W3: Respiratory Tract Infections CHILDREN

Question 1

EPIGLOTITTIS causative agents

Answer 1

H influenz
A B-Haemolytic Strept
Parainfluenz virus Type 4 (rare)

Question 2

Epiglottitis Presentation

Answer 2

red cherry-like epiglott
uncommon inflamm swelling;
stridor; drooling

Question 3

Epiglottitis Complications & Tx

Answer 3

Abx, intubation d/t enlarged epiglottis = severe resp obstruction

Question 4

RHINITIS

Answer 4

cold-like symptoms
Common; self-limiting
PRODROME: pneumon, meningitis, septicaemia
varied duration=> 10/14 days

Question 5

STRIDOR

Answer 5

high-pitched, wheezing sound caused by disrupted airflow
often inspiration, +/- stethoscope
(kinda sounds like a seal)

Question 6

PRODROME

Answer 6

an early symptom indicating the onset of a disease or illness.

Question 7

OTITIS MEDIA

Answer 7

semitransparent timpanic membrane ->erythema, bulging drum
common self-limiting; spontaneous rupture
1º viral (rhinovir); 2º overgrowth w/ Pneumococcus/ H. inflz.
=> ANALGESIA. ! ABX v WAIT !
3/7 days

Question 8

TONSILITIS/PHARYNGITIS CAUSATIVE AGENS

Answer 8

EBV (kissing mono) -> nothing
or
Group A Steptococcus -> Strept throat

Question 9

TONSILITIS/ PHARYNGITIS PRESENTATION & Tx

Answer 9

Strept throat: scarlet fever rash (rough)
palor around mouth,
7d malaise

2/3d symtomatic. !24hr swab!

Abx => Penicillin 10d

Question 10

DEFENCE MECH

Answer 10

• general imm syst
• resptract secretions are antimicro
• filtering action of URT
• MACROPHAGE-MUCOCIL ESCALATOR
  • macr. + ciliary escalator + cough reflex
  • macr. survey alveolar space = STERILITY -> cleared via mucus or via lymphatic

therefore intact epithelia is ESSENTIAL and compromise is found in pathology

Question 11

GROUP (LARYNGOTRACHEOBRONCHITIS): causative, pres. & Tx

Answer 11

Paraflu Common.
WELL but NOISY coryza+++, hoarse, stridor, bark cough

=> ORAL DEXAMETHASONE

Question 12

TRACHEITIS causative agents

Answer 12

Invasive staph or strep pneumoniae

H. influenzae

Question 13

TRACHEITIS presentation and Tx

Answer 13

• complication of group
• fever, malaise
• inflamm. pus. tracheal wall = difficulty breathing

=> augmentin (co-amoxicalv)

Question 14

BRONCHITIS causative agents

Answer 14

1.haemophillius influenzae
Pneumococcus

2. RSV, adenovirus

Question 15

BRONCHITIS presentation progression

Answer 15

endobronchial infection = SELF-LIMITING, no Tx REASSURE
-loose rough cough, post-tussive vomit sputum, nil wheeze

• symptoms progressive winters

Question 16

BRONCHIOLITIS causative agents

Answer 16

RSV, paraflu III, hMPV

Question 17

BRONCHIOLITIS

Answer 17

smaller airway inflamm. 30-40% common.
CHILDREN UNDER 12mos OLDER THAN 3mos, not recurrent, FEVER RARE

-crackles, wheeze, nasal stiffness, tachypnoea, poor feeding

• NPA viral ID
• no meds, just obs

Question 18

PERTUSSIS causative agent

Answer 18

Bordetella pertussis

Question 19

PERTUSSIS

Answer 19

coughing fits > vomit > colour change > whoop
2w

abx, vaccination

Question 20

GENERIC LTRI

Answer 20

• 48hr fever, SOB,cough, grunting
• wheeze = unlikely bacteria
• ↓bronchial sounds or +ve

Question 21

Pneumonia in children: typical pres. and mgmt

Answer 21

focal, crepitations, ↑fever

=> if longer than 2days
ORAL AMOXYCILLIN
ORAL MACROLIDE. (AZITH.)
IV IF VOMITTING

Question 22

Empyema in children

Answer 22

COMPLICATION OF PNEUMONIA (pleural space)
Pain +++, unwell d/t pneumonia
Good prognosis

Abx, +/- drainage