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Paediatrics > Respiratory Pediatrics > Flashcards

Respiratory Pediatrics Flashcards

1
Q

What are some of the negative effects of prescribing antibiotics in children?

A 
Diarrhoea
Oral thrush
Nappy rash
Allergic reaction
Multi resistance
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2
Q

Rhinitis can be a prodrome to which other serious illness in children?

A

Pneumonia, bronchiolitis
Meningitis
Septicaemia

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3
Q

What would be visualized during otitis media ?

A

Red bulging ear drum

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4
Q

What type of infection is otitis media ?

A

Primary viral infection

Can be secondary to an infection (Pneumococcus)

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5
Q

What is often the outcome of otitis media ?

A

Spontaneous rupture of drum

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6
Q

Antibiotics help in otitis media, True or False ?

A

False, they do not help

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7
Q

How would you diagnose tonsillitis/pharyngitis ?

A

Throat swab

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8
Q

How would you treat tonsillitis/pharyngitis?

A

Nothing or 10 days penicillin - do not give amoxycillin

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9
Q

How would a child present if they had croup ?

A

Well, coryza, stridor, hoarse voice, “barking cough”

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10
Q

How would a child present if they had epiglottitis ?

A

Toxic with stridor and drooling.

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11
Q

How would you treat an infant with croup ?

A

Oral dexamethasone

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12
Q

How would you treat an infant with epiglottitis ?

A

Intubation and antibiotics

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13
Q

What are some of the common bacteria which cause LRTI in children ?

A

Strep pneumoniae,

Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydia pneumoniae

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14
Q

What are some of the viral agents which cause LRTI in children?

A

RSV, parainfluenza III, influenza A and B, adenovirus, rhinovirus

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15
Q

How would a child present if they had Bronchitis?

A

Loose rattly cough.
Post-tussive vomit (vomiting after coughing).
The chest is often free of wheeze/creps.
Disturbed mucocilliary clearance.

The child is very well and the parent is often very worried.

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16
Q

What is the bacteria which causes Bronchitis ?

A

Haemophilus/Pneumococcus

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17
Q

What are the red flags in LRTI in children?

A 
Age <6 mo, >4yr
No relapse-remission
Static weight 
Disrupts child’s life
Associated SOB (when not coughing)
Acute admission
Other co-morbidities (neuro/gastro)
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18
Q

What is the difference between Bronchiolitis and Bronchitis ?

A

The difference between the two terms depends upon the anatomical area of the lungs that is infected.

Bronchiolitis is often viral (RSV).

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19
Q

How would a child present if they had bronchiolitis ?

A

Nasal stuffiness, tachypnoea and poor feeding.

Crackles and wheeze.

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20
Q

What is the management of brocnhiolotis ?

A

Observation

21
Q

Investigation recommended for LRTI such as bronchiolitis?

A

Nursing in same ward.
Monitor oxygen saturation.

No need for routine bloods and cultures.

22
Q

What are the cardinal signs of LRTI in children ?

A 
Lasts 48hrs
Fever
SOB
Cough
Grunting
Wheeze makes bacterial cause unlikely.
Reduced or bronchial breath sounds.
23
Q

When would you refer to a LRTI as pneumonia ?

A

If the signs are focal (in one specific zone i.e. LLZ)
If there are creps.
If the child is pyrexic.

24
Q

What is the first line and second line treatment for those with community acquired pneumonia ?

A
  1. PO Amoxycillin
  2. PO Macrolide

Only IV if vomitting

25
Q

How would a child present if they had pertussis ?

A

“coughing fits”

Vomitting and colour change.

26
Q

What would you treat as a priority in a sick child prior to prescribing antibiotics ?

A

Oxygenation
Hydration
Nutrition

27
Q

When would you treat a child with antibiotics for otitis media and what antibiotics would you prescribe?

A

If they are under 2 years and it is a bilateral OM

Oral amoyxicillin

28
Q

When would you prescribe antibiotics for tonsilitis?

A

If you have confirmed it is strep.

29
Q

When would you prescribe antibiotics for a LRTI and what antibiotic would you prescribe ?

A

If theyve had 2 days of fever, cough and focal signs (i.e. one side)

Oral Amoxycillin

30
Q

What causes asthma ?

A

Primary epithelial abnormality which is feuled by asthma/eczema etc.

Not caused by allergy

31
Q

What are the common investigations used to diagnose asthma ?

A

Spirometry
BDR
FeNO (Exhaled Nitric Oxide)
Peak flow

No wheeze = No asthma

32
Q

What other conditions would you expect in a pt with asthma ?

A

Hx:
Eczema
Hayfever
Food allergies

33
Q

What is the ideal pattern for diagnosis of asthma in a child ?

A

Wheeze (without URTI)
SOB at rest
Parental asthma
Responds to treatment

34
Q

When is an asthma diagnosis unlikely?

A

If <18 mths - infection

35
Q

What is some differential diagnosis for asthma onset under 5 y/o ?

A

CF
PCD
Bronchitis
Forgien body

36
Q

What is some differential diagnosis for asthma onset > 5y/o?

A

Dysfunctional breathing
Vocal cord dysfunction
Habitual cough
Pertussis

37
Q

How do you measure control of asthma ?

A

SANE =

Short acting Beta agonist/week.
Absence school/nursery.
Nocturnal symptoms /week.
Exertional symptoms/week.

38
Q

What are the 2 main classes of medication used to treat asthma?

A 
Short acting Beta agonists ( B2 agonists - 2 days a week)
Inhaled corticosteroids (ICS)
39
Q

What are the additional classes of medications which may be prescribed for asthma ?

A

Long acting beta agonists
Leukotriene receptor antagonists.
Theophyllines
Oral steroids

40
Q

What is the maximum dose of ICS you can prescribe to a child < 12 y/o ?

A

800mcg

41
Q

What is the first line preventer in asthma <5s ?

A

LTRA (Leukotriene Receptor Antagonists)

42
Q

We use LAMA in children in asthma true or false ?

A

False

43
Q

What are the adverse side effects in children of ICS ?

A

Height suppression (0.5-1cm)
Oral thrush
Abdrenocortical suppression

44
Q

What would you add on as a 3rd step preventer of asthma on children ?

A

LABA or LTRA

Increase ICS dose

45
Q

What must you have prescribed alongside a LABA ?

A

ICS

46
Q

What are the 2 main types of delivery systems in medication in child asthma ?

A

MDI/Spacer

Dry powder device

47
Q

Under 8 y/o cannot use dry powder devices true or false ?

A

True

48
Q

What are the other forms of management of childhood asthma ?

A

Stop tobacco smoke exposure.

Remove environmental trigger.

Paediatrics (17 decks)

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