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Pediatrics 👶🏻💕 > Urti > Flashcards

Urti Flashcards

1
Q

Q: What are the main types of upper respiratory tract infections (URTIs)?

A

A: Sinusitis, acute pharyngitis and tonsillitis, acute otitis media, viral laryngotracheobronchitis (croup), acute epiglottitis, and bacterial tracheitis.

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2
Q

Q: How is sinusitis classified based on duration?

A

A: Acute (<30 days), subacute (1-3 months), and chronic (>3 months).

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3
Q

What are the main sinuses affected by sinusitis at different ages?

A

A: Ethmoidal and maxillary sinuses are present at birth, maxillary becomes pneumatized by age 4, sphenoidal by age 5, and frontal sinuses develop between 7-8 years, fully developing in adolescence.

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4
Q

Which pathogens commonly cause acute bacterial sinusitis?

A

A: Streptococcus pneumoniae (30%), Haemophilus influenzae (20%), Moraxella catarrhalis (20%), and Streptococcus pyogenes (5%).

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5
Q

What are common symptoms of sinusitis in children?
A What are common symptoms of sinusitis in children?

A

A: Nasal congestion, purulent nasal discharge, fever, cough, bad breath, periorbital edema, headache, and facial pain.

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6
Q

What are indications that sinusitis may be bacterial rather than viral?

A

A: Persistent symptoms ≥10 days, severe symptoms (fever ≥39°C) with purulent discharge for ≥3 days, or worsening

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7
Q

What is the recommended treatment for uncomplicated acute sinusitis?

A

A: Amoxicillin-clavulanate for 10-14 days or until symptoms resolve.

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8
Q

Q: What are the common viral causes of pharyngitis?

A

A: Influenza, parainfluenza, adenoviruses, coronaviruses, enteroviruses, rhinoviruses, respiratory syncytial virus, cytomegalovirus, Epstein-Barr virus, herpes simplex virus, and human metapneumovirus.

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9
Q

Q: How is bacterial sinusitis differentiated from a viral cold?

A

A: Persistence of symptoms for ≥10 days, high fever (≥39°C) with purulent discharge ≥3 days, or worsening symptoms after initial improvement.

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10
Q

Describe the diagnosis approach for sinusitis.

A

A: Diagnosis is primarily clinical. Sinus aspirate culture is definitive but impractical for most. Imaging is generally not recommended in healthy children.

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11
Q

What is the standard treatment for uncomplicated acute sinusitis?

A

A: Amoxicillin-clavulanate for 10-14 days or one week beyond symptom resolution. Decongestants, antihistamines, mucolytics, and intranasal corticosteroids are not recommended.

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12
Q

What are the complications associated with sinusitis?

A

A: Orbital cellulitis, intracranial abscesses, meningitis, cavernous sinus thrombosis, subdural empyema, brain abscess, and osteomyelitis of the frontal bone (Pott’s puffy tumor).

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13
Q

What are the complications associated with sinusitis?

A

A: Orbital cellulitis, intracranial abscesses, meningitis, cavernous sinus thrombosis, subdural empyema, brain abscess, and osteomyelitis of the frontal bone (Pott’s puffy tumor).

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14
Q

What are common causes of pharyngeal inflammation?

A

A: Infectious agents, tobacco smoke, air pollutants, caustic substances, hot food and liquids, and inflammatory conditions like PFAPA syndrome, Kawasaki disease, IBD, and systemic lupus erythematosus.

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15
Q

What complications can arise from untreated GAS pharyngitis?

A

A: Acute otitis media, sinusitis, parapharyngeal abscess, acute rheumatic fever, poststreptococcal glomerulonephritis, and reactive arthritis.

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16
Q

What is the primary reason for treating GAS pharyngitis with antibiotics?

A

A: To prevent acute rheumatic fever, particularly if treatment starts within 9 days of illness onset.

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17
Q

What are signs of viral pharyngitis vs. bacterial (GAS) pharyngitis?

A

A: Viral pharyngitis often includes sneezing, rhinorrhea, cough, and diarrhea, while GAS pharyngitis has higher fever, sandpaper rash, conjunctivitis (with adenovirus), and tender cervical adenopathy.

