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Respiratory System > LRTI in Children > Flashcards

LRTI in Children Flashcards

1
Q

What are 5 bacterial infective agents?

A 
Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Mycoplasma pneumoniae
Chlamydia pneumoniae
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2
Q

What are 4 viral infective agents?

A

RSV
Parainfluenza III
Influenza A and B
Adenovirus

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3
Q

What is tracheitis?

A

Croup which does not get better - obstructed airways due to narrowing

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4
Q

Features of tracheitis

A

Swollen tracheal wall
Narrowed tracheal lumen
Luminal debris

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5
Q

What can tracheitis present with?

A

Fever

Inspiratory stridor

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6
Q

What bacteria causes tracheitis?

A

Staph or strep

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7
Q

What can be used to treat tracheitis?

A

Augmentin

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8
Q

What is bronchitis?

A

Common endobronchial infection

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9
Q

What are the symptoms of bronchitis?

A

Loose rattly cough with URTI
Post-tussive vomit
No wheeze/creps

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10
Q

What bacteria can cause bronchitis?

A

Haemophilus

Pneumococcus

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11
Q

How is bronchitis treated?

A

It is self-limiting, no antibiotics

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12
Q

What is the mechanisms of bronchitis?

A

It disturbs the mucociliary clearance from UTRI causing difficulty to remove bacteria
Causes minor airway malacia
Can last up to 4 weeks

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13
Q

What usually precedes bronchitis?

A

URTI

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14
Q

What is the criteria for persistent bacterial bronchitis?

A

Wet cough
More than 1 months
Remission occurs with antibiotics

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15
Q

What are the 3 steps to be taken with persistent bacterial bronchitis?

A

Diagnosis should be made
Parents reassured
No treatment given

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16
Q

What percentage of children does bronchiolitis affect?

A

30-40%

17
Q

What is the causative bacteria in bronchiolitis?

A

RSV

Others include:
Paraflu III
HMPV

18
Q

What is the clinical presentation of bronchiolitis?

A

Nasal stiffness
Tachypnoea
Poor feeding
Crackles +/- wheeze

19
Q

Who does bronchiolitis usually affect?

A

< 12 months old

20
Q

Is bronchiolitis a recurrent infection?

A

No, it is a one off

21
Q

What is the management of bronchiolitis?

A

maximal observation
Minimal intervention
Oxygen saturations according to severity

22
Q

Investigation for bronchiolitis?

A

NPA (cohering)

O2 saturations

23
Q

What are the general signs for LRTI in children?

A 
Pyrexia (> 38.5C)
SOB 
Cough 
Grunting 
Wheeze makes bacterial cause unlikely 
Reduced or bronchial breath sounds
24
Q

Infective agents in LRTIs

A

Viruses in <35%
Bacteria: pneumococcus, mycoplasma, chlamydia
Mixed infection in <40%

25
Q

When is it pneumonia and not a LRTI?

A

Signs are focal
Crepitations
High fever

Otherwise call it LRTI

26
Q

Investigation for community acquired pneumonia

A

CXR and inflammatory markers not routine

27
Q

Management of community acquired pneumonia

A

Nothing is symptoms are mild

1st: oral amoxycillin
2nd: oral macrolide
Only administered through IV if vomiting

28
Q

When to use oral over IV antibiotics

A

Antibiotics are indicated
In non-severe LTRI
When child not vomiting

29
Q

What are the benefits of oral antibiotics over IV?

A

Shorter hospital stay
Cheaper
Fewer for a few more hours

30
Q

What is pertussis?

A

Whooping cough - coughing fits lasting over two weeks, vomiting and colour change

31
Q

What can reduce the risk and severity of pertussis?

A

Vaccinations

32
Q

What is empyaema a complication of?

A

Pneumonia - spread of infection into pleural space causing pus formation

33
Q

Symptoms of empyaema?

A

Chest pain and very unwell

34
Q

What is the management of empyaema?

A

IV Antibiotics +/- drainage

35
Q

What is the prognosis on empyaema in children?

A

Good prognosis (in contract with adults)

36
Q

Can bronchitis be treated with antibiotics?

A

No

37
Q

What antibiotic is used to treat pneumonia and first antibiotic given in for general LTRIs?

A

Oral amoxycillin

38
Q

Is there an antibiotic for bronchiolitis?

A

No

39
Q

What is the first step in management in LTRIs before administering antibiotics (if appropriate)?

A

Oxygenation
Hydration
Nutrition

Then think about antibiotics

Respiratory System (29 decks)

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