The Ill Child

Question 1

What is Bronchiolitis?

Answer 1

Acute, Inflammatory Injury of the Bronchioles and is often caused Virally.

Often predisposed by a Cold that spreads into the infant’s chest.

Question 2

What is a common cause of bronchiolitis for children <1 years?

Answer 2

RSV

Question 3

List symptoms of Bronchiolitis

Answer 3

Snotty
Low Mood
Struggle with Feeding 
Might Need Oxygen 
Salivation
Bubbling around Mouth
Distinct Cough
Widespread Fine Crackles throughout Lung Fields

Question 4

What is treatment of Bronchiolitis?

Answer 4

Supportive as it is a virus.
Smaller feeds but more often (Bronchiolitis typically lasts 5 days)

O2 and IV Fluids if child is cyanosed, unable to eat or undergoing respiratory distress.

Question 5

What is Croup/Laryngotracheobronchitis Infection?

Answer 5

Acute, Viral Infection that affects 3 Aspects of the Respiratory Tract:

- Larynx 
- Trachea 
- Bronchi

Question 6

What is Croup most commonly caused by?

Answer 6

Parainfluenza or in some cases; RSV.

Question 7

What are symptoms of Croup?

Answer 7

Cold
Barking Cough
Stridor due to Narrowing of the Air Column (Trachea and Bronchi)

Child gets Suddenly Worse Overnight

Question 8

What is treatment of Croup?

Answer 8

Steroids i.e. Oral/Nebulised Dexamethasone.

Question 9

What is Epiglottitis?

Answer 9

ENT Emergency, usually caused by Haemophilus Influenzae

Question 10

What is the classic appearance of Epiglottitis?

Answer 10

Salivary drooling as child cannot swallow

Cherry red appearance

Question 11

What is the treatment of Epiglottitis?

Answer 11

Secure the airway then treat with steroids

DO NOT touch their airway PRIOR TO SECURING to prevent complete obstruction.

Question 12

What is the Paediatric Treatment of Asthma?

Answer 12

Salbutamol
Inhaled Steroid, Nightly Dose
LABA

Question 13

What is Meningitis?

Answer 13

infection of the Protective Membranes that Surround the Brain and Spinal Cord (i.e. The Meninges).

Causes can be Bacterial (E.coli or Strep) or Viral.

Question 14

List symptoms of Meningitis

Answer 14

Temperature
Lethargy
Poor Feeding
Low Mood 
Look Off-Colour

Question 15

List investigations for Meningitis

Answer 15

Lumbar Puncture
Urine Tests for UTIs
Bloods

Question 16

What is treatment of Meningitis?

Answer 16

Antibiotics i.e. Acyclovir.

Question 17

When a Child presents with a Fulminant Purpura Rash which is Non-Blanching on the Tumbler Test, what is the diagnosis?

Answer 17

Meningococcaemia

Note that the child will be in shock - treat with antibiotics.

Question 18

What are vasovagal episodes/syncope?

Answer 18

Brief, fainting Episodes that occur as a result of your body overreacting to a trigger e.g. Distress, and decreased oxygen supply to the Brain.

Some children can show ‘fitting movements’ and therefore, look like they are having a seizure.

Question 19

What are Febrile Seizures?

Answer 19

Fits that occur when a child has Fever/Pyrexia. Causes of Febrile Seizures include Meningococcaemia. WE DO NOT TREAT THESE.

Question 20

What are Reflex Anoxic Seizures?

Answer 20

Form of Syncope that are usually triggered by a Sudden Fright/Pain, the most common cause being an Unexpected Bump to the Head.
During the seizure, they are in Asystole and once they come out of the seizure, their heart rhythm and rate returns to normal.

Question 21

What are Breath-Holding Attacks?

Answer 21

Child experiences a sudden shock/pain or is upset/angry/distressed. The child stops breathing taking breaths in, turns pale/grey/cyanosed and then briefly faints.

Question 22

At what Length of Time does a Seizure become ‘damaging’?

Answer 22

5 minutes