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18
Q

What are signs of viral pharyngitis vs. bacterial (GAS) pharyngitis?

A

A: Viral pharyngitis often includes sneezing, rhinorrhea, cough, and diarrhea, while GAS pharyngitis has higher fever, sandpaper rash, conjunctivitis (with adenovirus), and tender cervical adenopathy.

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19
Q

Define acute otitis media (AOM) and otitis media with effusion (OME).

A

A: AOM is an infection with symptoms like fever and otalgia, while OME is middle ear effusion without infection signs.

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20
Q

What is the peak incidence of OM in children?

A

A: During the first 2 years of life, with over 80% experiencing at least one episode by age 3.

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21
Q

List risk factors for OM.

A

A: Age, male gender, genetic factors, socioeconomic status, lack of breastfeeding, tobacco smoke exposure, exposure to other children, respiratory allergies, winter season, pneumococcal vaccination status, immune deficiencies, and craniofacial anomalies.

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22
Q

What are the main bacterial causes of AOM?

A

A: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

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23
Q

What are the main bacterial causes of AOM?

A

A: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

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24
Q

Q: How should AOM be managed in children based on age and severity?

A

A: Observe for 3 days in children <6 years (unilateral) or >6 years (bilateral). Antibiotics if no improvement.

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25
Q

What are the main bacterial causes of AOM?

A

A: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

26
Q

What is the first-line antibiotic for AOM, and the duration of treatment?

A

A: High-dose amoxicillin (80-90 mg/kg); duration is 10 days for <2 years and 5-7 days for >2 years.

27
Q

What is the first-line antibiotic for AOM, and the duration of treatment?

A

A: High-dose amoxicillin (80-90 mg/kg); duration is 10 days for <2 years and 5-7 days for >2 years.

28
Q

What is the main cause of viral laryngotracheobronchitis (croup)?

A

A: Parainfluenza virus (types 1 and 2).

29
Q

What are the typical symptoms of mild croup?

A

A: Barking cough, hoarse cry or voice, inspiratory stridor on exertion, low-grade fever, coryzal prodrome, and symptoms worse at night.

30
Q

Describe moderate to severe croup.

A

A: Inspiratory stridor at rest, respiratory distress, tachycardia, use of accessory muscles, agitation, drooling, and possibly cyanosis.

31
Q

What are the treatment options for croup?

A

A: Supportive care, corticosteroids, nebulized epinephrine for severe cases, and hospital observation if necessary.

32
Q

What radiographic sign is associated with croup?

A

A: The “steeple sign,” showing subglottic narrowing on an AP neck radiograph.

33
Q

What are the hallmark features of acute epiglottitis?

A

A: High fever, sore throat, drooling, stridor, “tripod position,” and risk of rapid airway obstruction.

34
Q

Q: What is the classic radiographic sign of epiglottitis?
.

A

A: The “thumb sign” on a lateral neck radiograph

35
Q

What is the primary treatment for acute epiglottitis?

A

A: Securing the airway (often via intubation) and antibiotics like ceftriaxone.

36
Q

How can viral and bacterial pharyngitis be differentiated?

A

A: Bacterial pharyngitis often has tender lymph nodes, tonsillar exudates, and higher fever.

37
Q

How can viral and bacterial pharyngitis be differentiated?

A

A: Bacterial pharyngitis often has tender lymph nodes, tonsillar exudates, and higher fever.

38
Q

What is the main cause and demographic affected by bacterial tracheitis?

A

A: Most commonly caused by Staphylococcus aureus, often affects children aged 5-7, and usually follows a viral respiratory infection.

39
Q

What are key symptoms of bacterial tracheitis?

A

A: High fever, respiratory distress, brassy cough, and copious thick purulent secretions. It often does not respond to treatments for croup.

40
Q

What are key symptoms of bacterial tracheitis?

A

A: High fever, respiratory distress, brassy cough, and copious thick purulent secretions. It often does not respond to treatments for croup.

41
Q

How is bacterial tracheitis diagnosed?

A

A: Based on clinical signs like high fever and purulent secretions. X-rays may show subglottic narrowing and a ragged tracheal air column.

