W3 - URTI and LRTI in Children Flashcards
Describe the clinical presentation of EBV glandular fever
Fever
Swollen/tender glands
Sore throat
Rash
Headache
Tiredness/weakness
Loss of appetite
Enlarged spleen/liver
Describe the clinical presentation of sinusitis
Cheek pain/swelling/tenderness
Blocked/runny nose
Reduced sense of smell
Green/yellow snot
Sinus headache
Fever
Toothache
Facial pain
Bad breath
Irritability
Describe the clinical presentation of croup
Asthma symptoms
Coryza
Stridor
Hoarse/barking cough
Describe the clinical presentation of rhinitis
Sneezing
Itchy nose
Runny/blocked nose
Itchy/red/watery eyes
Cough
Itchy roof of mouth
Describe the clinical presentation of tonsillitis
Sore throat
Problems swallowing
Fever
Coughing
Headache
Earache
Tiredness
Swollen/painful glands
Pus-filled spots on tonsils
Bad breath
Describe the clinical presentation of laryngitis
Croaky/losing voice
Cough
Need to clear throat
Fever
Poor feeding
Stridor
Describe the clinical presentation of otitis media
Earache
Fever
Being sick
Lack of energy
Slight hearing loss
Pulling/tugging/rubbing ear
Poor feeding
Cough or runny nose
Loss of balance
Red eardrum
Describe the clinical presentation of pharyngitis
Sore throat
Difficulty swallowing
Fever
Swollen/red tonsils
Swollen/tender glands
Describe the clinical presentation of epiglottitis
Sore throat
Pain when swallowing
Difficulty breathing
Stridor
Fever
Irritability/restlessness
Muffled/hoarse voice
“Sniffling” position
Drooling
Which 7 common URTIs can present with fever?
EBV glandular fever
Sinusitis
Tonsilitis
Laryngitis
Otitis media
Pharyngitis
Epiglottitis
Which 4 common URTIs can present with cough?
Rhinitis
Croup
Laryngitis
Otitis media
Which URTI can present with “sniffling” position?
Epiglottits
Which URTI can present with a barking cough?
Croup
Which URTI can present with pus-filled spots on tonsils?
Tonsillitis
Which 2 URTIs can present with bad breath?
Tonsillitis
Sinusitis
Which URTI can present with red eardrum and loss of balance?
Otitis media
Which 3 URTIs can present with swollen glands?
Pharyngitis
Tonsillitis
EBV glandular fever
Which 3 URTIs can present with a runny or blocked nose?
Sinusitis
Rhinitis
Otitis media (runny)
What commonly causes glandular fever?
EBV
What 3 bacteria commonly cause sinusitis?
Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
What 2 viruses commonly cause rhinitis?
Rhinovirus
Adenovirus
What 2 bacteria commonly cause tonsilitis?
Strep pyogenes
Staph aureus
What 4 things commonly cause otitis media?
Parainfluenza
Influenza
Adenovirus
Rhinovirus
What 2 things commonly cause pharyngitis
Strep pyogenes
Staph aureus
What commonly causes epiglottitis
Haemophilus influenzae
What commonly causes croup
Parainfluenza I
What 5 bacteria commonly cause illness in kids, and what type are they?
Pneumococcus
Haemophilus
Staph
Moraxella
Strep pyogenes
Commensals
What 5 virusees commonly cause illness in kids?
EBV
Rhinovirus
Adenovirus
Parainfluenza
Influenza
In 2018, URTIs and LRTIs were responsible for what % of hospital admissions in Scotland?
37%
What 3 supportive therapies are key for helping children with URTIs?
Oxygenation
Hydration
Nutrition
What 5 side effects are associated with antibiotic use
Diarrhoea
Oral thrush
Nappy rash
Allergic reaction
Multi-resistance
Regardless of whether the culprit is bacteria or virus, what 4 things can we offer those with URTIs?
Sugary fluids
Analgesia
Antipyretic
Time (with review)
Which URTI is most very common, which 4 are common and which one is rare?
Rhinitis - very common
Tonsilitis, pharyngitis, croup, otitis media - common
Epiglottitis - rare
How can we investigate tonsillitis and pharyngitis?
Throat swab
What 2 clinical signs can we look for in epiglottitis?
Stridor and drooling
Rhinitis is most common in what months (and what weeks are these)?
Aug-March (W35-W10)
Rhinitis is a prodrome to what other 4 conditions?
Pneumonia
Bronchiolitis
Meningitis
Septicaemia
What medicine can we give for tonsilitis and pharyngitis, and what should we not give?
Give: either nothing or 10 day penicillin
Don’t give amoxycillin (rash)
How can we manage otitis media?
Pain needs analgesia, possibly antibiotics
Amoxicillin if child is under two and bilateral or systemically unwell
How can we manage epiglottitis?
Intubation
Antibiotics
Name common LRTIs
Tracheitis
Bronchitis (and bacterial bronchitis)
Bronchiolitis
Pertussis
Empyema
Pneumonia
Name 5 common symptoms of LRTI and cause
48 hrs duration
Fever >38.5
SOB
Cough
Grunting
Usually viral and commensal bacteria
What causes tracheitis?
Staph or strep
What causes bronchitis?
Haemophilus
Pnemococcus
What causes bacterial bronchitis?
RSV
Adenovirus
What causes bronchiolitis
RSV
Sometimes Paraflu III, HMPV
At what age is bronchitis common
1-4
What causes bacterial bronchitis?
Disturbed mucocilary clearance leading to minor airway malacia
What things make broncholitis more likely?
Being born after 1 Aug
Having older siblings
2 signs/symptoms of tracheitis
Fever
Sick child
How do you treat bronchiolitis?
Antibiotics
4 symptoms of bronchitis
Loose rattly cough
Post-tussive vomit
No wheeze
Child very well, parents worried
Name 6 symptoms of bronchiolitis
Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze
Low grade fever
Name 3 symptoms of whooping cough
Coughing fits
Vomiting
Colour change
2 symptoms of empyema
Chest pain
Very unwell
How do you treat empyema?
Antibiotics +/- drainage
How do you investigate (and not!) bronchiolitis in kids?
Oxygen sats for severity
No routine need for CXR, bloods or bacterial culture
How do you treat bronchiolitis
Nursing in same area (NPA)
Max observation, minimum intervention
No medications proven to work
How do you treat bronchitis?
Diagnose
Reassure
Don’t treat cough (it’s needed as an immune defence)
Name 4 bacteria causing LRTI
Strep pneumoniae
Haemophilus influenza
Moraxella catarrhalis
Mycoplasma pneumoniae
Name 7 viral causes of LRTI
Rhinovirus
RSV
Parainfluenza III
Influenza
Adenovirus
Coronavirus
Human Meta Pneumo Virus
In children, should (or rather, could) you treat the following with antibiotics, and if so, which one?
Tracheitis
Bronchitis
LRTI/Pneumonia
Bronchiolitis
Empyema
Tracheitis - Augmentin
Bronchitis - No
LRTI/Pneumonia - if 2 day cough, fever and focal signs, give oral amoxycillin
Bronchiolitis - No
Empyema - IV antibiotics
Name 4 safety netting features for LRTI
Breathing rate increases
Fluid intake reduces to 50-70% of normal
Less responsive
Fever doesn’t settle
