Short cases in Respiration: in paediatrics-final MBBS

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This is not a complete note or a guide. This was prepared by me based on the teachings of Dr.R.M.Mudiyanse just to aid the short cases.

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Short cases in Respiration: in paediatrics-final MBBS

  1. 1. Why persistent? Nearby spacer/MDI/ DPI 3. Pleural effusion with some respiratory distress probably a child who is recovering from DHF. Why recovering from DHF? Recovery rash, flushing, 2 cannula either side Why respiratory distress? Tachypnea. So COUNT RR/HR Respiration short cases BA Bronchiolitis PE Bronchiectasis 1. 2. 3. 4. Pathology Severity Acute/chronic Complications: FTT/ HF Pathology 1. Upper airway: stridor 2. Lower airway: U/L or B/L diffuse or localized 3. Pleural effusion 4. Systemic: Pleural effusion in DHF pt who is recovering (NOT just dengue fever) Emphysematous chest, B/L rhonchi, Eczema → BA If clubbing + → can’t be BA. May be bronchiectasis/ chr lung Dx Features of hyperinflation (→bronchiolitis) 1. Barrel shaped chest 2. Hyper-resonant over the liver 3. Hyper-resonant over the heart Severity: Effort, Efficacy, Effects Effort 1. Recessions 2. Respiratory rate 3. Stridor 4. Grunting 5. Accessory muscles use 6. Flare of Alea nasi Efficacy 1. Air entry – silent chest is a dangerous sign. 2. Chest expansion 3. Cyanosis, hypoxia (pulse oxymeter, 92%) Effects 1. CNS -Drowsy, agitation 2. CVS – Pallor, bradycardia, tachycardia. Why do you say this is severe asthma? Comprehensive diagnosis-e.g. 1. Moderately severe bronchiolitis in a child with FTT. 2. BA with mild distress in a child probably with persistent asthma who has an eczema as well. Yapa Wijeratne

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