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Paediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What can rhinitis be a prodrome to?

A
  • Pneumonia
  • Bronchiolitis
  • Meningitis
  • Septicaemia
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2
Q

When does rhinitis usually occur?

A

Very common

5-10 per year but concentrated in the winter months

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3
Q

How long does a runny nose usually last?

A

10-14 days

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4
Q

How long can earache last?

A

Up to 8 days usually

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5
Q

What is otitis media?

A

A common self-limiting infection of the ear

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6
Q

How does otitis media present?

A
  • Painful ear
  • Erythema in ear
  • Bulging drum (may spontaneously rupture)
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7
Q

What organisms can cause otitis media?

A
  • Primary viral infection
  • Secondary infection with pneumococcus or haemophilus influenza
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8
Q

How is otitis media managed?

A
  • Analgesics
  • Antibiotics have more side effects than benefits so are generally not used
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9
Q

What antibiotic should not given in tonsillitis/pharyngitis?

A

Amoxicillin

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10
Q

How long does a sore throat usually last?

A

About 2-7 days

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11
Q

How is tonsillitis/pharyngitis treated?

A

Either nothing or 10 days of penicillin if known strep infection

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12
Q

What organism is responsible for croup?

A

Para’flu I

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13
Q

What organism is responsible for epiglottitis?

A

H. influenza type B

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14
Q

How does croup present?

A
  • Coryza
  • Stridor
  • Hoarse voice
  • Barking cough
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15
Q

How does epiglottis present?

A

Stridor and drooling

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16
Q

How is croup treated?

A

Oral dexamethasone

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17
Q

How is epiglottitis treated?

A

Intubation and IV antibiotics

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18
Q

How long does croup usually last?

A

2-3 days

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19
Q

What common agents are implicated in LRTI?

A
  • Bacterial overgrowth
    • Strep pneumoniae
    • Haemophilus influenza
    • Moraxella catarrhalis
    • Mycoplasma pneumoniae
    • Chlamydia pneumoniae
  • Viral infection
    • RSV
    • Parainfluenza III
    • Influenza A and B
    • Adenovirus
    • Rhinovirus
20
Q

What are the principles of management for LRTI?

A
  • Make a diagnosis
  • Assess the patient (oxygenation, hydration, nutrition)
  • Treat or wait for resolve
21
Q

What is the most common LRTI of childhood?

A

Bronchitis

22
Q

How does bronchitis present?

A
  • Loose rattly cough
  • Post-tussive vomit - “glut”
  • Chest free of wheeze/creps
  • Child very well, parent worried
23
Q

What organisms are associated with bronchitis?

A
  • Haemophilus
  • Pneumococcus
24
Q

What is the mechanism of bacterial bronchitis?

A
  • Disturbed mucociliary clearance due to Minor airway malacia and RSV/adenovirus
  • Lack of social inhibition!
  • Bacterial overgrowth is secondary
25
Q

What is the cycle of bronchitis in the winter?

A
  • Resp virus obtained
  • Clearance stops for <4 weeks
  • Cough and rattle
  • Clearance almost recovered
  • Child picks up another virus
26
Q

What are the red flags of bronchitis?

A
  • Age <6 mo, >4yr
  • Static weight
  • Disrupts child’s life
  • Associated SOB (when not coughing)
  • Acute admission
  • Other co-morbidities (neuro/gastro)
27
Q

How long does a cough usually last?

A

Can be 7-25+ days

28
Q

What are the 3 points in the management of persistent bacterial bronchitis?

A
  • Make the diagnosis
  • Reassure
  • Do not treat
29
Q

What organisms can cause bronchiolitis?

A
  • usually RSV
  • Paraflu III
  • HMPV (Human metapneumovirus)
30
Q

How does bronchiolitis present?

A

(LRTI)

  • Nasal stuffiness
  • Tachynpnoea
  • Poor feeding
  • Crackles +/- wheeze
31
Q

What is the incidence of bronchiolitis?

A

Affects 30-40% of all infants

32
Q

What is the expected course of bronchiolitis?

A
  • Child is well days 1+2 of cough
  • Gets worse days 3-5
  • Parent usually seeks medical attention about day 5
  • Child stabilises days 6+7
  • Recovery days 7-14
33
Q

When does RSV infection usually occur?

A

Christmas period

34
Q

When is it bronchiolitis?

A
  • <12 months old
  • One off
  • Follows the typical history
35
Q

How is bronchiolitis managed?

A
  • Maximal observation
  • Minimal intervention
36
Q

How is bronchiolitis investigated?

A
  • NPA (nasopharyngeal aspirate)
  • Oxygen saturation for severity
37
Q

What is there no routine need for in bronchiolitis?

A
  • CXR
  • Bloods
  • Bacterial cultures
38
Q

What medications are proven to work in bronchiolitis?

A

NONE

39
Q

When should a LRTI be suspected?

A
  • 48 hrs, fever (>38.5oC), SOB, cough, grunting
  • Wheeze makes bacterial cause unlikely
  • Reduced or bronchial breath sounds
40
Q

When can you call a LRTI pneumonia?

A
  • Signs are focal
  • Crepitation’s
  • High fever
41
Q

What is the BTS guidelines for the management of community acquired pneumonia?

A
  • Nothing is symptoms are mild
  • Oral Amoxycillin first line
  • Oral Macrolide second choice
  • Only for iv if vomiting
42
Q

How is pertussis characterised?

A

(Whooping cough)

Coughing fits with vomiting and colour change

43
Q

Why does pertussis still occur despite vaccination?

A

Vaccination reduces risk and severity but does not eliminate the possibility

44
Q

When is LRTI/pneumonia treated?

A

History of 2 days fever, cough and focal signs (ie one side) then treat with oral amoxycillin

45
Q

What is treatment for acute respiratory infections aimed at?

A

Maintaining oxygenation, hydration and nutrition

46
Q

When is otitis media treated?

A

Oral amoxicillin if <2 years with bilateral OM

Paediatrics (38 decks)

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