respiratory symptoms in children

Question 1

wheezing in a child < 6 - ddx (7)

Answer 1

structural

• tracheomalacia, bronchomalacia
• foreign body inhalation

infection

• episodic viral wheeze
• viral resp tract infection
• protracted bacterial bronchitis

wheeze syndromes

• pre-school wheeze (basically asthma but in a kid)
• multi-trigger wheeze

Question 2

protracted bacterial bronchitis - criteria to diagnose (6)

Answer 2

wet cough > 4 weeks
only symptom is cough
dyspnoea only when coughing

day and night symptoms
worse with posture change

child is otherwise well

Question 3

protracted bacterial bronchitis - management

• initial
• incomplete resolution

Answer 3

amoxiclav 22.5 + 3.2mg/kg up to 1g, BD for 2 weeks
or bactrim DS if hypersensitive to penicillin
if partial improvement at 2 weeks - repeat course for extra 2 weeks