Paed: Lungs Flashcards
List some inflammatory responses of Rhinovirusea….
- Vasodilation (increased blood flow to basal submucosa = nasal stuffiness)
- Incr. Vascular permeability
- Production of mucous
Symptoms a result of innate immunity rather than viral infection
At what age can cough and cold syrups be recommended to children?
From 6 years old
Home remedies for treating viral infections
Honey = small benefit (over 1)
Name the 4 Upper RTI
- Rhinitis (common cold)
- Sinusitis (rhino-sinusitis)
- Pharyngitis (tonsillitis)
- Otitis media
Main symptoms of the 4 upper RTI
- Rhinitis (common cold)
- Sinusitis (rhino-sinusitis)
- Pharyngitis (tonsillitis)
- Otitis media
- Rhinitis (common cold)
= nasal discharge - Sinusitis (rhino-sinusitis)
= pus + sinus pain - Pharyngitis (tonsillitis)
= sore throat - Otitis media
= earache
Name the 4 Lower RTi
- Croup
- Bronchiolltis (0-12m)
- Bronchitis
- Pneumonia
Main symptoms of lower RTI
- Croup
- Bronchiolltis (0-12m)
- Bronchitis
- Pneumonia
- Croup
= bark, strider, hoarse cry - Bronchiolltis (0-12m)
= SOB, WHEEZE - Bronchitis
= COUGH - Pneumonia
= WHEEZE
Name the 4 sinuses
- Ethmoid = Bridge of nose
- Maxillary = around the cheeks
- Frontal = forehead = UNTIL 7
- Sphenoid = located deep in the face
= DOSENT DEVELOP TILL ADOLESCENTS.
Will sinusitis respond without antibiotics? For how long?
Yes, for 2 weeks (typically)
Red aga for sinusitis?
- 7-10 days of mucopurulent discharge
- Focal pain
- Poor response to decongestants
4.. tenderness/ tooth pain
When to refer child with tonsillitis?
- Fever over 38
- Tender Cervical Lymphadenopathy
- Tonsillitis exudate/ white spots on tonsils
- No cough, but sore through, difficulty swallowing
Red flags for Otitis Media
- Fever over 38
2 ear discharge
3 ear fullness
4 blocked ears
Treatment of Otitis Media in children
“Wait qnd see” prescription antibiotics (observe for 2 days)
Croup
If significant Stridor at rest then give?
Oral prednisolone 1mg per kg
During croup, which airway is narrowed?
Subglottic airway
Pathophysiology of Bronchiolitis
Inflammation of bronchioles
Symptoms of Bronchiolitis?
Rhinitis
Tachypnea
Wheezing
Poor feeding, crackles in chest
Low Spo2 (less 92%)
** risk factor for ASTHMA
Are antibiotics and CS useful to treat Bronchiolitis?
Main symptoms for Bronchitis?
COUGH
Most common cause if Bronchitis?
VIRAL!!!
INFLUENZA (common)
RSV
ADENOVIRUS
Acute treatment for
VIRAL INDUCED WHEEZING
Bronchiodilators
Oral steroids
Evidence..
(ICS for a week unproven,
Montelukast has evidence for allergic rhinitis but not for viral induced Wheezing)
Key feature of asthma
Wheeze
At what age can asthma be diagnosed?
From 6 years (can perform a spirometry)
-too young before 12 months
-no degree of certainty between 1 to 5
Are antibiotics needed in Whooping Cough?
Yes!
Initiated as soon as possible and within 3 weeks of onset of cough
When are children with whooping cough considered non infections
After 5 days of antibiotic treatment
OR
3 days from onset of cough if untreated
Is Whooping Cough a notifiable disease?
Yes!!!!
When should pregnant mums vaccinate for Whooping cough
At third trimester
Why less COVID 19 in children?
- Lower numbers of ACE2 receptors
- Higher IFN-1 and neutrophil response
What is
MULTI SYSTEM INFLAMMATORY SYNDROME
MSIS
Rare complication in children with COVID19
Causes inflammation in organs
Symptoms include
Fever
Bloodshot eyes
Stomach ache, vomiting, diarrhoea
Large lymph nodes in neck
Neck pain
Strawberry tongue
Swollen hands
Irritable Or excessively sleepy
