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Respiratory medicine > L15 - URTI / LRTI in children > Flashcards

L15 - URTI / LRTI in children Flashcards

1
Q

Presentation of URTIs inchildren

A
  • Coryza (cold)
  • sore throat
  • ear ache
  • sinusitis (uncommon)
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2
Q

Presentation of LRTIs in children

A
  • cough
  • wheeze
  • respiratory dsitress
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3
Q

Treating a child with the common cold?

A

Pain treated with paracetamol or ibuprofen.

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4
Q

Describe pharyngitis?

A
  • Pharynx and soft palate inflamed.
  • Local lymph nodes are enlarged and tender.
  • Usually due to viral infection.
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5
Q

Pharyngitis commonly caused by?

A

Adenoviruses
Enteroviruses
Rhinoviruses

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6
Q

What is acute otitis media?

A

Ear pain and fever.

Most common in children between 6-12 months

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7
Q

On examination of a child with acute otitis media, what might be seen?

A

Tympanic membrane seen to be bright and red, bulging.

Less of normal light reflection.

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8
Q

Indications for tonsilectomy?

A
  • Recurrent severe tonsilitis
  • Perionsillar abscess (quincy)
  • Obstructive sleep apnoea
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9
Q

Stridor

A

Due to partial obstruction of lower portion of upper airway, including upper trachea and pharynx.

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10
Q

Croup

A
  • Barking cough like sea lion.
  • Harsh stridor.
  • Variable degree of difficulty breathing with chest retraction.
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11
Q

Whooping cough caused by…

A

Bacterium bordetella pertussis.

Spread from person to person by airborne droplets.

Sudden attack (paroxysm) of coughs followed by whoop.

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12
Q

Acute bronchitis

A

Inflammatory condition

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13
Q

Bronchiolitis

A

Bronchioles of young child swollen by inflammation.

Passage of air to and from alveoli difficult.

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14
Q

Give an example of a cause of bronchiolitis and pneumonia in infants

A

RSV - Respiratory synctial virus

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15
Q

Describe what happens if RSV inhaled

A
  • Virus establishes infection in the nasopharynx and lower respiratory tract.
  • Young infant develops cough, rapid respiratory rate and cyanosis.
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16
Q

How might a neonate develop interstital pneumonia at birth?

A

Caused by chlamydia trachomastis acquired from the mother at birth.

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17
Q

Pneumonia

A

Infection that inflames the air sacs in one or both lungs.

Sac’s may fill with fluid or pus.

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18
Q

Patients with pneumonia usually present feeling unwell and have…

A
  1. Chest pain: may be pleuritic in nature
  2. Cough: may produce sputum
  3. Dyspnoea: shortness of breath
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19
Q

An X-ray of patient with pneumonia may show…

A

Shadow’s indicating consolidation.

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20
Q

What virus causes measles?

A

Rubeola virus

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21
Q

Incubcation period and symtpoms of measles

what are koplik’s spots?

A

Incubation period 10-14 days.

Symptoms: fever, runny nose, conjunctivitis, cough

Koplik’s spots: white lesions on buccal mucosa.

Rash 1-2 days after

22
Q

Where does the rubeola virus replicate?

A

Epithelium of nasopharynx, middle ear and lung

23
Q

TB causes by…

A

Mycobacterium tuberculosis

Aerosol transmission

24
Q

Broncholitis

A

Inflammatory condition of tracheobronchial tree.

Characterised by cough and excessive mucus production.

25
Q

B. Pertussis colonises…

A

Ciliated respiratory epithelium causing the specifically human infection - whooping cough.

26
Q

Empyema

A

Infection of pleural space

27
Q

What may be given for relief, to patients with severe upper airway obstruction?

A

Nebulished epinephrine with oxygen

28
Q

Acute epiglotitis

often caused by?

A

Intense swelling of the epiglottis and surrounding tissue.

Usually caused by H.influenzae type B.

Onset is usually very acute.

29
Q

Describe what symptoms a child with epiglotitis may present with?

A
  • Increased fever
  • very ill
  • intensely painful throat that prevents child from speaking or swallowing
  • soft inspiratory stridor
  • child sitting immobile, with an open mouth to optimize the airway
30
Q

Symptoms of viral illness (common cold)

A 
Nasal discharge 
Sneezing 
Painful throat / ears 
Pyrexia 
Headache 
Malaise
31
Q

Signs of viral illness

A
  • Red pharynx
  • pus
  • bilateral red tympanic membranes
  • yellow / green discharge
32
Q

Tonsilitis commonly caused by…

A

Group A streptococcus

- may require throat swab

33
Q

Treatment of tonsilitis

A

Analgesia

Antibiotics is bacterial infection

34
Q

Treatment for croup

A

Dexamethasone (corticosteroid)

- decreases laryngeal mucosal edema.

35
Q

What score is used evaluate the severity of croup?

A

Westley score: assesses five factors

  1. Level of consciousness
  2. Cyanosis
  3. Stridor
  4. Air entry
  5. Retractions
36
Q

Epiglottitis may be caused by

A

Haemophilus influenza type B

37
Q

Bronchiolitis may be caused by…

A

Human metepneumovirus
Adenovirus
Influenza

38
Q

Signs of bronchioitis

A 
Tug 
Nasal flare 
Head bob 
Recession 
Crackles 
Wheeze on chest examination
39
Q

Symptoms of pneumonia

A 
Pyrexia 
Lethargy 
Breathlessness 
Cough 
Chest pain 
Abdominal pain
40
Q

Signs of pneumonia

A 
Pyrexia 
Tachcardia 
Tachypnoea 
Desaturation 
Recession 
Crepitations 
Wheeze
41
Q

Pneumonia caused by…

A

Under 5s: RSV, strep pneuomoniae, mycoplasma, viruses

Over 5s: strep pneumoniae, mycoplasma, viruses

42
Q

Possible investigations for Pneuomonia

A

CXR

Cough swab

43
Q

Symptoms of empyema: patient might have?

A
  • Fever
  • cough
  • breathlessness
  • lethargy
  • malaise
  • reduced exercise tolerance
44
Q

Signs of empyema

A
  • Reduced chest expansion
  • reduced breath sounds
  • stony dull on percussion
45
Q

Causes of empyema

A

Strep pneuomoniae, staph aureas

46
Q

Investigations for empyema

A

Blood culture
Pleural fluid PCR and culture
CXR
USS

47
Q

Possible treatment for empyema

A

antiobiotics, chest drain

48
Q

Describe a lung abscess

A

Pus in cavity in lung parenchyma.

49
Q

Describe how a lung abscess may form

A

Pneumonitis
Necrosis
Cavitation
Abscess formation

50
Q

Types of TB

A

Latent
- immune system can’t kill bacteria, but prevents it spreading to body
Active
- immune system fails to kill or contain the infection and it spreads within lungs/ body. symptoms develop.

Latent TB can develop into an active TB disease at a later date.

51
Q

Describe nontuberculous mycobacteria

A

Mycobacteria which do not cause TB.
Resembles TB.
Difficult to eradicate.
Incidence rising in CF patients.

Respiratory medicine (16 decks)

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