Upper Respiratory Tract Infections in Children

Question 1

What clinical sign are URTIs often associated with?

Answer 1

Fever

Question 2

What is rhinitis?

Answer 2

Runny nose

Question 3

What is otitis media?

Answer 3

an infection of the middle ear that causes inflammation (redness and swelling) and a build-up of fluid behind the eardrum.

Question 4

What age group is most commonly affected by otitis media?

Answer 4

Anyone can develop a middle ear infection but infants between six and 15 months old are most commonly affected

Question 5

What kind of infectious agent most commonly causes otitis media?

Answer 5

Viruses

Question 6

Otitis media can be secondary to a cold and an overgrowth of which two bacteria?

Answer 6

pneumococcus/ haemophilus

Question 7

What is the most significant complication of otitis media?

Answer 7

Spontaneous rupture of the eardrum

Question 8

What would you expect to see when examining an ear suffering from otitis media?

Answer 8

absence of the light reflex (light of otoscope shining back at you), redness in the ear canal and a bulging eardrum.

Question 9

What will be released from he ear when the eardrum ruptures?

Answer 9

Pus

Question 10

What is the typical duration of symptoms in those suffering from otitis media?

Answer 10

3 days (but can last up to 7 days)

Question 11

Should antibiotics be used to treat otitis media?

Answer 11

Whether to treat with antibiotics or not is controversial because the benefits of antibiotic therapy do not necessarily outweigh the harm (refer to NICE 2018 guidelines on the antimicrobial management of acute otitis media). Harmful effects of the antibiotics used in otitis media include diarrhoea & nappy rash.

Question 12

What is the most significant symptom in otitis media?

Answer 12

Pain

Question 13

What is tonsillitis/pharyngitis?

Answer 13

A sore throat

Question 14

What should the clinician do first when a patient presents with a sore throat?

Answer 14

Throat swab- to determine whether it is viral or bacterial

Question 15

What should be prescribed if the patient has strep throat?

Answer 15

warrants a 10 day course of penicillin (but do not give amoxycillin!)

Question 16

What other illness do children with a strep throat also have?

Answer 16

Scarlett Fever

Question 17

What VIRUS can look like white bacterial colonies on the tonsils?

Answer 17

Epstein Barr

Question 18

What is the medical name for croup?

Answer 18

laryngotracheobronchitis

Question 19

What is croup caused by?

Answer 19

parainfluenza virus `

Question 20

What is the typical duration of croup?

Answer 20

1 day

Question 21

What are the clinical features of croup?

Answer 21

• The child is very well generally but very noisy
• Stridor is caused by the narrowed voice box due to inflammation
• Barking cough is caused by bronchitis
• Runny nose

Question 22

What is croup treated with?

Answer 22

Oral dexamethosone

Question 23

If a child presents with croup, what other condition should you check for?

Answer 23

Epiglottitis

Question 24

How is epiglottis differentiated from croup?

Answer 24

In epiglottitis the child will have stridor & drooling but none of the other symptoms of croup (barking cough, runs nose).