Paeds Resp Flashcards
Incidence of Rhinitis
very common, 5-10 per year winter months
treatment of rhinitis
self-limiting condition
what should you do if you are not sure about a rhinitis?
review
Otitis media incidence
common, self limiting
Si and Sy or Otitis media
erythema
bulging ear drum
ear pain
primary infection in otitis media is
viral
secondary infection in otitis media is with
pneumococcus/ H’ flu
what can happen in otitis media to the ear drum?
spontaneous rupture
do you treat Otis media with antiBs ?
NO does usually help
What DO you give for Otitis media?
analgesia
Tonisillitis / pharyngitis
common?
yah
dilemma with tonsillitis / pharyngitis is
viral or bacterial?
how do you tell if tonsillitis / pharyngitis is viral or bacterial?
do throat swab
treatment of tonsillitis / pharyngitis
either nothing or 10 days penicillin
P of Croup
Para’flu 1
is croup common?
yah
do kids with croup appear well or unwell?
well
Sy and SIs of Croup
Coryza ++, stridor, hoarse voice, “barking” cough
treatment of croup
oral dexamethasone
P of Epiglottitis
H. influenza Type B
is Epiglottitis common?
no rare
Is the child in Epiglottitis well?
no - toxic
treatment of Epiglottitis
intubation and antibiotics
Principles of management of LRTI
make diagnosis
assess the patient
-Oxygenation, hydration, nutrition
to treat or not to treat grey area
is Bronchitis common?
yahhhhh
what kind of cough do you get in Bronchitis?
loss rattly cough
mouthful of mucus coughed up
Other Sy and Is of Bronchitis
post-tussive vomit “glut”
Chest free of wheeze / creps
bugs responsible for Bronchitis
haemophilus / Pneumococcus
treatment of Bronchitis
mostly self limiting
how is the child in Bronchitis
VERY well, parent worried
IN bacterial bronchitis is bacterial overgrowth the primary or secondary issue?
SECONDARY
virus first - switches of mucociliary clearance
therefore antiBs dont solve issue
management of persistent bacterial bronchitis
make diagnosis
reassure
do not treat
Incidence of Bronchiolitis
LRTI of INFANTS
affects 30-40% or all infants
<12 months
one off (NOT recurrent)
Typical history
P of Bronchiolitis
usually RSV
Si and Sy Bronchiolitis
nasal stuffiness, tachypnoea, poor feeding
crackles +/- wheeze
management of Bronchiolitis
maximal observation
minimal intervention
History of LRTI
48hrs, fever (>38.5), SOB, cough, grunting
wheeze makes bacterial cause unlikely
reduced or bronchial breath sounds
Infective agents in LRTI
virus + commensal bacteria/bacterium
should you call it pneumonia?
no, call it LRTI
investigations in LRTI
nothing
CXR NOT routine
management LRTI
nothing if symptoms are mild
oral amoxycillin first line
Pertussis/ whooping cough common?
this is common!
what is Pertussis/ whooping cough?
bronchitis caused by Bordetella pertussis infection
S of Pertussis/ whooping cough
“coughing fits”
vomiting and colour change
vaccination against Pertussis/ whooping cough reduces … and …..
risk and severity
treatment of Pertussis/ whooping cough
supportive
when to treat otitis media?
age under 2 AND bilateral OM
oral amoxycillin
when to treat tonsillitis?
if you know if its Strep
penicillin 10days
when to treat LRTI/ pneumonia
2 days fever, cough, focal signs
oral amoxycillin
Solution to asthma problem
no wheeze …
if QoL affected, confirm diagnosis with trial of…
QoL not affected….
no asthma
ICS
watch and see
key words in asthma
wheeze - genuine
variability - symtoms come and go ebb and flow
responds to treatment
aetiology of asthma
“hyperactive’ airways, chronic bronchial inflammation
S of Asthma
where and difficulty in breathing triggers viral URTI cold exercise allergens
other factors that increase risk of asthma
parental Hx asthma
eczema
hayfever
food allergies
asthma treatment
ICS for 2 months
ideal history of asthma
wheeze (with and without URTI)
SOB@rest
parental asthma
Responds to treatment
treatment of asthma
bronchodilators -SABA
steroids - ICS
LABA + leukotriene receptor antagonist add ons
Other management of Asthma
stop tobacco smoke exposure
remove environmental triggers
