Paediatric Respiratory Flashcards
What are the most common RTIs in children?
Rhinitis Tonsilitis Otitis media Pharyngitis Epiglottitis Pneumonia/itis Bronchitis Empyaema Bronchiolitis Croup
What are the viral agents that cause upper respiratory tract infections?
Adenovirus Influenza A, B Para’flu I, III RSV Rhinovirus
What are the bacterial agents that cause upper respiratory tract infections?
H influenzae M catarrhalis (Mycoplasma) (S aureus) Streptococci (B haemolytic, S pyogenes, Non haemolytic, S pneumoniae)
What are the clinical features of otitis media?
Erythema
Bulging drum
What is the treatment for otitis media?
Analgesics
Augmentin
What is the treatment for tonsillitis/pharyngitis?
10 days penicillin
Dont give amoxycillin
What are the symptoms of croup?
Coryza
Stridor
Hoarse voice
“Barking” cough
What agent usually causes croup?
Paraflu 1
What is the treatment for croup?
Oral dexamthasone
What agent usually causes epiglottitis?
H influenzae type B
What are the symptoms of epiglottitis?
Stridor
Drooling
What is the treatment for epiglottitis?
Intubation and antibiotics
What are the common bacterial agents that cause lower respiratory infections?
Strep pneumoniae Haemophilus influenzae Moraxella catarrhalis Mycoplasma pneumoniae Chlamydia pneumoniae
What are the common viral agents that cause lower respiratory infections?
RSV
Parainfluenza III
Influenza A and B
Adenovirus
What is the treatment for tracheitis?
Augmentin
What agent usually cause tracheitis?
Staph or strep
What agent usually causes bronchitis?
Haemophilus
Pneumococcus
What are the symptoms of bronchitis?
Loose rattly cough
Post-tussive vomit
What are the features of bacterial bronchitis?
First winter bad
Second winter better
Third winter fine
What is the criteria for persistent bacterial bronchitis?
Wet cough
More than 1 month
Remission with antibiotics
What agents usually cause bronchiolitis?
RSV
Paraflu III
HMPV
What are the symptoms of bronchiolitis?
Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze
What are the general symptoms of a LRTI?
48hrs Fever SOB Cough Grunting Reduced or bronchial breath sounds
What is the treatment for community acquired pneumonia?
Oral amoxycillin
Oral macrolide
Only IV if vomiting
What are the symptoms of pertussis?
Coughing fits
Vomiting
Colour change
What is empyema?
Complication of pneumonia
Extension of infection into pleural space
What are the symptoms of empyema?
Chest pain
Very unwell
What is the treatment for empyema?
Antibiotics
Drainage
What are the symptoms of asthma?
Wheeze Cough SOB Variable/reversible Responds to treatment
What are the triggers for asthma?
URTI
Exercise
Allergen
Cold weather
What mechanism causes the wheeze to occur in asthma?
Bronchoconstriction
Airway wall thickening
Luminal secretions
What is the differential diagnosis for asthma?
Foreign body Cystic fibrosis Immune deficiency Ciliary dyskinesia Crop
What is used to measure control of asthma?
SANE Short acting beta agonist/week Absence nursery/school Nocturnal symtoms/week Excertional symtoms/week
What are the classes of medications used in asthma?
Short acting beta antagonist Inhaled corticosteroids Long acting beta antagonist Leukotrine receptor antagonist Theophyllines Oral steroids
What is the management for asthma?
Start on low dose ICS
Review after 2 months
When would an asthma programme need to be stepped up from SABA?
Using inhaled B2 agonist 3 times a week or more
What is added on to a SABA?
Low dose ICS
What is step 3 of asthma management?
Add on LABA
Add on LTRA
Increase ICS dose
What are the adverse effects of ICS?
Height suppression
Oral candidiasis
Adrenocortical suppression
What should be considered when giving a LABA?
Don’t use without ICS
Use as fixed dose inhaler
What are the delivery systems used for asthma medication?
MDI/spacer
Dry powder device
What other management plans can help with asthmas symptoms?
Stop tobacco smoke exposure
Remove environmental triggers (cat, dog)
How is an mild asthma attack treated?
SABA via spacer with prednisolone
How is a moderate asthma attack treated?
SABA via nebuliser and prednisolone
How is a severe asthma attack treated?
IV salbutamol IV aminophylline IV magnesium (nebuliser) IV hydrocortisone Intubate and ventilate
