14589847
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
over 5 years ago
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| Question | Answer |
| 1. TRUE/FALSE - these infants would be considered to be at a high risk of severe airway compromise if they developed bronchiolitis. A. Infants under 10 weeks of age. | True. Very young infants (<3 months of age) are susceptible to severe airway compromise in view of the fact that their airways are small and narrow. |
| 1. TRUE/FALSE - these infants would be considered to be at a high risk of severe airway compromise if they developed bronchiolitis. B. Preterm or low birth weight infants. | True. In preterm/low birth weight infants airways are narrow and may be underdeveloped. |
| 1. TRUE/FALSE - these infants would be considered to be at a high risk of severe airway compromise if they developed bronchiolitis. C. Infants with chronic lung disease. | True. Infants with chronic lung disease have underlying lung pathology which would be further compromised with any intercurrent bout of chest infection. |
| 1. TRUE/FALSE - these infants would be considered to be at a high risk of severe airway compromise if they developed bronchiolitis. D. Infants with congenital acyanotic heart disease. | True. Infants with heart disease (in the setting of a left to right shunt) are predisposed to lung parenchymal infections due to an increased blood flow to the lungs and severe airway compromise owing to a heightened ventilation perfusion mismatch. |
| 2. TRUE/FALSE - consider these in the differential diagnosis of bronchiolitis in a 12 month old infant. A. Asthma with intercurrent viral illness. | True. Asthma is not generally diagnosed <1yo but should be considered in the setting of FHx of asthma, or if the infant has a history of allergy or eczema, along with recurrent episodes of wheeze that are clearly bronchodilator responsive. |
| 2. TRUE/FALSE - consider these in the differential diagnosis of bronchiolitis in a 12 month old infant. B. Pneumonia | True. Pneumonia is suggested by the presence of localised chest signs. |
| 2. TRUE/FALSE - consider thesein the differential diagnosis of bronchiolitis in a 12 month old infant. C. Foreign body. | True. Foreign body inhalation must always be considered as a possibility even in the absence of a history of foreign body inhalation. |
| 2. TRUE/FALSE - consider thesein the differential diagnosis of bronchiolitis in a 12 month old infant. D. Cardiac failure | True. Cardiac failure will present with chest signs not unlike bronchiolitis and needs to be considered as it may be the presenting feature in a child with a yet undiagnosed cardiac anomaly. |
| 3. TRUE/FALSE - these are useful in the management of severe bronchiolitis. A. Steroids | False. Neither steroids nor antibiotics have a role in the management of bronchiolitis. |
| 3. TRUE/FALSE - these are useful in the management of severe bronchiolitis. B. Nebulised salbutamol | False. Infants with bronchiolitis typically do not respond to bronchodilator therapy. Bronchodilators may worsen respiratory compromise by causing a ventilation perfusion mismatch. |
| 3. TRUE/FALSE - these are useful in the management of severe bronchiolitis. C. Oxygen | True. In a child with moderate to severe bronchiolitis, supplemental humidified oxygen is useful for saturations less than or equal to 92%. Indiscriminate use of high flow oxygen is to be avoided unless required to treat hypoxia, as it may lead to carbon dioxide retention. |
| 3. TRUE/FALSE - these are useful in the management of severe bronchiolitis. D. IV fluids | True. IV fluids are indicated in infants with moderate to severe bronchiolitis as they may be unable to feed owing to increased WOB (or feeds may be withheld for risk of aspiration so IV fluids may be necessary). Fluid requirements may be heightened owing to increased losses secondary to fever and tachypnoea. Fluid intake and urine output need to be carefully monitored and signs of fluid overload sought as children with bronchiolitis are predisposed to the syndrome of inappropriate ADH secretion (SIADH). NG fluids are an alternative. |
| 3. TRUE/FALSE - these are useful in the management of severe bronchiolitis. E. Continuous positive airway pressure (CPAP) | True. In children with severe lung pathology, CPAP may be required to provide adequate respiratory support. Those not responding to CPAP or showing signs of respiratory fatigue (decreased respiratory effort, progressive hypoxia or hypercapnia on blood gas) will require assisted ventilation. |
| 3. TRUE/FALSE - these are useful in the management of severe bronchiolitis. F. Cold and flu medications | False. There is no proven benefit from cold/ flu medications. These can promote secondary infection and have their own side effects. |
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