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year 4 paediatrics > respiratory infections > Flashcards

respiratory infections Flashcards

1
Q

what commonly causes tonsilitis and pharangitis?

A
  • ussually viral
  • can be caused by group A beta haemolytic strep
  • can distringuish bacterial from viral if there is pleurelent exudate and lymphadenopathyh
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2
Q

what is the scoing system used to catagorise croup?

A

westly scorring system

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3
Q

which children should be admitted to hospital for croup?

A

Haemodynamically significant congenital heart disease
< 3 months old
Inadequate fluid intake < 50-75%

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4
Q

what is the causative organism of croup?

A

parainfluenza

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5
Q

how long does croup last?

A

5-6 days

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6
Q

what is the management of mild croup?

A
  • discharged home with oral dexamethasone
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7
Q

what is the management of moderate/severe croup?

A
  • admission to hospital
  • oxygen
  • oral dexamethasone
    nebulised budenaside and adrenaline

intubation if fatigued

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8
Q

what are the complicatins of croup?

A
  • airway obstruction

- superinfection= superimpostion with staphylococcus causing bacterial tracheitis

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9
Q

what ate the symptoms of croup?

A
  • barking cough

- stridor

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10
Q

how is croup diagnosed?

A
  • clinical diagnosis
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11
Q

what is the peak presenting age for epiglotisis?

A

6-12 years old

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12
Q

what are risk factors for epiglotisis?

A

Male gender
Unvaccinated
Immunocompromised

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13
Q

what is the causative organism in epiglotitis?

A

Haemophylis influenza B (HIB)

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14
Q

how to investigatew epiglotitis?

A
  • senior paediatrician and anasthetics
  • simply opn mouth- no instruments
  • no bloods showing inflamatory markers until the airway has been secured
  • can use laryngyscope
  • neck radiograph will show thumb sign
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15
Q

what are clinical features of epiglotitis?

A
  • stridpor
  • tripod position
  • drooling
  • dyphagia
  • pyrexial
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16
Q

what are complications of epiglotitis?

A

Airway obstruction: occurs secondary to significant upper airway inflammation and oedema

Mediastinitis: infection can track along the retropharyngeal space and involve the mediastinum, which is associated with a poor prognosis

Soft tissue involvement: cellulitis or abscess within the neck

17
Q

how is epiglotisis managed?

A
  • secure the airway
  • nebulise adrenaline
  • IV abx (broad spectrum like cephtriaxone)

dexamethasone is second line

18
Q

how does whooping cough present?

A
  • paroxysmal cough worse at night- lasting 4 days or more (infants may have apneoic episodes)
  • leads to ‘whoop in between’
  • post tussive vomiting
  • cough may cause subconjunctival haemorrhage
  • can have marked lymphocytosis
19
Q

what is the causative organism for whooping cough?

A

gram negative bacteria- pertussis

20
Q

whan are vaccines given against wooping cough?

A

infants are routinely immunised at 2, 3, 4 months and 3-5 years.

Newborn infants are particularly vulnerable, which is why the vaccination campaign for pregnant women was introduced

but this is not lifelong protection

21
Q

how is whooping cough diagnosed?

A

per-nasal swab - may take several days or weeks to come back
PCR

22
Q

which patients with whooping cough should be admitted?

A
  • under 6 months
23
Q

what is the management or whooping cough?

A
  • pertussis is a notifiable disease- tell authorities
  • use an oral macrolide abx- clarythromycin
  • contacts to be given prophylaxis
  • school exclusion for 48hrs after abx or 21 days from onset of symptoms
24
Q

what are complications of whooping cough?

A

subconjunctival haemorrhage
pneumonia
bronchiectasis
seizures

25
Q

what age range is affected by bronchiolitis?

A

<1 … peak incidence 3-6 months, maternal IgG provides protection for newborn babies

26
Q

what is the causative oragansim in bronchiolitis?

A

RSV

27
Q

what are symptoms of bronchiolitis?

A

coryzal symptoms (including mild fever) precede:
dry cough
increasing breathlessness
wheezing, fine inspiratory crackles (not always present)
feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission

28
Q

what is the management for bronchiolitis?

A

humidified oxygen is given via a head box and is typically recommended if the oxygen saturations are persistently < 92%

nasogastric feeding may be needed if children cannot take enough fluid/feed by mouth

suction is sometimes used for excessive upper airway secretions

29
Q

when should you consider referring to hospital for bronchiolitis?

A

a respiratory rate of over 60 breaths/minute

difficulty with breastfeeding or inadequate oral fluid intake (50-75% of usual volume ‘taking account of risk factors and using clinical judgement’)

clinical dehydration….How are their nappies?

year 4 paediatrics (27 decks)

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