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Paediatrics > URTI > Flashcards

URTI Flashcards

1
Q

Why is URTI worse in infants

A

Breath more through their nose
Airways are smaller
Blocked runny nose can be big issue

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2
Q

What are viral causes of URTI

A 
RSV
Parainfluenza virus
Adenovirus
Rhinovirus = common cold 
Influenza A, B
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3
Q

What are bacterial causes of URTI

A 
Strep pneumonia
Strep A 
H. influenza
Mycoplasma pneumonia 
S.Aureus
M. catarrhalis
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4
Q

How can you differentiate between causes of URTI

A

Throat swab
Nasal swab
Blood culture

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5
Q

What are signs of respiratory distress

A 
Increased HR +RR
Low sats
Grunting
Nasal flaring
Recession - sternal / intercostal / subcostal / supraclavicular
Cyanosis 
Sweating 
Tracheal tug
Head bob
Wheeze
Exhaution
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6
Q

What must you think of with an URTI and what is key to Rx

A

Will it become a serious illness / become invasive

Is child going to get
worse, at worst or past the worst ? = REVEIW

Oxygen
Hydration
Nutrition
Suction / saline (mucolytic) may be needed

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7
Q

What is Rhinitis

A

Runny nose in winter

Typically 5-10 / year

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8
Q

What causes Rhinitis

A

RSV

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9
Q

What is important with Rhinitis

A

Could be a prodrome to a more serious illness so review

Meningitis/ sepsis / pneumonia / bronchiolitis

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10
Q

How do you treat Rhinitis

A

Anti-histamine
Decongestant
NSAID

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11
Q

What is otitis media

A

Self limiting ear infection

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12
Q

What ae the symptoms of otitis media

A

Painful red ear
Bulging ear drum
Can rupture
Lasts about a week

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13
Q

What causes otitis media and what makes you more at risk

A

Virus = most common
S.pneumonia
H.influenza

Scarlet fever / reflux / cleft palate

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14
Q

How do you treat otitis media

A

Analgesia best

Amoxicillin if <2 or bilateral

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15
Q

What causes croup (Laryngotracheabronchitis) and who is it common in

A

Para influenza 1
RSV
Common in <4 / LBW / premature

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16
Q

What are the symptoms of croup

A

Stridor (wheeze on inspiration) - due to oedema + secretion - often minimal
Hoarse voice
Barking cough
Coryza / URTI - few days prior
Likely pyrexial / low grade fever
Can get 2 bacterial infection leading to tracheitis

17
Q

What are more severe signs of croup

A

Resp distress or stridor at rest

  • Increased HR or RR
  • Low sat
  • Restless child
  • Recessions
  • Cyanosis
18
Q

What is CI in croup

A

Airway examination due to risk of obstruction

19
Q

What do you give to all children with croup

A

Oral dexamethasone
Pred if not available
Nebulised or iM if necessary
Supportive treatment at home if not severe
Hygiene to avoid spread / stay off school

20
Q

When do you admit

A

<6 month
Abnormal airway
Severe / uncertain

21
Q

What can you do in hospital

A

High flow O2
Fluid
Nebulised adrenaline if severe
Intubation if severe

22
Q

Ddx of stridor

A 
Foreign body
Any obstruction
Laryngomalcia in babies
Tracheitis
Epiglotitis
Peritonsillar abscess
Choking
23
Q

How does foreign body present

A 
Sudden onset 
Cough
Choking
Vomit
Stridor
Wheeze
Onesided reduced air entry 
SOB
24
Q

What causes tracheitis

A

S.Aureus
Strep
M.catarrhalis

25
Q

How does tracheitis present

A 
Stridor
Hoarse
Barking cough
High fever
Toxic 
Airway may obstruct 
Viral prodrome
26
Q

How do you treat

A

Urgent airway protection
IV steroid
IV Ax - Fluclox +- ceftriaxone

27
Q

When do you think tracheitis

A

Stridor recurs despite steroid therapy

28
Q

What causes epiglottis

A 
H. influenza
- More rare due to vaccination 
Group A strep
S. pneumonia
S.aureus
29
Q

How does epiglottis present

A 
Sudden onset
Stridor
Drooling as can't swallow
Recession
Cyanotic 
High RR and low sats
Difficulty swallowing 
Dysphonia
Swelling can block whole airway 
Tripod position
Hx - high fever / sore throat 
Very unwell
30
Q

How do you treat

A

DO NOT TOUCH
ITU / anaethetist
ABCDE
A = priority so endotracheal intubation due to risk of obstruction
No examination or cannula as may obstruct
X-ray to exclude foreign body / show oedema
Secure airway
Intubation - most don’t need
Tracheostomy if not able to intubate
Ax and culture when stable - ceftriaxone and vanc

31
Q

When do you suspect

A

Unvaccinated child

32
Q

Complication

A

Epiglottis abscess

33
Q

What is laryngomalacia

A

Part of larynx above vocal cords has tendency to cause partial obstruction

34
Q

How does it present

A

Chronic stridor on inhalation when larynx flops across airway
NO associated resp distress

35
Q

How do you Rx

A

Resolves by age 2

Surgery / tracheostomy = rare

36
Q

What can cause snoring in children

A 
Obesity 
Nasal problems
Recurrent tonsillitis
Down's 
Hypothyroid
37
Q

If child choking

A

Encourage coughing + sit upright
Back slap + abdominal thrust if ineffective
If cyanosed or airway obstruction = BLS

Paediatrics (35 decks)

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