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Questions and Answers
Which of the following is NOT a typical physiological change that occurs during an asthma attack?
Which of the following is NOT a typical physiological change that occurs during an asthma attack?
A patient presents with asthma symptoms primarily triggered by pollen, pet dander and mold. Which type of asthma is most likely?
A patient presents with asthma symptoms primarily triggered by pollen, pet dander and mold. Which type of asthma is most likely?
Which of these factors is most likely to trigger intrinsic asthma?
Which of these factors is most likely to trigger intrinsic asthma?
A patient experiences coughing, wheezing, and shortness of breath that began 10 minutes after they started exercising. What condition does the patient have?
A patient experiences coughing, wheezing, and shortness of breath that began 10 minutes after they started exercising. What condition does the patient have?
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Which of the following is a common symptom of asthma?
Which of the following is a common symptom of asthma?
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What is the primary characteristic of status asthmaticus?
What is the primary characteristic of status asthmaticus?
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Which of the following is NOT an effect of inhaled corticosteroids when used daily over a long period?
Which of the following is NOT an effect of inhaled corticosteroids when used daily over a long period?
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What is the primary action of bronchodilators in treating asthma?
What is the primary action of bronchodilators in treating asthma?
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A child with an asthma exacerbation is not treated quickly and progresses to respiratory failure without intubation. What is the most severe risk?
A child with an asthma exacerbation is not treated quickly and progresses to respiratory failure without intubation. What is the most severe risk?
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Which class of medication is typically used on a daily basis to prevent inflammation in the airways?
Which class of medication is typically used on a daily basis to prevent inflammation in the airways?
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For long-term use, what consideration is important when using bronchodilators?
For long-term use, what consideration is important when using bronchodilators?
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What is the expected time frame for symptom improvement after using short-acting bronchodilators?
What is the expected time frame for symptom improvement after using short-acting bronchodilators?
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Which of the following is NOT a typical symptom of croup?
Which of the following is NOT a typical symptom of croup?
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Leukotriene modifiers, such as montelukast, are primarily used for what purpose in respiratory treatment?
Leukotriene modifiers, such as montelukast, are primarily used for what purpose in respiratory treatment?
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What is the primary characteristic of mucus in cystic fibrosis?
What is the primary characteristic of mucus in cystic fibrosis?
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The majority of cases of acute bronchitis are caused by which type of pathogen?
The majority of cases of acute bronchitis are caused by which type of pathogen?
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Which of the following class of medications is most likely to improve the effectiveness of corticosteroids and allow for lower doses?
Which of the following class of medications is most likely to improve the effectiveness of corticosteroids and allow for lower doses?
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Which of the following is NOT a classification of Croup provided?
Which of the following is NOT a classification of Croup provided?
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Which of the following is NOT a typical symptom of acute bronchitis?
Which of the following is NOT a typical symptom of acute bronchitis?
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Typically, how long does a cough last when someone has acute bronchitis?
Typically, how long does a cough last when someone has acute bronchitis?
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Which of the following is not a treatment approach for acute bronchitis?
Which of the following is not a treatment approach for acute bronchitis?
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Which of the following is NOT a typical symptom of cystic fibrosis?
Which of the following is NOT a typical symptom of cystic fibrosis?
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Which non-pharmacological treatment is primarily used to address respiratory issues in cystic fibrosis?
Which non-pharmacological treatment is primarily used to address respiratory issues in cystic fibrosis?
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What is the primary purpose of using hypertonic saline in the treatment of cystic fibrosis?
What is the primary purpose of using hypertonic saline in the treatment of cystic fibrosis?
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Which medication helps keep airways open in individuals with cystic fibrosis by relaxing the bronchial muscles?
Which medication helps keep airways open in individuals with cystic fibrosis by relaxing the bronchial muscles?
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What is the main use of oral pancreatic enzymes in treating cystic fibrosis?
What is the main use of oral pancreatic enzymes in treating cystic fibrosis?
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A patient with cystic fibrosis has difficulty with nutrient absorption and is experiencing constipation. Which two types of medications could be used to treat these problems?
A patient with cystic fibrosis has difficulty with nutrient absorption and is experiencing constipation. Which two types of medications could be used to treat these problems?
