URTI in children

Question 1

what is the upper resp tract

Answer 1

airway proximal to the voicebox

Question 2

what conditions count as URIT

Answer 2

otitis
rhinitis
tonsillitis
pharyngitis
laryngitis
epiglottitis

Question 3

side effects from abx

Answer 3

diarrhoea
oral thrush
nappy rash
allergic reaction
multi resistance

• 1/3-1/2 of abx will cause a side effect

Question 4

how common are URTI

Answer 4

very common

acute URIT - 14% of all admissions in scotland
acute tonsillitis - 3%
croup - 2%
otitis media - 0.6%

majority are self-limiting

Question 5

how common is rhinitis

Answer 5

very common
each person may have 5-10/yr

Question 6

when does rhinitis tend to occur

Answer 6

winter months

Question 7

severity of rhinitis

Answer 7

self limiting condition

can be a prodrome to other illnesses (1/100 000)

• pneumonia
• meningitis
• septicaemia

review if unsure

Question 8

how long does rhinitis normally last

Answer 8

~50% for 11 days

~20 for 14 days

some a bit longer

Question 9

what is otitis media

Answer 9

infection of the middle ear

Question 10

what does the eardrum look like in OM

Answer 10

red

bulging eardrum

may be rupture and discharge

Question 11

how common is otitis media

Answer 11

common and self limiting

Question 12

what causes otitis media

Answer 12

1y viral infection e.g. cold

2y infection w/ pneumococcus/H influenzae

Question 13

natural hx of OM

Answer 13

spontaneous rupture of eardrum

Question 14

management of OM

Answer 14

abx usually don’t help

symptomatic Rx - paracetamol or ibuprofen for the pain

Question 15

normal duration of earache

Answer 15

typically 3 days

20% up to 7 days

Question 16

when to treat OM w/ abx

Answer 16

• severe uni and bilateral ≥6m/o, severe pain >48hrs
• non-severe bilateral 6-23 mths

Question 17

treatment of tonsillitis/pharyngitis

Answer 17

is it viral or bacterial

throat swab

either nothing or 10 days penicllin

DO NOT GIVE AMOXYCILLIN

Question 18

viral vs bacterial tonsillits

Answer 18

throat swab - takes 48hrs for results

strep throat - often have scarlet fever (faint pink rash, rough texture); classically pallor around the mouth, generally unwell

Question 19

normal duration of sore throat

Answer 19

2-3 days

some variation

Question 20

what causes croup

Answer 20

parainfluenza virus

Question 21

features of croup

Answer 21

child is generally well but noisy

coryza

stridor

hoarse voice

barking cough

Question 22

management of croup

Answer 22

oral dexamethasone

Question 23

what causes epiglottitis

Answer 23

H. influenzae type b

Question 24

how common is epiglottitis

Answer 24

rare

Question 25

features of epiglottitis

Answer 25

child is very unwell

stridor, drooling

Question 26

management of epiglottitis

Answer 26

intubation

abx

Question 27

normal duration of croup

Answer 27

1-2 days

some longer (up to 3)