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Respiratory block > Lower respiratory tract infection in children > Flashcards

Lower respiratory tract infection in children Flashcards

1
Q

What are common infective agents ?

A 
Bacterial:
    - strep pneumoniae
    - haemophilus influenzae
    - Moraxella catarrhalis
    - mycoplasma pneumoniae
    - chlamydia pneumoniae 
Viral:
    - RSV
    - parainfluenzae III
    - influenza A + B
    - adenovirus
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2
Q

What is tracheitis ?

A

Inflammation of the trachea

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3
Q

What is the description of tracheitis ?

A

Croup which doesn’t get better

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4
Q

What are the symptoms of tracheitis ?

A

Fever
Swollen tracheal wall
Narrow tracheal lining
Luminal debris

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5
Q

What are the common causative agents for tracheitis ?

A

Staph or strep infection

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6
Q

What is the treatment of tracheitis ?

A

Augmentin

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7
Q

How common is bronchitis ?

A

Very common

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8
Q

What are the symptoms of bronchitis ?

A

Loose rattily cough with URTI
Post-tussive vomit - ‘glut’
Chest free of wheeze and creps

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9
Q

Is bronchitis self-limiting ?

A

Yes

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10
Q

What is the causative agents for bronchitis ?

A

Haemophilus/Pneumococcus

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11
Q

What is the mechanism of bacterial bronchitis ?

A

Disturbed mucocilary clearance

- minor airway malacia
- RSV/adenovirus
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12
Q

What does bacterial bronchitis usually follow on from ?

A

URTI

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13
Q

What is Bronchiolitis defined as ?

A

A lower respiratory tract infection of infants

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14
Q

What % of children are usually affected by bronchiolitis ?

A

30-40%

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15
Q

What is the cause of bronchiolitis ?

A

RSV (Respiratory Syncytial Virus)

Parainfluenza 3, HMPV (human metapneumovirus)

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16
Q

What are the symptoms of bronchiolitis ?

A

Nasal Stiffness
Tachypnoea
Poor feeding
Crackles +/- wheeze

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17
Q

When is the peak incidence of Bronchiolitis ?

A

3 months

18
Q

What separates bronchiolitis from asthma ?

A

Bronchiolitis is a 2 week infection from start to finish, asthma is recurrent

19
Q

What are the differences between LRTIs and bronchiolitis ?

A

LTRI:

- in all ages
- more rapid onset of symptoms
- fever

Bronchiolitis:

- ages <12 months
- 3 days before reach peak
- fever rarely >38°C
20
Q

Why does feeding have complications during the course of bronchiolitis ?

A

It is essentially exercise for the baby who is unused to the idea of breathing through the mouth, nose is blocked
Feeding the baby now has complications

21
Q

What is the management of bronchiolitis ?

A

Maximal observation

Minimal intervention

22
Q

What does an NPA involve ?

A

A catheter (or tube) is inserted a short distance into your child’s nose (this should occur with minimal discomfort to your child)
Gentle suction is used to collect some mucus
The mucus is then sent to the laboratory for
testing

23
Q

What tests are there no need for in bronchiolitis ?

A

CXR
Bloods
Bacterial cultures

24
Q

What are the relevant investigations for bronchiolitis ?

A

Nasopharyngeal aspirate

Oxygen saturation to determine severity

25
Q

Are there any medications proven to help bronchiolitis ?

A

No

26
Q

What is the definition of a LRTI ?

A

48 hours of fever (above 38.5 degrees)
SOB
cough and grunting

27
Q

What can you infer from wheeze ?

A

Bacterial cause is unlikely

28
Q

How do you confirm a lower respiratory tract infection ?

A

Reduced or bronchial breath sounds

29
Q

What are the infective agents for LRTI ?

A

Viruses in <35% (higher in younger)
Bacteria Pneumococcus, Mycoplasma, Chlamydia
Mixed infection in <40%

30
Q

How can you tell if the LRTI is pneumonia ?

A

Signs are focal (one side of the chest)
Creps – fine crackles
High fever

31
Q

What are the possible investigations for community acquired pneumonia ?

A

CXR -(rarely going to help) and inflammatory makers NOT “routine”

32
Q

What is the management for community acquired pneumonia ?

A 
Nothing if symptoms are mild
(always offer to review if things get worse!)
Oral Amoxycillin first line
Oral Macrolide second choice
Only for iv if vomiting
33
Q

When would you consider antibiotics for an LRTI ?

A

After 48 hour history exists

34
Q

What is the only thing that causes coughing fits ?

A

Pertussis

35
Q

What is pertussis also known as ?

A

Whooping cough

36
Q

What are the symptoms of pertussis ?

A

Vomiting

Colour change

37
Q

Is pertussis common ?

A

Yes

38
Q

What reduces the risk and severity of pertussis ?

A

Vaccination

39
Q

What is empyema ?

A

Extension of infection into pleural space

40
Q

Where can empyema arise from ?

A

Complications of pneumonia

41
Q

What are the symptoms of empyema ?

A

Chest pain

Very unwell

42
Q

What is the treatment of empyema ?

A

Antibiotics

Drainage

Respiratory block (38 decks)

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