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Paediatrics > Respiratory disease > Flashcards

Respiratory disease Flashcards

1
Q

What are the causes of glandular fever/infectious mononucleosis?

A

1) EBV (90% of cases)

2) CMV

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2
Q

What is the HxPC in glandular fever?

A

1) Exudative pharyngitis
2) Generalised, tender, lymphadenopathy
3) Lethargy
4) Widespread erythematous macular rash
5) Hepatosplenomegaly

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3
Q

What is the classic triad for Dx of glandular fever?

A

1) Lymphocytosis
2) >/=10% atypical lymphocytes on peripheral blood film
3) +ve serology for EBV

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4
Q

What investigation may be used to Dx glandular fever?

A

The monospot test

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5
Q

What are the GI complications of glandular fever?

A

1) hepatitis; 2) splenomegaly; 3) spleen rupture

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6
Q

What are the CNS complications of glandular fever?

A

1) aseptic meningitis; 2) encephalitis; 3) GBS

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7
Q

What are the other complications of glandular fever?

A

POST-VIRAL TENDERNESS; lymphoma; orchitis; myocarditis; pneumonia

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8
Q

What is the causative organism in croup?

A

Parainfluenza viruses

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9
Q

How is croup managed?

A

Admit (for moderate/severe) + single dose oral dexamethasone

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10
Q

How is croup managed as an emergency?

A

High flow oxygen + nebulised adrenaline

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11
Q

What is the HxPC of croup?

A
  1. Stridor (laryngeal oedema + secretions)
  2. Barking cough, worse at night
  3. Pyrexia
  4. Coryzal Sx
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12
Q

What type of cough is seen in croup?

A

Barking cough, worse at night

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13
Q

What is the dose of oral dexamethasone in croup?

A

0.15mg/kg

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14
Q

What are the causes of stridor in children?

A
  1. Croup
  2. Laryngomalacia
  3. Epiglossitis
  4. Foreign body upper airway obstruction
  5. Anaphylaxis
  6. Measles
  7. Diptheria
  8. Severe LN swelling (as in mono)
  9. Hypocalcaemia from decreased vit D
  10. Retropharyngeal abscess
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15
Q

What is the causative organism in whooping cough?

A

Bordetella pertussis

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16
Q

How long might Sx last in whooping cough?

A

10-14 WEEKS

17
Q

What are the 3 phases of whooping cough?

A
  1. CATARRHAL PHASE
  2. PAROXYSMAL PHASE
  3. CONVALESCENT PHASE
18
Q

What are the features of the catarrhal phase of whooping cough?

A

1 week of coryzal Sx

19
Q

What are the features of the paroxysmal phase of whooping cough?

A

Paroxysmal/spasmodic cough, followed by an inspiratory ‘whoop’
Lasts 3-6 weeks

20
Q

How is whooping cough Dx?

A

Blood film - marked lymphocytosis (>15x10^9)
Nasal swab, culture or PCR (PCR more sensitive)
CXR = patchy atelectasis (as with bronchiolitis)

21
Q

What are the complications of whooping cough?

A
  1. Subconjunctival haemorrhage (from coughing)
  2. Seizures (from anoxia from coughing)
  3. Pneumonia
  4. Bronchiectasis
22
Q

How is whooping cough managed?

A

Oral macrolide, e.g. erythromycin, but only decreases Sx if started in the catarrhal phase
Close contacts should receive erythromycin prophylaxis + unvaccinated children should be vaccinated

23
Q

How long should children stay off school with whooping cough?

A

May return to school 5 days after commencing antibiotics

24
Q

What are the causative organisms of bronchiolitis?

A
  1. RSV
  2. Mycoplasma
  3. Adenovirus
  4. May be secondary to bacterial infection
25
Q

What is the organism that most commonly causes bronchiolitis?

A

RSV - in 75-80%

26
Q

Who are at increased risk of developing bronchiolitis?

A
  1. Premature infants
  2. Infants with heart/lung abnormalities
  3. Immunocompromised
27
Q

What may be given when a child is at increased risk of severe disease to prevent them getting bronchiolitis?

A

Palvizumab - a monoclonal Ab

28
Q

What are the CXR findings in bronchiolitis?

A

Hyperinflation + ‘patchy’ atelectasis + gas trapping

29
Q

How should bronchiolitis be investigated?

A 
Temperature
O2 sats
RR
HR
Cap refill/hydration status
Bloods
(CXR)
30
Q

How should bronchiolitis be managed?

A

Humidified O2 if sats <92%
Supported feeding/NG feeding necessary
Suction for upper airway secretions

31
Q

What are the causative organisms of pneumonia in newborns?

A
  1. Group B strep

2. Gram -ve enterococci

32
Q

What are the causative organisms of pneumonia in children <5y/o?

A 
1. Viruses most common in <5y/o, usually, RSV
Other causes =
2. Strep pneumoniae
3. H. influenzae
4. Bordetella pertussis
5. Chlamydia trachomatis
6. S. aureus
33
Q

What are the causative organisms of pneumonia in children >5y/o?

A

Bacterial most common:

  1. Mycoplasma pneumoniae
  2. Strep pneumoniae
  3. Chlamydia pneumoniae
34
Q

What is the cause of epiglottitis?

35
Q

What features should lead you to suspect epiglottis?

A
  1. Pyrexia, toxic-looking child
  2. Child is drooling (because it is painful for them to swallow)
  3. Inspiratory stridor
  4. Tripod position (to optimise the airway)

Paediatrics (27 decks)

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