Respiratory tract infections

Question 1

what is the causative organism responsible for croup?

Answer 1

parainfluenza I

Question 2

what causative organism is responsible for epiglottis?

Answer 2

haemophillus influenza

Question 3

what is the treatment for croup?

Answer 3

dexamethasone

Question 4

what is the presentation of croup?

Answer 4

barking cough
coryza
stridor

Question 5

what is the presentation of epiglottis?

Answer 5

stridor

drooling

Question 6

what causative organisms are responsible for tonsillitis/pharyngitis?

Answer 6

viral: EBV
bacterial: group A strep

Question 7

what investigation would you carry out to determine if the source of the tonsillitis was bacterial or viral?

Answer 7

throat swab

Question 8

what is the treatment for bacterial tonsillitis?

Answer 8

10 days penicillin

Question 9

what is the average duration of tonsillitis?

Answer 9

7-10 days

Question 10

what is the average duration of otalgia from otitis media?

Answer 10

3-7 days

Question 11

what can be viewed on otoscope suggestive of ottits media?

Answer 11

bulging ear drum
erythema
spontaneous rupture of tympanic membrane

Question 12

what causative organisms are responsible for bronchitis?

Answer 12

haemophillus

pneumococcus

Question 13

what is the presentation of bronchitis?

Answer 13

rattling cough
post-tussive vomit of glut
no wheeze or crepitations

Question 14

what are the red flag signs with regards to LRTI in children?

Answer 14

age <6 or > 4 yrs 
no relapse-remission
static weight 
disrupts childs weight 
associated SOB when not coughing 
acute admission
other co-morbidities

Question 15

in what age group is bronchiolitis found?

Answer 15

< 12 months

most common at 3 months

Question 16

what is the presentation of bronchiolitis?

Answer 16

infants < 12 months 
nasal stiffness 
tachypnoea 
poor feeding 
wheeze +/- crackles

Question 17

what is the average duration of bronchiolitis?

Answer 17

12-16 days

Question 18

what is the treatment for bronchiolitis?

Answer 18

max observation

min intervention

Question 19

what causative organism is responsible for bronchiolitis?

Answer 19

respiratory syncytial virus (RSV)

others include: parainfluenza III & HMPV

Question 20

what is the presentation of pneumonia in a child?

Answer 20

> 48 hours fever
cough
SOB
grunting

Question 21

on clinical examination of a patient with suspected pneumonia, what finding would make you think that this wasn’t pneumonia?

Answer 21

wheeze

Question 22

what investigations would you carry out to diagnose pneumonia in a child?

Answer 22

none

its a clinical diagnosis

Question 23

what’s the treatment for children with pneumonia?

Answer 23

nothing if mild
1st line oral amoxicillin
2nd line oral macrolide

( IV if vomiting )

Question 24

when would you term LRTI in a child ‘pneumonia’?

Answer 24

if it was focal, there was crepitations and a high fever

Question 25

what sign would you observe on clinical examination of a child with pneumonia?

Answer 25

reduced or bronchial breath sounds | if focal - crepitations

Question 26

how do LRTI usually arise in children?

Answer 26

initiated by a viral infection which disrupts the normal bacterial community in the LRT i.e. viral infection i.e. RSV/adenovirus paralyses the cilia with disrupts the mucocilliary escalator which causes colonisation of bacteria

Question 27

what are the side effects of antibiotics in children?

Answer 27

``` diarrhoea oral thrush napy rash allergic reaction resistance ```

Question 28

in what age group is pertussis most common?

Answer 28

school age (5-16yrs)

Question 29

what organism is responsible for tracheitis?

Answer 29

staph aureus

Question 30

what is the treatment for tracheitis?

Answer 30

IV / oral flucloxacilin +/- ceftriaxone | steroids ?

Question 31

what is the presentation of tracheitis?

Answer 31

barking cough stridor fever recurs despite steroids

Question 32

what is the most likely diagnosis for a child who was diagnosed with croup but hasn't responded to dexamethasone?

Answer 32

tracheitis

Question 33

what are differentials of a barking-like cough and stridor?

Answer 33

croup tracheitis foreign body epiglottitis

Question 34

what investigation would you carry out for suspected bronchiolitis?

Answer 34

nasopharyngeal aspirate