Upper Respiratory Tract Infections in Children

Question 1

What is the fine line between bacterial colonisation and infection?

Answer 1

Epithelium

Question 2

What are the side effects of antibiotics?

Answer 2

Diarrhoea, Oral Thrush, Nappy rash, Allergic Reaction, Multi resistance

Question 3

What fraction of all admission to hospital are due to upper respiratory tract infections?

Answer 3

over 1/3

Question 4

What do upper respiratory tract infections often come with?

Answer 4

Fever

Question 5

What are the two dilemma’s linked to UTI’s?

Answer 5

Antibiotics or not?, prodrome to serious illness?

Question 6

What are the three things to advise a child that comes to see you early on in their UTI?

Answer 6

Paracetamol, sugary fluids and time

Question 7

How many cold is normal in the winter months?

Answer 7

2

Question 8

What do you do if youre not too sure how far into an infection the child is?

Answer 8

Get the parents to review them

Question 9

What is rhinutis?

Answer 9

Infection that results in a runny nose

Question 10

What is otitis media?

Answer 10

Infection of the ears

Question 11

What secondary infection is linked to otitis media?

Answer 11

Pneumococcus

Question 12

What is the main treatment to use in otitis media?

Answer 12

Analgesia

Question 13

How do you diagnose tonsillitis/pharyngitis?

Answer 13

Throat swab

Question 14

What is the treatment for tonsillitis/pharyngitis?

Answer 14

Nothing or 10 days on penicillin

Question 15

What do children with streptococci usually have?

Answer 15

Scarlet fever, pink rash that feels like sandpaper, sick for about a week,

Question 16

What is the cause of croup?

Answer 16

Para flu I

Question 17

What are the symptoms of croup?

Answer 17

Stridor and a barking cough

Question 18

What is the treatment for croup?

Answer 18

oral dexamethasone or prednisolone

Question 19

what is the cause of epiglottis?

Answer 19

H.influeza type B

Question 20

What are the symptoms of epiglottis?

Answer 20

Stridor and drooling.

Question 21

What is the treatment for epiglottis?

Answer 21

intubation and antibiotics

Question 22

What are some URTI?

Answer 22

• Otitis media
• Pharyngitis
• Laryngitis
• Epiglottitis
• Croup
• Rhinitis

Question 23

What are examples of viral infective agents?

Answer 23

• Adenovirus
• Influenza A, B
• Para’flu I, II
• RSV
• Rhinovirus

Question 24

What are examples of bacterial infective agents?

Answer 24

• H influenza
• M catarrhalis
• Mycoplasma
• Staph. aureus
• Streptococci (S. Pyogenes, S. pneumoniae)

Question 25

What are examples of bacterial infective agents?

Answer 25

• H influenza
• M catarrhalis
• Mycoplasma
• Staph. aureus
• Streptococci (S. Pyogenes, S. pneumoniae)

Question 26

What is rhinitis a prodrome to?

Answer 26

• Pneumonia
• Bronchiolitis
• Meningitis
• Septicaemia

Question 27

Describe the appearance of otitis media?

Answer 27

Erythema (rash)

Bulging drum

Question 28

How can otitis media occur?

Answer 28

• As a primary viral infection

- As a secondary infection with pneumococcus/ H’flu

Question 29

Why is it advisable to not treat otitis media with antibiotics?

Answer 29

• Often the main symptom is pain and that can be treated with analgesics
• Antibiotics would take effect from day 2/3 after the worst of the symptoms
• Studies show that a large proportion of those who took antibiotics suffered from side effects
• The benefits do not outweigh the negatives
• First do no harm

Question 30

How long does the earache associated with otitis media usually last?

Answer 30

Usually up to 8 days

Question 31

What are the benefits of delaying treatment for otitis media?

Answer 31

• Fewer patients are treated unnecessarily saving money and decreasing risk of antibiotic resistance
• Fewer people experience side effects

Question 32

What is definite about treatment for otitis media?

Answer 32

• Analgesia works
• Antibiotics may work after 24 hours but they are not advised
• The illness resolves within a short period of time

Question 33

What should not be given to treat tonsillitis?

Answer 33

Amoxycillin

Question 34

How can bacterial and viral tonsillitis be differentiated?

Answer 34

The only way is for a throat swab to be sent to the lab and cultured to see if bacterial colonies grow. Culturing takes 48 hours

Question 35

What is the dilemma surrounding whether to treat tonsillitis with antibiotics or not?

Answer 35

Culturing takes 48 hours to show if it is bacterial and will respond to antibiotics. However within this time the infection will start to improve by itself

Question 36

What is another name for croup?

Answer 36

Laryntracheobronchitis

Question 37

How does the child appear with croup?

Answer 37

Well

Question 38

How does the child appear with epiglottitis?

Answer 38

Toxic and very well

Question 39

What is the dilemma between diagnosis of croup/ epiglottitis?

Answer 39

• You need to get it right
• Epiglottitis is the differential diagnosis for croup
• However, epiglottitis is extremely serious as it can block the airways

Question 40

What are the majority of URTIs caused by?

Answer 40

Pathogens

Question 41

What is normally not useful in the treatment of URTIs?

Answer 41

Antibiotics

Question 42

What are most URTIs?

Answer 42

Self limiting