Aeitology/physiology
The most common causative organism of epiglottitis?
Haemophilus influenzae type B (Hib)
Give two differentials for a child presenting with stridor
Foreign body
Epiglottitis
Croup
Laryngyomalacia
Airway burn
What is the first line treatment for mild asthma
Air therapy - LABA+ICS used when needed
What age range requires admission to hospital if the temperature >=38 degrees
3 months old or younger
What pattern of inheritance is cystic fibrosis
Autosomal recessive
What time of the day is asthma typically worse?
At night
How is bronchiolitis managed?
No drug therapy usually required and therapy is supportive. Give O2 if saturations are 92% and encourage adequate fluid intake (may require NG tube or IV). Consider the need for ventilatory support.
What causes bronchiolitis?
Respiratory syncytial virus (RSV)
Describe the pathophysiology of asthma?
reversible airflow obstruction caused by bronchial hypersensitivity, eventually leading to chronic inflammation
What is the typically age range of children who present with bronchiolitis
Neonate-2 years old
(Most common in infants under 6 months and can be diagnosed in children of up to 2 years)
What is the cutoff FeNO value for the diagnosis of asthma in children (5-16 years)
FeNO level is 35 ppb or more
50 for adults!
Give three signs of respiratory distress in children
Tracheal tug
Cyanosis
Intercostal Recession
Use of accessory muscles
Subcostal recession
Nasal flaring
Additional breath sounds (grunting, stridor etc)
What causes cystic fibrosis?
Defect in the CFTR gene
Give two examination findings in a child with croup
Stridor, barking/seal cough, coryzal symptoms, respiratory distress, fever
If hospital admission is not indicated in cases of mild croup what should be prescribed?
Single dose of oral dexamethasone (0.15 mg/kg)
Give an example of a long-acting beta agonist
Any one of the following:
Salmeterol
Formoterol
Olodaterol
Indacaterol
Describe the pathology seen in bronchiectasis
Permanent and abnormal widening of the bronchi and impaired mucocilliary clearance due to inflammation and infection
Give a possible examination finding on a child with bronchiectasis
Inspiratory crackles, wheeze, ronchi, finger clubbing
Onset of cough has to be within 21 days
What age are children typically when they receive their first Hib
First dose of 6 in 1 vaccine is at 8 weeks