Child health- resp Flashcards
what is pneumonia
common lrt infection caused by inflammation of the lung tissue
what causative organism of pneumonia is common in children and young adults and peaks every 4 years
mycoplasma pneumonia
risk factors for pneumonia in children under 5
malnutrition
overcrowding
indoor air pollution
parental smoking
clinical features of tuberculosis in children
chronic cough/fever >2 weeks
night sweats
weight loss
lymphadenopathy
risk factors for Tb in children
HIV
malnutrition
household contact
treatment of tb
2 months RIPE- rifampicin, izoniazid, pyrazinimide, ethambutol
then 4 months RI
what is bronchiolitis
inflammation of the bronchioles
cause of bronchiolitis
viral- 80% RSV
what is the most common cause of a serious LRT infection in children under 1 years
bronchiolitis
who is bronchiolitis most common in
children under 1 years, most commonly children under 6 months
clinical features of bronchiolitis
diffuse crackle
dyspnoea
tachypnoea
poor feeding
mild fever
apnoeas
newborn babies can only breathe through their nose true/false
true- 3-6 months begin to breathe through mouth
immediate referral to hospital for bronchiolitis in children when-
apnoea
child looks seriously unwell
severe respiratory distress (grunting, chest movements, rr>70)
central cyanosis
o2 <92%
investigation for bronchiolitis
PCR- throat/pernasal swabs
management of bronchiolitis
supportive
what is croup
common childhood illness usually caused by inflammation of the urt as a result of a (usually) viral infection
which age group does croup usually affect
children aged 6 months-6 years old, most commonly children <3 years old
which seasons is croup most common in
autumn
winter
which viruses are the main causes of croup
most commonly parainfluenza I
parainfluenza II, III, IV
RSV
adenovirus
characteristic barking cough, hoarseness, stridor-
croup
management of croup
supportive, steroids if severe (eg dexamethasone), mortality rate low
moderate, severe, and life threatening peak flow readings
moderate- >50%
severe- <50%
life threatening- <33%
features suggesting very severe life threatening asthma attacks
high PaCO2 >6kPa
PaO2 <8kPa
first line IV therapy for children not responding to initial bronchodilators in acute asthma attacks
IV magnesium sulphate
nebulisers used in the management of acute asthma attacks
5mg salbutamol and 0.5mg ipratropium bromide
what should be given initially in management of acute asthma attacks before IV therapy is considered
nebulisers and steroids (oral or IV)
features of life-threatening asthma- 33,92 CHEST
PEF <33%
SO2 <92%
cyanosis
hypotension
exhaustion, altered consciousness
silent chest
tachyarrhythmias
intrinsic/extrinsic asthma causes 90% of childhood cases of asthma
extrinsic asthma- atopic individuals
typical triggers in atopic asthma
infection
night time/early morning
exercise
animal dander
cold/damp
dust
strong emotions
symptoms of asthma
wheezing attacks and episodic shortness of breath
reduced exercise tolerance
cough is frequent
symptoms worse at night
spirometry reading in patients with asthma
FEV1/FVC <0.7
peak flow variability in asthma patients
> 20%
FENO in asthma patients
> 40ppb in adults
35ppb in children
what improvement in FEV1 after bronchodilator use is typically required to support a diagnosis of asthma
12%
most likely chest XRAY finding in patients with asthma
hyperinflation
what should be given in management of severe croup if there is significant concerns about the airway
nebulised adrenaline
common cold virus-
rhinovirus, RSV
which pathogens are the most common causes of epiglottis
hib- h influenza type b- incidence decreased due to vaccines
streptococcus (most common)
staph aureus
pseudomonas
typical age range of epiglottis
ages 2-7
clinical features of epiglottis
sudden onset
drooling, unable to swallow
constant, soft stridor
muffled voice
fever
gold standard test for epiglottis
laryngoscopy
what sign is seen in epiglottis on a lateral neck X-RAY
‘thumb-print’ sign
antibiotic used in epiglottis
ceftriaxone
pathogen of ‘whopping cough’ (pertussis)
bordatella pertussis
what other symptoms are associated with ‘whooping cough’
vomiting
cyanosis
first line investigation for pertussis
pernasal swab
most sensitive investigation for pertussis
PCR
