paediatric respiratory Flashcards
What is otitis media
Common self limiting painful ear - infection of the middle ear
What does the ear look like on otoscopy in otitis media
Erythema and a buldging ear drum
When is amoxycillin given for otitis media in children
Child less than 2 with bilateral otitis media or if they are systemically un well
What should not be given for treatment of tonsillitis
Amoxycillin
What is Croup
Laryngotracheobronchitis
What is the presentation of croup
- Initial runny nose and cold symptoms
- Then in the morning presents with croup - barking cough
What is the treatment of croup
Dexamethasone
What is tracheitis
Inflammation of trachea - presents with croup which does not get better
What is the treatment of tracheitis
Antibiotics
What is the presentation of bronchitis
- 1- 4 years old
- Loose rattly cough with URTI
- Post-tussive vomit
- No wheeze or crepitations
- Child appears very well
What is the presentation of bronchiolitis
- Day 1 cough
- then gets worse for few days
- Starts to stabilise and recover
- Nasal stuffiness
- tachypnoea
- poor feeding
- crackles with or without wheeze
- low grade fever
What is used to investigate bronchiolitis
NPA - nasopharyngeal airway
O2 sats
What does wheeze make more unlikely in the diagnosis
Less likely to be bacterial
What is the presentation of pneumonia
- Focal signs
- Crepitations
- High fever
What is the NICE guidelines for a child less than 2 with a respiratory tract infection
- Oxygenation, hydration and nutrition
- Do not need antibiotics
What is the difference between bronchiolitis compared to asthma and viral wheeze
- Bronchiolitis is in <12 monhs old
- Bronchiolitis is not chronic or recurrent
What is the treatment for tracheitis
Augmentin
Which antibiotic for pneumonia or LRTI
oral amoxycillin
What is the treatment for empyema
IV antibiotics
What is the presentation of asthma
- Chronic
- Wheeze
- Cough
- Shortness of breath
- Multiple triggers such as cold
- reversible
- Diurnal variation
What are the 3 key points required for asthma
- Cough, wheeze and difficulty breathing
- Variability
- Responds to steroids
What is the guideline for investigations of asthma in children between 5 and 16
- FeNO >35ppb
- Bronchodilator reversability with spirometry
- Peak flow variability
- Skin prick test or total IgE blood eosinophils
What is the presentation of a habitual cough
- 6-11 years old
- Dry cough
- loud
- single
- throat clearing
- Strong FH of asthma
- Absent when sleeping or watching TV
What is the presentation of laryngomalacia
- Variable nose
- Infant appears well