42
Q

How is bacterial tracheitis diagnosed?

A

A: Based on clinical signs like high fever and purulent secretions. X-rays may show subglottic narrowing and a ragged tracheal air column.

43
Q

What is the typical treatment for bacterial tracheitis?

A

A: Empiric antibiotics, such as vancomycin or clindamycin and a third-generation cephalosporin, along with airway support and possible intubation.

44
Q

What is the typical treatment for bacterial tracheitis?

A

A: Empiric antibiotics, such as vancomycin or clindamycin and a third-generation cephalosporin, along with airway support and possible intubation.

45
Q

What is the difference between orbital and periorbital cellulitis?

A

A: Orbital cellulitis includes eye pain, paralysis of eye muscles, and ophthalmoplegia, while periorbital cellulitis involves swelling around the eye without these severe symptoms.

46
Q

What is the difference between orbital and periorbital cellulitis?

A

A: Orbital cellulitis includes eye pain, paralysis of eye muscles, and ophthalmoplegia, while periorbital cellulitis involves swelling around the eye without these severe symptoms.

47
Q

Describe the symptoms and complications of peritonsillar abscess.

A

A: Symptoms include sore throat, fever, trismus, and dysphagia. Complications include aspiration pneumonitis if the abscess ruptures.

48
Q

What are the clinical signs of retropharyngeal abscess?

A

A: Fever, irritability, decreased oral intake, drooling, neck stiffness, torticollis, sore throat, and neck pain, with possible bulging of the posterior pharyngeal wall.

49
Q

How is retropharyngeal abscess treated?

A

A: Intravenous antibiotics, often a third-generation cephalosporin combined with ampicillin-sulbactam or clindamycin; surgical drainage if necessary.

50
Q

What is hand-foot-mouth disease, and what causes it?

A

A: A viral illness caused by Coxsackie A16, characterized by vesicles on the oropharynx, palms, soles, and sometimes the trunk and extremities.

51
Q

Q: What is herpangina, and what are its symptoms?

A

A: Caused by Coxsackie virus, herpangina presents with severe throat pain, fever, and ulcers in the posterior oropharynx.

52
Q

Describe scarlet fever and its association with GAS pharyngitis.

A

A: Scarlet fever presents with a fine, sandpaper-like rash that begins on the face and spreads, with a “strawberry tongue” and circumoral pallor.

53
Q

What distinguishes spasmodic croup from viral croup?

A

A: Spasmodic croup affects older children (>3 years), often occurs suddenly at night, lacks a coryzal prodrome, and may have an atopic family history.

54
Q

What is the purpose of chemoprophylaxis for household contacts of epiglottitis cases?

A

A: Rifampin prophylaxis may be given to household contacts to prevent spread, particularly in cases with unimmunized family members.

55
Q

What is the “gold standard” test for diagnosing GAS pharyngitis?

A

A: Throat culture, with high sensitivity and specificity for group A beta-hemolytic streptococci.

56
Q

Q: Why is rapid antigen detection testing (RADT) used for GAS?

A

A: RADT provides quick results (within 30 minutes) to facilitate immediate treatment in symptomatic cases.

57
Q

What factors contribute to a higher frequency of OM in early childhood?

A

A: Short, horizontal Eustachian tubes, immature immune systems, and higher exposure to viral URTIs.

58
Q

Why is it unnecessary to eliminate chronic GAS carriage in most cases?

A

A: Chronic carriers are usually asymptomatic and pose minimal risk, so routine antibiotics are not indicated unless there are specific indications.

59
Q

What is the recommended antibiotic regimen for a non-immediate penicillin-allergic patient with GAS?

A

A: A 10-day course of a first-generation cephalosporin, or a 5-day course of azithromycin for those with macrolide allergies

60
Q

When is endotracheal intubation indicated for patients with croup or tracheitis?

A

A: For children with severe respiratory distress unresponsive to treatment, to secure the airway and provide respiratory support.

61
Q

What are signs of chronic suppurative otitis media?

A

A: Persistent middle ear inflammation with discharge lasting at least 6 weeks, potentially leading to conductive hearing loss.

Pediatrics 👶🏻💕 (10 decks)

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