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Respiratory System DO > LRTI Children > Flashcards

LRTI Children Flashcards

1
Q

Where do LRTI occur

A

Below the voice box

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2
Q

Name 5 LRTI

A 
Tracheitis
Pneumonia
Bronchitis
Empyema
Bronchiolitis
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3
Q

How many hospital admission where there in 2013/14 due to LRTI in 0-14 year olds

A

27,326

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4
Q

How many hospital admission where there in 2010/11 due to LRTI in 0-14 year olds

A

22,008

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5
Q

What type of agents can cause LRTI

A

Bacteria

Viruses

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6
Q

What type of bacterial agents are known to be able to cause LRTI

A 
Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Mycoplasma pneumoniae
Chlamydia pneumoniae
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7
Q

What type of viral agents are known to be able to cause LRTI

A

RSV
Parainfluenza III
Influenza A and B
Adenovirus

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8
Q

What is tracheitis

A

Croup which does not get better

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9
Q

What does tracheitis cause

A

Swollen tracheal wall
Narrowed tracheal lumen
Luminal debris

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10
Q

What will a child with tracheitis present with

A

Fever
Biphasic stridor
Sick child

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11
Q

What is the causative agent of tracheitis

A

Strep

Staph

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12
Q

What can be used to treat tracheitis

A

Augmentin

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13
Q

What is bronchitis

A

A very common endobronchial infection

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14
Q

What does bronchitis cause

A

Loose rattily cough in the URT
Post-tussive vomit (glut)
Chest is free of wheeze/creps

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15
Q

What causes bronchitis

A

Common respiratory commensals Haemophilus/Pneumococcus

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16
Q

How is bronchitis treated

A

It is mostly self-limiting

Child will be very well

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17
Q

What mechanism does bacterial bronchitis use

A

It disturbs the mucociliary clearance

Causes minor airway malacia

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18
Q

What tends to precede bacterial bronchitis

A

URTI

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19
Q

How long does bacterial bronchitis last

A

About 4 weeks

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20
Q

What are the first 3 winters with bacterial bronchitis like

A 
1st = bad
2nd = better
3rd = fine
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21
Q

What is the criteria for a persistent bacterial bronchitis

A

Wet cough
Present for over a month
Remission occurs with antibiotics

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22
Q

What are the 3 steps to be taken with persistent bacterial brochitis

A

Diagnosis should be made
Parents reassured
No treatment given

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23
Q

How many infants does bronchiolitis affect

A

30-40%

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24
Q

What causes bronchiolitis

A

Mainly RSV

Sometimes parainfluenza III or HMPV

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25
Q

Is memory produced against RSV

A

No

It removes the intracellular membrane

26
Q

How many nuclei does RSV have

A

More than one

27
Q

What signs and symptoms does bronchiolitis have

A

Nasal stuffiness
Tachypnoea
Poor feeding
The child may have some crackles or wheeze.

28
Q

What can bronchiolitis be classified as

A

Wheezy bronchitis
Asthmoid bronchitis
Viral associated wheeze
Asthma

29
Q

At what age is the peak of bronchiolitis seen

A

Around 3 months

30
Q

State 3 features of bronchiolitis

A

Disease of under 12 months
One of condition
Has a typical history

31
Q

How many days does it take to recover from bronchiolitis

A

7 days

32
Q

How should bronchiolitis be managed

A

Maximal observation

Minimal intervention

33
Q

What investigations can be done for bronchiolitis

A 
Nasopharyngeal aspirate (cohorting)
Oxygen saturations (severity)
34
Q

What investigations are not required for bronchiolitis

A

CXR
Bloods
Bacterial cultures

35
Q

What medication is available for bronchiolitis

A

None

36
Q

What medication has been proven not to work for bronchiolitis

A 
Salbutamol
Ipratropium bromide
Adrenalin
Steroids
Antibiotics
Nebulised saline
37
Q

How long do LRTI present for

A

48 hours

38
Q

State 5 features of LRTIs

A 
Fever (over 38.5˚C)
SOB
Cough
Grunting
Reduced or bronchial breath sounds
39
Q

How many cases of LRTIs are caused by viruses

A

35% (higher in younger children)

40
Q

How many cases of LRTIs are caused by a mixed infection

A

40%

41
Q

What bacterial agents can cause LRTIs

A

Bacteria Pneumococcus
Mycoplasma
Chlamydia

42
Q

When should a LRTI be called pneumonia

A

When:
Signs are focal
Creps
High fever

43
Q

What are the steps to treat pneumonia

A

Hydration
Oxidation
Nutrition
Antibiotics

44
Q

What is not a routine part of investigations for community acquired pneumonia according to BTS guidelines

A

CXR

Imflammatory markers

45
Q

How should community acquired pneumonia be managed according to BTS guidelines

A

Nothing if the symptoms are mild (review if things get worse)
Oral amoxycillin first line
Oral macrolide 2nd choice
IV if vomiting

46
Q

Should IV or oral antibiotics be used when antibiotics are indicated in a non-severe LRTI when the child is not vomiting

A

Oral

47
Q

Why is oral antibiotics preferred

A

Shorter stay in hospital
Cheaper
Child will have fever for a few more hours

48
Q

Give 5 conditions where antibiotics are not indicated

A 
Bronchiolitis
Croup
Acute LRTI
Otitis media
Pharyngitis/tonsillitis
49
Q

How does vaccination benefit pertussis (whooping cough)

A

Risk is reduced

Severity of illness is reduced

50
Q

State 2 symptoms of pertussis

A

Coughing fits

Vomiting and colour change

51
Q

What is empyema

A

Pus in the body cavity

A complication of pneumonia which occurs when the infection extends into the pleural space

52
Q

What does empyema cause

A

Chest pain

Child will be very unwell

53
Q

What treatment is given for empyema

A

Antibiotics

May require drainage

54
Q

What is the prognosis of empyema in children

A

Good in contrast with adults

55
Q

Does tracheitis require antibiotics

A

Yes

56
Q

What antibiotic does tracheitis require

A

Augmentin

57
Q

Does bronchitis require antibiotics

A

No

58
Q

Does LRTI/pneumonia require antibiotics

A

Usually when there is a fever for over 2 days, cough and focal signs

59
Q

Does bronchiolitis require antibiotics

A

No

60
Q

Does empyema require antibiotics

A

Yes

61
Q

What antibiotic does LRTI/pneumonia require

A

Oral amoxycillin

62
Q

What antibiotic does empyema require

A

IV antibiotics

Respiratory System DO (33 decks)

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