Lower Respiratory Tract Infections

Question 1

Upper respiratory tract infections can be caused by viral, bacterial or fungal infections, which are all acquired. Which of the following is NOT part of the upper respiratory tract?

1 - larynx
2 - primary bronchi
3 - pharynx
4 - nasal cavity

Answer 1

2 - primary bronchi

Question 2

Which of the following is typically linked with causing an upper respiratory tract infection that us acquired?

1 - pollen
2 - smoke
3 - dust mites
4 - irritant chemicals
5 - all of the above

Answer 2

5 - all of the above

Question 3

When does the incidence of an upper respiratory tract infection peak?

1 - 0-12 months
2 - 1-2 years old
3 - 1-5 years old
4 - 10-15 years old

Answer 3

3 - 1-5 years old

Boys and girls are equally affected

Question 4

On average, how many colds does a child <2 get in a year?

1 - 3-4
2 - 5-7
3 - 8-10
4 - 11-15

Answer 4

3 - 8-10

Question 5

On average, how many febrile episodes does a child under two get per year? (click for answer!)

1 - 1-2
2 - 3-4
3 - 5-6
4 - 7-8

Answer 5

2 - 3-4

Question 6

Is stridor (abnormal, high-pitched respiratory sound produced by irregular airflow in a narrowed airway.
due to turbulent airflow) a hallmark of upper or lower respiratory tract infections?

Answer 6

• upper

Question 7

In the 1st year if life, how many upper respirator tract infections does the typical child have?

1 - 1-2
2 - 1-5
3 - 10-12
4 - >20

Answer 7

2 - 1-5

• 10-12 in some primary school aged children
• risk of infection increases in nurseries, day care etc…

Question 8

What % of all respiratory tract infections, do upper respiratory infections account for?

1 - 100%
2 - 80%
3 - 40%
4 - 20%

Answer 8

2 - 80%

Question 9

The common cold is the most common cause of an URTI. What is the most common cause of this?

1 - viral
2 - bacterial
3 - fungal
4 - pollen

Answer 9

1 - viral

Common viruses:
- Rhinoviruses
- Coronaviruses
- Respiratory Syncytial Virus.

Question 10

Viruses are the most common cause of the common cold in paediatrics. Which of the following is the most common virus causing URTI, such as the common cold?

1 - Coronaviruses
2 - Respiratory Syncytial Virus
3 - Rhinoviruses
4 - Adenoviruses
5 - Parainfluenza
6 - Influenza

Answer 10

3 - Rhinoviruses

Question 11

Which of the following do children with the common cold NOT typically present with?

1 - fatigue
2 - loss of appetite
3 - high grade fever
4 - coryzal symptoms

Answer 11

3 - high grade fever

Typically causes a low grade fever

Coughs can last up to 4 weeks

Question 12

In a child with coryzal symptoms due to the common cold, which 2 of the following can they be treated with?

1 - anti-virals
2 - nasal saline drops
3 - analgesia for discomfort (paracetamol)
4 - antibiotics

Answer 12

2 - nasal saline drops
3 - analgesia for discomfort (paracetamol)

Question 13

Pharyngitis is inflammation of the pharynx and soft pallet (back of roof of mouth), which can spread to the tonsils. Is Pharyngitis typically causes by viral or bacterial infections?

Answer 13

• viral

Question 14

Which 2 of the following are the most common causes of Pharyngitis?

1 - Coronaviruses
2 - Enterovirus
3 - Rhinoviruses
4 - Adenoviruses
5 - Parainfluenza
6 - Influenza

Answer 14

2 - Enterovirus
4 - Adenoviruses

Question 15

Patients can have all of the following symptoms in Pharyngitis/tonsillitis, but which is by far the most common?

1 - coryzal symptoms (nasal congestion, headache, earache, cough).
2 - Fever >38ºC
3 - Dysphagia
4 - Sore throat and refusal of foods
5 - enlarged lymph nodes

Answer 15

4 - Sore throat and refusal of foods
- occurs in 99% of patients

Question 16

Viral induced wheeze is thought to be caused by an abnormal immune response to a virus causing inflammation and obstruction of the smaller airways. Typically what age are affected by this?

1 - <12 months
2 - 1-2 years
3 - 6 months to 5 years
4 - 5-10 years

Answer 16

3 - 6 months to 5 years

Typically occurs in 1/3 of all children

Question 17

Viral induced wheeze is thought to be caused by an abnormal immune response to a virus causing inflammation and obstruction of the smaller airways. Which of the following is NOT a common risk factor?

1 - Prematurity
2 - Overweight
3 - Previous bronchiolitis
4 - Male gender

Answer 17

2 - Overweight

Question 18

Viral induced wheeze is thought to be caused by an abnormal immune response to a virus causing inflammation and obstruction of the smaller airways. Which of the following is NOT a typical clinical presentation of this?

1 - cough
2 - wheeze
3 - SOB
4 - conjunctivitis

Answer 18

4 - conjunctivitis

Typically occurs following an URTI, commonly viral

Question 19

Which 2 of the following are the most likely differentials for viral induced wheeze?

1 - asthma
2 - bronchiolitis
3 - bronchiectasis
4 - pneumonia

Answer 19

1 - asthma
2 - bronchiolitis

Viral induced wheeze patients have NO symptoms between intervals.

Patients with asthma will likely still have symptoms between asthma exacerbations

Question 20

All of the following are used to treat a viral induced wheeze, EXCEPT which one?

1 - Bronchodilators (salbutamol)
2 - Oxygen
3 - Steroids if severe
4 - Antivirals

Answer 20

4 - Antivirals

Question 21

Do all children who develop a viral induced wheeze go on to develop asthma?

Answer 21

• no

Most grow out of it by 5 years old, but a few children may develop asthma

Question 22

In childhood pneumonia,