Paediatric Respiratory Flashcards
Name some of the common side effects of antibiotics in children
- Diarrhoea
- Oral thrush
- Nappy rash
- Allergic reaction
- Multi resistance
What is the average duration of a runny nose?
2 weeks
What are the features of otitis media?
- Erythema
- Bulging drum
- Primarily viral
- Potentially rupture of the eardrum
What is the average duration of earache?
1 week
How should otitis media be managed
- Analgesia
- No antibiotics
What is the average duration of a sore throat?
3 days
What are the features of croup?
- Caused by paraflu 1
- Child is well
- Coryza, stridor and barking cough
How can croup be treated?
Oral dexamethasone
What are the features of epiglottitis?
- Caused by Hib
- Child is toxic (high fever, high pulse and low blood pressure)
- Stridor and drooling
How is epiglottitis treated?
- Intubation
- Antibiotics
What is the average duration of croup?
3+ days
Which organisms commonly cause LRTIs in children?
- Strep pneumoniae
- H influenzae
- Moraxella catarrhalis
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- RSV
- Parainfluenza III, Influenza A & B, adenovirus and rhinovirus
How should LRTIs be managed?
- Oxygenation
- Hydration
- Nutrition
Name the features of bronchitis
-Loose rattly cough
-Post-tussive vomit
-Chest free of wheeze/creps
Haemophilus/pneumococcus
-Mostly self limiting
-Child is well
-Disturbed mucociliary clearance with secondary bacterial overgrowth
What are the red flags for bronchitis?
- <6 months > 4 yrs
- No relapse-remission
- Static weight
- Disrupts child’s life
- Associated SOB
- Acute admission
- Other co-morbidities
What is the average duration of a cough?
2-3 weeks
What are the features of bronchiolitis?
- Usually RSV (also paraflu III and HMPV)
- Nasal stuffiness, tachypnoea and poor feeding
- Crackles +/- wheeze
- <12 months old
- One off
How is bronchiolitis managed?
- Observation
- Sats
- No medicines proven to work
How is community acquired pneumonia managed?
- Nothing if symptoms are mild
- Oral amoxycillin is first line
- Oral macrolide is 2nd line
- IV if vomiting
What are the features of pertussis (whooping cough)?
- Coughing fits
- Vomiting
- Colour change
What are the key features of asthma?
- Wheeze
- Variability
- Responds to treatment
What causes asthma?
- Host response to environment
- Genes
Name the presenting features of asthma
- Wheeze
- Cough: dry, nocturnal and exertional
- SOB at rest
- Parental history of asthma
- PH: eczema, hayfever and food allergies
- Response to treatment
What is the differential for asthma?
- Under five: congenital, CF, PCD, bronchitis and foreign body
- Over five: dysfunctional breathing, vocal cord dysfunction, habitual cough and pertussis
What are the goals of asthma treatment?
- Minimal symptoms
- Minimal need for reliever medication
- No attacks
- No limitation of physical activity
How can asthma control be measured?
- SABA use per week
- Absence from school/nursery
- Nocturnal symptoms per week
- Excertional symptoms per week
Which classes of medications can be used to treat asthma in children?
- SABAs
- ICS
- LABAs
- Leukotriene receptor antagonists
- Theophyllines
- Oral steroids
When should a regular preventer be used?
- Diagnostic test
- B2 agonists > 2 days a week
- Symptomatic 3 times a week or more or waking one night a week
How can a mild exacerbation of asthma be treated?
SABA via spacer +/- prednisolone
How can a moderate exacerbation of asthma be treated?
SABA nebuliser and prednisolone +/- Ipratropium bromide
How can a severe exacerbation of asthma be treated?
- IV salbutamol
- IV aminophyline
- IV magnesium
- IV hydrocortisone
- Intubation and ventilation
