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A2. Respiratory system > Lower respiratory tract infections - children > Flashcards

Lower respiratory tract infections - children Flashcards

1
Q

What is tracheitis?

A

Inflammation of the trachea

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2
Q

What is the incidence of bronchiolitis?

A

20% of children will get admitted to hospital with this

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3
Q

Incidence of LRTI

A
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4
Q

What are the common infective agents?

A

•Bacterial

–Strep pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydia pneumoniae

•Viral

–RSV, parainfluenza III, influenza A and B, adenovirus

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5
Q

What is the description of tracheitis?

A

•“croup which does not get better”

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6
Q

What are the symptoms of tracheitis?

A

•Fever, sick child

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7
Q

What are the common causative agents for tracheitis?

A

Staoh or strep

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8
Q

What is the treatment for tracheitis?

A

Augmentin

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9
Q

Is bronchitis common?

A

Yes, very

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10
Q

What are the symptoms of bronchitis?

A

Loose rattly cough with URTI

Post-tussive vomit - ‘glut’

Chest free of wheeze and creps

Mostly self - limiting

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11
Q

What are the common causes of bronchitis?

A

Haemophilus/Pneumococcus

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12
Q

What is the mechanism of bacterial bronchitis?

A

Disturbed mucociliary clearance

  • minor airway malacia
  • RSV/adenovirus
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13
Q

Why do people get recurrent colds in winter?

A
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14
Q

What does bacterial bronchitis usually follow on from?

A

URTI

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15
Q

What is Bronchioloitis defined as?

A

A lower respiratory tract infection of infants

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16
Q

What is usually the cause of Bronchiolitis?

A

RSV (Respiratory Syncytial Virus)

Parainfluenza 3, HMPV (human metapneumovirus)

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17
Q

What are the symptoms of bronchiolitis?

A

Nasal Stiffness, tachypnoea, poor feeding

Crackles +/- wheeze

18
Q

What is the most common cause of LRTI in infancy?

A

Bronchiolitis

19
Q

When is the peak incidence of Bronchiolitis?

A

3 months

20
Q

What separates bronchiolitis from asthma?

A

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

21
Q

Why does feeding have complications during the course of bronchiolitis?

A

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

22
Q

What is managent of bronchiolitis?

A

Maximal Observation

Minimal Intervention

23
Q

What are the relevant investigations for bronchiolitis?

A

Nasopharyngel aspirate

Oxygen saturasion to determine severity

24
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

25
Q

Is there any need for

–CXR

–Bloods

–Bacterial cultures ?

A

NO

26
Q

Are there any medications proven to help bronchiolitis?

A

NO

27
Q

What is the definition of a LRTI?

A

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

28
Q

What can you infer from wheeze?

A

Bacterial cause is unlikely

29
Q

How do you confirm a lower respiratory tract infection?

A

Reduced or bronchial breath sounds

30
Q

What are the infective agents for LRTI?

A

–Viruses in <35% (higher in younger)

–Bacteria Pneumococcus, Mycoplasma, Chlamydia

–Mixed infection in <40%

31
Q

How can you tell if the LRTI is pneumonia?

A

–Signs are focal (one side of the chest)

–Creps – fine crackles

–High fever

32
Q

What are the possible investigations for community acquired pneumonia?

A

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

33
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

34
Q

When woud you consider antibiotics for an LRTI?

A

After 48 hour history exists

35
Q

LOOK

A
36
Q

What is the only thing that causes coughing fits?

A

Pertussis

37
Q

What are the symptoms of pertussis?

A

Vomiting and colour change

38
Q

Is pertussis common?

A

Yes

39
Q

Where can empyema arise from?

A

Complications of pneumonia

40
Q

What is the treatment of empyema?

A

Antibiotics and drainage

41
Q

To treat or not to treat

A

A2. Respiratory system (77 decks)

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