Lower Respiratory Tract Infection In Children

Question 1

Lower respiratory tract infections

Answer 1

Croup/tracheitis
Pneumonia
Bronchitis
Empyema
Bronchiolitis

Question 2

Common bacterial infective agents

Answer 2

Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Klebsiella pneumoniae

Question 3

Common viral infective agents

Answer 3

RSV
Parainfluenza III
Influenza A and B
Adenovirus
Human metapneumovirus

Question 4

Common symptoms of LRTIs

Answer 4

Cough
Wheeze
Difficulty breathing
Systemic upset

Question 5

Laryngotracheobronchitis (croup)

Answer 5

Common viral infection causing narrowing in large ariways

Question 6

Symptoms of croup

Answer 6

Inspiratory stridor
Hoarseness
Respiratory distress
Cough (barky seal)
Fever
Rhinorrhoea (runny nose)

Question 7

Croup is worse at

Answer 7

Night

Question 8

Management on croup

Answer 8

Support, reassurance and advice
Oral Dexamethasone 0.15ml/kg (steroid)
Admission if moderate or severe - oxygenation, nebulised adrenaline

Question 9

Epiglottitis symptoms

Answer 9

High fever
Drooling
Leaning forward
Sore throat

Question 10

Vaccine for epiglottitis

Answer 10

H.influenzae

Question 11

Bacterial tracheitis symptoms

Answer 11

Fever
Sick
Croup that doesn’t get better

Question 12

Epiglottitis bacteria

Answer 12

Haemophilus pneumoniae

Question 13

Bacterial tracheitis bacteria

Answer 13

Staphylococcus aureus

Question 14

Treatment for bacterial tracheitis

Answer 14

Co-amoxiclav

Question 15

Bronchiolitis virus

Answer 15

RSV

Question 16

Bronchiolitis peaks in

Answer 16

Winter

Question 17

Bronchiolitis

Answer 17

Inflammation, congestion and mucus in bronchioles

Question 18

Bronchiolitis symptoms

Answer 18

Mild fever
Congestion
Cough
Wheeze and crackles
Tachypnoea

Question 19

Management of bronchiolitis

Answer 19

Support, reassurance and advice

Admit if respiratory distress - observation, oxygenation, NPA

Question 20

Whooping cough (bordetella pertussis) symptoms

Answer 20

Coughing fits
Vomiting due to cough
Red in face
Inspiratory ‘whooping’ sound

Question 21

Whooping cough caused by

Answer 21

Bacteria

Question 22

Treatment for whooping cough

Answer 22

Macrolide antibiotics (clarithromycin, erythromycin, azithromycin)

Question 23

Bronchitis

Answer 23

Endobronchial infection

Question 24

Bronchitis symptoms

Answer 24

Loose rattly cough with URTI

Vomit due to cough

Question 25

Bronchitis bacteria

Answer 25

Haemophilus influenzae

Pneumococcus

Question 26

Management of bronchitis

Answer 26

Resolves on its own

Question 27

Bacterial bronchitis

Answer 27

Secondary overgrowth of bronchitis

Question 28

Mechanism of bacterial bronchitis

Answer 28

Disturbed mucociliary clearance

Question 29

Pneumonia symtoms in neonates

Answer 29

Grunting
Poor feeding
Irritable
Lethargy
Tachypnoea
Cough

Question 30

Pneumonia fever

Answer 30

> 39, persistent and repetitive

Question 31

Pneumonia symptoms in infants

Answer 31

Cough
Tachypnoea
Grunting
Respiratory distress 
Not feeding
Irritable
Preceding URTI

Question 32

Preschool symptoms

Answer 32

Cough
Fever
Pain

Question 33

Investigations of pneumonia

Answer 33

Chest x-ray

Inflammatory markers

Question 34

Management of pneumonia

Answer 34

Mild symptoms = nothing
Oral amoxicillin first
Oral macrolide second
IV if vomiting

Question 35

Empyema

Answer 35

Complication of pneumonia, extension of infection into plural space

Question 36

Empyema symptoms

Answer 36

Pleuritic pain

Very unwell

Question 37

Treatment of empyema

Answer 37

IV antibiotics and drainage

Question 38

Viral induced wheeze

Answer 38

Infective exacerbation of asthma, wheeze associated with viral infection of airway

Question 39

Treatment of viral induced wheeze

Answer 39

Bronchodilators