6M

Question 2

BRONCHIOLITIS FX

PAEDIATRICS

Answer 2

• Coryza (inc mild fever) precede:
  o Dry cough
  o Increasing SOB
  o Wheezing, fine inspiratory crackles
  o Feeding difficultues ass w/ increasing SOB

Question 3

BRONCHIOLITIS IMMEDIATE REFERRAL

Usually 999

PAEDIATRICS

Answer 3

• Apnoe
• Child looks seriously unwell to HCP
• Severe RS distress i.e. grunting, marked chest recession or RR >70bpm
• Centreal cyanosis
• Persis O2 sats <92%

Question 4

BRONCHIOLITIS ‘consider’ hospital referral

PAEDIATRICS

Answer 4

• RR >60bpm
• Diff breastfeeding or inadequate oral fluid intake*
• Clinical rehydration

*50-75% usual volume

Question 5

BRONCHIOLITIS IX

PAEDIATRICS

Answer 5

• **Immunofluorescecne (IF) of nasopharyngeal secreation **
• ~show RSV

Question 6

BRONCHIOLITIS TX

PAEDIATRICS

Answer 6

Largely supportive
- Humidified O2 (via headbox)
- Nasogastric feeding (IA)
- Suction (IA)