Paediatric Respiratory

Question 1

what investigation is done for suspected tonsillitis in children, and what is its aim?

Answer 1

throat swab, to identify whether infection is bacterial or viral

Question 2

what is the treatment of viral vs bacterial tonsillitis in children?

Answer 2

viral - nothing

bacterial - 10 days penicillin

Question 3

what is the treatment for croup?

Answer 3

oral steroids (dexamethasone)

Question 4

if you suspect croup in a child, which rarer severe infections should be ruled out?

Answer 4

epiglottitis, tracheitis

Question 5

what is the management for epiglottitis?

Answer 5

intubation and antibiotics

Question 6

which organism is responsible for croup in children?

Answer 6

parainfluenza virus 1

Question 7

which organism is responsible for epiglottitis in children?

Answer 7

haemophilus influenzae Type B

Question 8

which symptom is found both in croup and epiglottitis?

Answer 8

stridor

Question 9

which symptoms can help distinguish between croup and epiglottitis?

Answer 9

epiglottitis also presents with drooling

croup presents with coryza, hoarse voice, barking cough

Question 10

if a child presents with upper respiratory symptoms, what is the common approach for management?

Answer 10

wait and review

Question 11

does a child with bronchitis normally feel well or unwell?

Answer 11

child feels well

Question 12

what is a common trigger for bronchitis?

Answer 12

viral URTI causing secondary bacterial bronchitis

Question 13

how are LRTI normally initiated in children?

Answer 13

they occur as a secondary infection after a viral URTI has damaged the mucociliary escalator

Question 14

what is the approach for mild pneumonia in children?

Answer 14

nothing

Question 15

what is the approach for moderate/severe pneumonia in children?

Answer 15

oral amoxycillin

if that doesn’t work, oral macrolide

Question 16

what is the approach for moderate/severe pneumonia in children?

Answer 16

oral amoxycillin

Question 17

when should a LRTI/pneumonia be treated in children?

Answer 17

when they have had symptoms for 48 hours of:

• cough
• SoB
• high fever
• focal signs
• crepitations

Question 18

when should otitis media be treated in children?

Answer 18

if child under 2years old and otitis media is bilateral

Question 19

if otitis media needs to be treated in a child, what is the treatment for it?

Answer 19

oral amoxycillin

Question 20

in children with LRTI, what three things should be managed before giving antibiotics?

Answer 20

• oxygenation
• hydration
• nutrition

Question 21

what is bronchitis characterised by in children?

Answer 21

relapse and remission of cough

Question 22

what are some red flags for children with LRTI?

Answer 22

• less than 2yo, older than 4yo
• no remission of cough
• impaired growth
• QoL affected
• SoB at rest
• other comorbidities

Question 23

four key signs that point to asthma in a child?

Answer 23

wheeze
variability
SoB at rest
responds to treatment

Question 24

when is no intervention needed in a child with potential asthma?

Answer 24

if it’s not affecting their QoL

Question 25

if a child has asthma which is affecting their QoL, what is the initial management?

Answer 25

2 months of inhaled corticosteroids

Question 26

how can you differentiate between croup and tracheitis in children?

Answer 26

tracheitis doesn’t respond well to steroid treatment, will recur despite dexamethasone