Lower Respiratory Tract Infection in Children

Question 1

What infection is associated with A?

Answer 1

Pneumonia

Question 2

What infection is associated with B?

Answer 2

Bronchitis

Question 3

What infection is associated with C?

Answer 3

Empyema

Question 4

What infection is associated with D?

Answer 4

Bronchiolitis

Question 5

What infection is associated with E?

Answer 5

Tracheitis

Question 6

What are common bacterial infective agents?

Answer 6

Strep pneumoniae

Haemophillus influence

Moraxella catarrhalis

Mycoplasma pneumoniae

Chlamydia pneumoniae

Question 7

What are common viral infective agents?

Answer 7

RSV

Parainfluenza III

Influenza A and B

Adenovirus

Question 8

What are the principles of patient management?

Answer 8

Make a diagnosis

Assess the patient

Decide to treat or not to treat

Question 9

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

Answer 9

Increasing

Question 10

How common is tracheitis?

Answer 10

Uncommon

Question 11

What can tracheitis be described as?

Answer 11

Croup which does not get better

Question 12

What are symptoms of tracheitis?

Answer 12

Fever

Sick child

Question 13

What is tracheitis usually caused by?

Answer 13

Staph or strep invasive infection

Question 14

Why does tracheitis lead to struggling to breath?

Answer 14

Swollen tracheal wall and luminal debris narrows the tracheal lumen

Question 15

How common is bronchitis?

Answer 15

Common

Question 16

What are symptoms/signs of bronchitis?

Answer 16

Loose rattly cough with upper respiratory tract infection

Poast-tussive vomit

Chest free of wheeze/creps

Question 17

What is bronchitis usually caused by?

Answer 17

Haemophilus

Pneumococcus

Question 18

Why does bacterial bronchitis cause problems?

Answer 18

Disturbed mucociliary clearance

Question 19

What kind of infection is bacterial bronchitis normally?

Answer 19

Secondary infection

Question 20

How long can a cough last for with bronchitis?

Answer 20

25 days

Question 21

What is a typical natural history of bacterial bronchitis?

Answer 21

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

Question 22

What should you do when you see persistant bacterial bronchitis?

Answer 22

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

Question 23

Who does bronchiolitis normally affect?

Answer 23

Infants

Question 24

What percentage of all infants does bronchiolotis affect?

Answer 24

30-40%

Question 25

What is bronchiolitis normally caused by?

Answer 25

RSV Paraflu HMPV

Question 26

What are symptoms of bronchiolitis?

Answer 26

Nasal stuffiness Tachypnoea Poor feeding Crackles Maybe wheeze

Question 27

What long can brionchiolitis last?

Answer 27

More than 16 days

Question 28

When do RSV cases peak?

Answer 28

During winter, especially around winter

Question 29

What is usually seen when diagnosis bronchiolitis?

Answer 29

\<12 months old One of (not recurrent) Typical history

Question 30

What is the management of bronchiolitis?

Answer 30

Maximal observation Minimal intervention

Question 31

What investigations should be done for bronchiolitis?

Answer 31

Nasopharyngeal asparate (NPA) Oxygen saturations

Question 32

What medication is proven to work for bronchiolitis?

Answer 32

None

Question 33

What are common symptoms for lower respiratory tract infections?

Answer 33

Fever (\>38.5^oC) Shortness of breath Cough Grunting Reduced or bronchial breath sounds Wheeze if viral

Question 34

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

Answer 34

Bacterial infection

Question 35

What can be said about the word pneumonia?

Answer 35

It causes great anxiety

Question 36

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

Answer 36

To support clinical findings

Question 37

What is not routine for community acquired pneumonia?

Answer 37

Chest X-ray Inflammatory markers

Question 38

What does the management of community acquired pneumonia involve?

Answer 38

Nothing if the symptoms are mild Oral amoxicillin first line Oral macrolide second choice Only use IV if vomiting

Question 39

When should you use an IV antibiotic for pneumonia?

Answer 39

If the patient is vomiting

Question 40

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

Answer 40

Amoxicillin is first line Macrolide is second line

Question 41

What are advantages of oral antibiotics vs IV?

Answer 41

Shorter hospital stay Cheaper

Question 42

What is the advantage of IV antibiotics instead of oral?

Answer 42

Fever cleared quicker

Question 43

When should you use oral antibiotics?

Answer 43

Antiobiotics are indicated Non-severe lower respiratory tract infection Child is not vomiting

Question 44

What is pertussis also known as?

Answer 44

Whooping cough

Question 45

What is the other name for whooping cough?

Answer 45

Pertussis

Question 46

How common is pertussis?

Answer 46

Common

Question 47

What reduces the risk and severity of pertussis?

Answer 47

Vaccination

Question 48

What are symptoms of pertussis?

Answer 48

Coughing fits Vomiting Colour change

Question 49

What is empyaema?

Answer 49

Extension of infection into pleural space

Question 50

What is a possible complication of pneumonia?

Answer 50

Empyema

Question 51

What are the symptoms of empyema?

Answer 51

Chest pain Very unwell

Question 52

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

Answer 52

Very good in children compared to adults