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Which of the following is considered a breakthrough medication, approved for people 12 years and older with cystic fibrosis?
Which of the following is considered a breakthrough medication, approved for people 12 years and older with cystic fibrosis?
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At what age is the medication Symdeko approved for use in individuals with cystic fibrosis?
At what age is the medication Symdeko approved for use in individuals with cystic fibrosis?
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What is the primary characteristic of epiglottitis that distinguishes it from the symptoms of cystic fibrosis?
What is the primary characteristic of epiglottitis that distinguishes it from the symptoms of cystic fibrosis?
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Study Notes
Respiratory Disorders
- Acute Otitis Media (AOM): Inflammation of the middle ear, common in children aged 6 months to 3 years. Incidence higher during winter months.
- AOM Causes: Bacterial (Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae) and viral (RSV, rhinoviruses, influenza, adenoviruses).
- AOM Symptoms: Ear pain (pulling, difficulty eating/lying down), fever, irritability, loss of appetite, ear canal drainage, nasal congestion/cough, vomiting/diarrhea.
- AOM Treatment: Analgesics (pain relief) for children aged 6-23 months with non-severe unilateral otitis media. Antibiotics are often given if symptoms don't improve after 48-72 hours. Myringotomy (incision) may be needed to promote drainage and reduce pressure. Tympanoplasty ventilating tubes can also be used.
- Asthma: A long-lasting inflammatory condition of the airways leading to periodic blockages, exaggerated airway response to triggers. Caused by bronchial spasms, excess mucus, and airway lining swelling.
- Asthma Attacks: Lungs become inflamed causing mucus buildup, swelling, tightening of airway muscles, leading to a cycle of anxiety and physical reactions.
- Asthma Triggers: Exercise, viral/bacterial agents, allergens (mold, dust, pollen), pollutants, changes in weather, food additives, and animal dander.
- Asthma Types: Extrinsic (atopic) – often allergic to external triggers (pollen, pet dander, dust mites, mold etc.). Intrinsic (nonatopic) – internal factors (irritants, emotional stressors, fatigue, infections). Exercise-induced asthma – airways constrict after physical activity.
- Asthma Severity Levels: Intermittent, mild, moderate, severe (based on frequency of symptoms/exacerbations, activity level, lung function results). Symptoms, nighttime issues, need for medication frequency details included in each level.
- Status Asthmaticus: Severe, persistent respiratory distress, bronchospasm even after medical treatment, may require mechanical ventilation. Untreated can lead to death.
- Asthma Treatment: Preventing flare-ups using medications, managing environmental triggers, and providing education/support to both the child and parents. Goal is to optimize respiratory function.
- Anti-inflammatory Medications (Asthma): Inhaled corticosteroids (e.g., fluticasone, budesonide) reduce airway swelling, but can have side effects (glucose issues, appetite, fluid retention, weight gain, mood changes, growth/blood pressure).
- Bronchodilators (Asthma): Relax smooth muscles in the airways providing quick relief for moderate/severe symptoms. Short-acting beta-agonists (SABAs) provide fast relief, often used for exercise-induced bronchospasm. Common examples include albuterol, metaproterenol, levalbuterol, pirbuterol. Used for immediate relief, daily management, nighttime symptoms, and exercise-induced bronchospasm.
- Leukotriene Modifiers (Asthma): Used alongside steroids to prevent bronchospasm, improve lung function. Possible side effects include diarrhea, inflammation, throat issues, nausea, ear/sinus infections, headaches.
- CROUP (Acute Laryngotracheobronchitis): Group of infectious diseases with laryngeal obstruction as the common feature.
- CROUP Diseases: Acute laryngitis, epiglottitis, acute laryngotracheitis, laryngitis, tracheobronchitis.
- CROUP Symptoms: Rhinitis, sore throat, fever, stridor, barking cough, hoarseness, dyspnoea. Details available on presentation descriptions.
- CROUP Treatment: Treatment varies by severity level ranging from oral/IV antibiotics to nebulisation to ensure rapid treatment/improvement. Detailed on presentation descriptions.
