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Y4 Paeds > Upper Resp > Flashcards

Upper Resp Flashcards

1
Q

what is croup?

A

laryngotracheobronchitis

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2
Q

what age is most affected by croup?

A

2yrs

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3
Q

what commonly causes croup?

A

parainfluenza virus

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4
Q

state some organisms that cause croup?

A 
parainfluenza (type 1,2,3,4)
respiratory syncytial virus 
adenovirus 
rhinovirus 
enterovirus 
measles 
influenza A and B 
mycoplasma pneumoniae (rare)
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5
Q

what are risk factors for croup?

A

male
autumn and spring season
C/C variant of CD14 C159T gene (have lower prevalence of croup)

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6
Q

how long do viral resp infections usually last?

A

couple of days

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7
Q

how long does pertussus last ?

A

3 months

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8
Q

how long does croup last?

A

1-4 days (since its caused most commonly by parainfluenza virus)

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9
Q

when are symptoms worse for resp infections/conditions?

A

at night since the child is lying down and they are not able to cough or breath as well as they would when standing up

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10
Q

what are the symptoms of mild croup?

A

occasional barking cough

child is happy and will drink/eat/play

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11
Q

what are the symptoms of moderate croup?

A

frequent barking cough
audible stridor at rest
child is not distressed or agitated

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12
Q

what are the symptoms of severe croup?

A

frequent barking cough
prominent stridor
use of accessory muscles
child is distressed

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13
Q

what are DD for croup?

A 
epiglottis 
inhaled foreign body 
acute anaphylaxis 
bacterial tracheitis 
diphtheria 
laryngomalacia 
peritonsillar abscess 
retropharyngeal abscess 
laryngeal web, papillomata
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14
Q

does epiglottis or croup have prior features ?

A

croup has coryza

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15
Q

will epiglottis or croup have a raised temperature?

A

epiglottis >38.5

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16
Q

where can mild croup be managed ?

A

at home

17
Q

when should mild croup be admitted?

A 
previous Hx of airway obstruction 
<6months old 
immunocompromised 
poor response to treatment 
diagnosis is uncertain 
significant parental anxiety
18
Q

what advice should be given for home managed croup?

A

symptoms usually resolve within a couple of days
antibiotics aren’t required since it is a viral infection
paracetamol can be used to control pain
ensure adequate fluid intake
seek urgent medical advice if symptoms worsen

19
Q

what medication can be used for croup?

A

single dose of oral dexamethasone (0.15mg/kg)
nebulised adrenaline
oxygen

20
Q

what are some complications of croup?

A 
Lymphadenitis
Otitis Media
Dehydration
bacterial superinfection 
pulmonary oedema, pneumothorax (very rare)
21
Q

what age is the peak incidence of croup?

A

2yrs

22
Q

what is the voice like in croup?

A

hoarse

23
Q

what is the voice like in epiglottitis?

A

weak/silence

24
Q

what organism causes whooping cough?

A

Bordetella pertussis

25
Q

when are vaccines against pertussis given?

A

2,3,4 months

booster given at 3yrs and 4 months before school

26
Q

what type of bacteria is bordetella pertussis ?

A

gram negative bacillus

27
Q

what are the three stages for whooping cough?

A

catarrhal phase
paroxysmal phase
convalescent phase

28
Q

what occurs in the catarrhal phase of whooping cough ?

A 
rhinitis
conjunctivitis 
irritability 
low grade fever 
dry cough
29
Q

what occurs at the paroxysmal phase of whooping cough?

A

the classic sign of repeated coughing followed by an inspiratory gasp (producing the classic whoop sound)
may be followed by vomiting as the abdominal pressure has increased so much from coughing and increased mucosal secretions

30
Q

what occurs at the convalescent phase of whooping cough?

A

up to 3 months of the cough gradually decreases in frequency

31
Q

what are the DD of pertussis ?

- all with long natural histories

A 
bronchiolitis 
asthma 
mycoplasma pneumonia 
bacterial pneumonia 
TB
32
Q

what does bordetella pertussis do to the airways?

A

paralyse the cilia and promote inflammation, impairing the clearance of respiratory secretions which leads to a cough

33
Q

what investigations can be done for pertussis ?

A

PCR and culture of nasopharyngeal aspirate

anti pertussis toxin IgG serology (if cough is >2weeks and <5yrs)

anti-pertussis toxin detection in oral fluids (if cough >2weeks and >5yrs)

FBC (usually reveals lymphocytosis)

34
Q

what antibiotic can be given for whooping cough if <21days duration?

A

clarithromycin

co-trioxazole 2nd line

35
Q

what are some complications of whooping cough?

A

secondary bacterial pneumonia
seizures
encephalopathy

36
Q

what is the commonest chronic resp condition in children?

A

asthma

Y4 Paeds (15 decks)

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