Lower Respiratory Tract Infections in Children Flashcards

1
Q

What are common bacterial agents that cause infections?

A

strep pneumoniae, Haemophilus influenzae, Moraxella catrrhalis, Mycoplasma pneumoniae, chlamydia pneumoniae,

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2
Q

What are comon viral agents that cause infection?

A

RSV, parainfleunza III, influenze A and B, adenovirus

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3
Q

What are the principles of management of a LRTI?

A

Make a diagnosis, Asess the patient (oxygenation, hydration, nutrition), to treat or not to treat

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4
Q

What is tracheitis?

A

it is croup which doesnt get better, inflammation of the trachea.

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5
Q

What are the symptoms of tracheitis?

A

Barking cough, stridor, fever and sickness
Fever, sick child
Swollen tracheal wall, narrowed tracheal lumen, luminal debris

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6
Q

What bacteria causes tracheitis?

A

Staph or strep

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7
Q

What is an endobronchial infection?

A

An infection inside the airway

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8
Q

What are the symptoms of bronchitis?

A

loose rattly cough started off with an URTI with an end of the cough there is vomit (post tussive vomit)

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9
Q

What bacteria cause bronchitis?

A

Pneumococcus and Haemophilus

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10
Q

What is the mechanism of bacterial bronchitis?

A

Distrubed mucociliary clearance, lack of social inhibition, bacterial overgrowth is secondary.

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11
Q

How are bacterial infections transmitted during winter?

A

The respiratory virus is picked up, mucociliary escalator switches off for up to 4 weeks, cough and rattle, mucociliary escalator slowly recovers.

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12
Q

What is the natural history of bacterial bronchitis?

A

It follows URTI, lasts 4 weeks, 60-80% respond to antibiotics.

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13
Q

What URTI does bronchitis follow?

A

Rhinovirus

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14
Q

How does the cough morbidity vary with each winter?

A

First winter - bad, second winter better, Third winter - fine

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15
Q

What is the diagnosis for bacterial bronchitis?

A

Make a diagnosis, Reassure (parents and grandparents), Do not treat

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16
Q

How does bronchitis differ from bronchiolitis?

A

Bronchitis is the infection of the large airways and bronchiolitis is the infection of the small airways

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17
Q

What is bronchiolitis?

A

It is a LTRI of infants

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18
Q

What percentage of infants does bronchiolitis affect?

A

30 - 40%

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19
Q

What are the common viruses that cause bronchiolitis?

A

Respiratory syncytial virus, parainfluenza, human metanuma virus

20
Q

What are the symptoms of bronchiolitis?

A

Stiuffy nose, tachypnoae, poor feeding

21
Q

Why do infants feed poorly when they have bronchiolits?

A

They’ve only got one orifice through which they feed and breath with a nose block and that is their mouth.

22
Q

What might you hear during an examination of a infant that has bronchiolitis?

A

Crackles +/- wheezes

23
Q

What are the management techniques of bronchiolitis?

A

Maximal observation, minimal intervention

24
Q

What are the investigations carried out during bronchiolitis?

A

NPA

Oxygen saturation

25
Q

What is a lower respiratory tract infection often characterised by?

A

48-hour history of fever, SOB, cough and often grunting

26
Q

What does wheeze rule out in LRTIS?

A

Wheeze makes the bacterial cause unlikely.

27
Q

What are the infective agents of LRTIs

A

Virus and commensal bacteria/bacterium, mycoplasma, Chlamydia.

28
Q

When are you allowed to call in pneumonia?

A

Signs are focal in one area (Left lower zone)
Craputations
High Fever (otherwise call it a LRTI)

29
Q

What are the management methods for pneumonia?

A

Nothing if the symptoms are mild
Oral Amoxycillin first line
Oral Macrolide second choice
Only for iv if vomiting

30
Q

What are the benefits of oral antibiotics?

A

Shorter hospital stay, Cheaper

31
Q

What vaccination do to the risk and severity of pertussis?

A

It reduces the risk and severity

32
Q

What is pertussis characterised by?

A

• Coughing fits, vomiting and color change

33
Q

What is empyema?

A

• The complication of pneumonia, extension of the infection into pleural space.

34
Q

What are the treatments for empyaema?

A

• Antibiotics +/- drainage

35
Q

What is the treatment for tracheitis?

A

Augmentin

36
Q

What the most common cause of LRTI in infancy?

A

Bronchiolitis

37
Q

What is the peak incidence of bronchiolitis?

A

3 months

38
Q

What separates bronchiolitis from asthma?

A

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

39
Q

What are the relevant investigations for bronchiolitis?

A

Nasopharyngel aspiration, Oxygen saturasion to determine severity

40
Q

What does 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

41
Q

How can you confirm a lower respiratory tract infection?

A

Reduced or bronchial breath sounds

42
Q

What are the possible investigations for community acquired pneumonia?

A

CXR and inflammatory makers NOT routine

43
Q

What is the management forcommunity 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
44
Q

When would you consider antibiotics for an LRTI?

A

After 48 hour history exist

45
Q

What is the treatment for empyema?

A

Antibiotics and drainage