- Acute Bronchitis: Infectious disease affecting large/medium bronchi, characterized by a cough lasting up to 3 weeks.
- Acute Bronchitis Classification: Acute, chronic bacterial bronchitis, chronic bronchitis.
- Acute Bronchitis Reasons: Primarily viral (RSV, rhinoviruses, parainfluenza, influenza, adenoviruses, coronaviruses, bocaviruses), but bacterial (Mycoplasma pneumoniae, Chlamydophilia pneumoniae) are also possible.
- Acute Bronchitis Symptoms: Runny nose (3-4 days), cough (initially dry, then productive), high fever, deep/rapid breathing.
- Acute Bronchitis Treatment: Hydration, proper temperature and air humidity, antipyretics, mucolytic drugs.
- Cystic Fibrosis (CF): Genetic condition affecting a protein causing mucus to become thick/sticky. Blockages, damage, and infections in affected organs like the respiratory/digestive tract, and other areas possible.
- CF Classification: Cystic fibrosis with systemic symptoms (respiratory, digestive tract, other organs), and undefined.
- CF Symptoms: Bronchitis, pneumonia, pancreatic exocrine insufficiency, infertility in men.
- CF Treatment: Non-pharmacological (physiotherapy to clear secretions, nutritional treatment to maintain proper weight), and drug treatment addressing associated symptoms.
- Epiglottitis: Severe inflammation of the epiglottis, often in children aged 2-5 years. Characterised by airway blockage.
- Epiglottitis Cause: Infection with Haemophilus influenzae type B (Hib), but other bacteria (Streptococcus pneumoniae, Group A, B, C streptococci) also possible.
- Epiglottitis Symptoms: Sore throat, pain/difficulty swallowing (dysphagia). "Frog in the throat" sensation, muffled voice, inspiratory stridor, snoring sound during exhalation, drooling, toxic appearance, high fever, irritability, restlessness, retractions of the chest, rapid heart rate, weak pulse (tripod position)
- Epiglottitis Treatment: Prevention using the Hib conjugate vaccine (from 2 months of age). Intravenous (IV) and oral antibiotics (7-10 days). Corticosteroids in certain cases to reduce swelling during early stages. Continuous monitoring after initial treatment.
- Pneumonia: Acute infection/inflammation of the lung tissue (bronchioles, alveolar ducts, sacs, alveoli) disturbing normal gas exchange.
- Pneumonia Cause: Viral (RSV, influenza, parainfluenza, rhinovirus, adenovirus), bacterial (pneumococci, streptococci, staphylococci), mycoplasma, and inhaling foreign substances.
- Pneumonia Symptoms: Infants/Infants may show symptoms such as vomiting, seizures, poor feeding, irritability, fever, stiff neck, bulging fontanel, cyanosis around the mouth, respiratory distress, diminished breath sounds, crackles, and pleural friction rub. Older children may show symptoms such as headache, chest/abdominal pain, high fever, periods of drowsiness/restlessness, tachycardia, tachypnea, dry cough, expiratory grunting, cyanosis, reduced breath sounds, crackles(lung consolidation), moist crackles/blood-tinged mucus.
- Pneumonia Types: Lobar (large segment of one/more lung lobes), Broncho (terminal bronchioles/nearby lobules), Interstitial (alveolar/peribronchial tissues), Aspiration (fluid or food substance inhalation).
- Pneumonia Treatment: Managing symptoms (pain, fever). Supportive care (airway, hydration). Specific antibiotic treatment targeting the organism. Anti-inflammatory medications for some patients. Pneumococcal conjugate vaccine (PCV-13) for prevention.
References (Sources)
- Meadows-Oliver, M. (2015). Pediatric Nursing Made Incredibly Easy. Wolters Kluwer.
- Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/diagnosis-treatment/drc-20353706
- RCH - https://www.rch.org.au/clinicalguide/guideline_index/croup_laryngotracheobronchitis/
- NCBI - https://www.ncbi.nlm.nih.gov/books/NBK448067/
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Test your knowledge on asthma management with this quiz. It covers symptoms, triggers, treatments, and the physiological changes associated with asthma attacks. Perfect for medical students and healthcare professionals.
