Lower Respiratory Tract Infection in Children Flashcards

1
Q

What are common bacterial infective agents?

A

Strep pneumoniae

Haemophillus influence

Moraxella catarrhalis

Mycoplasma pneumoniae

Chlamydia pneumoniae

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2
Q

What are common viral infective agents?

A

RSV

Parainfluenza III

Influenza A and B

Adenovirus

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3
Q

What are the principles of patient management?

A

Make a diagnosis

Assess the patient

Decide to treat or not to treat

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4
Q

Is the prevalence of lower respiratory tract infections increasing or decreasing?

A

Increasing

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5
Q

How common is tracheitis?

A

Uncommon

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6
Q

What can tracheitis be described as?

A

Croup which does not get better

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7
Q

What are symptoms of tracheitis?

A

Fever

Sick child

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8
Q

What is tracheitis usually caused by?

A

Staph or strep invasive infection

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9
Q

Why does tracheitis lead to struggling to breath?

A

Swollen tracheal wall and luminal debris narrows the tracheal lumen

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10
Q

How common is bronchitis?

A

Common

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11
Q

What are symptoms/signs of bronchitis?

A

Loose rattly cough with upper respiratory tract infection

Poast-tussive vomit

Chest free of wheeze/creps

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12
Q

What is bronchitis usually caused by?

A

Haemophilus

Pneumococcus

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13
Q

Why does bacterial bronchitis cause problems?

A

Disturbed mucociliary clearance

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14
Q

What kind of infection is bacterial bronchitis normally?

A

Secondary infection

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15
Q

How long can a cough last for with bronchitis?

A

25 days

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16
Q

What is a typical natural history of bacterial bronchitis?

A

Following upper respiratory tract infection

Lasts 4 weeks

60-80% respond

First winter bad

Second winter better

Third winter fine

Caused by pneumococcus/H flu

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17
Q

What should you do when you see persistant bacterial bronchitis?

A

1) Make the diagnosis
2) Reassure
3) Do not treat

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18
Q

Who does bronchiolitis normally affect?

A

Infants

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19
Q

What percentage of all infants does bronchiolotis affect?

A

30-40%

20
Q

What is bronchiolitis normally caused by?

A

RSV

Paraflu

HMPV

21
Q

What are symptoms of bronchiolitis?

A

Nasal stuffiness

Tachypnoea

Poor feeding

Crackles

Maybe wheeze

22
Q

What long can brionchiolitis last?

A

More than 16 days

23
Q

When do RSV cases peak?

A

During winter, especially around winter

24
Q

What is usually seen when diagnosis bronchiolitis?

A

<12 months old

One of (not recurrent)

Typical history

25
Q

What is the management of bronchiolitis?

A

Maximal observation

Minimal intervention

26
Q

What investigations should be done for bronchiolitis?

A

Nasopharyngeal asparate (NPA)

Oxygen saturations

27
Q

What medication is proven to work for bronchiolitis?

A

None

28
Q

What are common symptoms for lower respiratory tract infections?

A

Fever (>38.5oC)

Shortness of breath

Cough

Grunting

Reduced or bronchial breath sounds

Wheeze if viral

29
Q

If a wheeze is heard in a lower respiratory tract infection what does it make unlikely?

A

Bacterial infection

30
Q

What can be said about the word pneumonia?

A

It causes great anxiety

31
Q

What are chest X-rays only used for with pneumonia?

A

To support clinical findings

32
Q

What is not routine for community acquired pneumonia?

A

Chest X-ray

Inflammatory markers

33
Q

What does the management of community acquired pneumonia involve?

A

Nothing if the symptoms are mild

Oral amoxicillin first line

Oral macrolide second choice

Only use IV if vomiting

34
Q

When should you use an IV antibiotic for pneumonia?

A

If the patient is vomiting

35
Q

What medicines are the first and seconds lines for community acquired pneumonia?

A

Amoxicillin is first line

Macrolide is second line

36
Q

What are advantages of oral antibiotics vs IV?

A

Shorter hospital stay

Cheaper

37
Q

What is the advantage of IV antibiotics instead of oral?

A

Fever cleared quicker

38
Q

When should you use oral antibiotics?

A

Antiobiotics are indicated

Non-severe lower respiratory tract infection

Child is not vomiting

39
Q

What is pertussis also known as?

A

Whooping cough

40
Q

What is the other name for whooping cough?

A

Pertussis

41
Q

How common is pertussis?

A

Common

42
Q

What reduces the risk and severity of pertussis?

A

Vaccination

43
Q

What are symptoms of pertussis?

A

Coughing fits

Vomiting

Colour change

44
Q

What is empyaema?

A

Extension of infection into pleural space

45
Q

What is a possible complication of pneumonia?

A

Empyema

46
Q

What are the symptoms of empyema?

A

Chest pain

Very unwell

47
Q

What is the prognosis of empyema like in children compared to adults?

A

Very good in children compared to adults