Paediatric pneumonia

Question 1

viral causes of paediatric pneumonia 3

Answer 1

RSV

influenza

parainfluenza

Question 2

most common bacterial cause of paeidatric pneumonia 1

Answer 2

strep pneumoniae- most common

Question 3

one cuase of paeidatric pneumonia in 5-14 yo 1

Answer 3

mycoplasma (atypical)

Question 4

main cause of paediatric pneumonia in neonates 1

Answer 4

group B strep

Question 5

who is at risk of an aspiration syndrome pneumonia 4

Answer 5

prematurity

cerebral palsy

CNS depression

epilespsy

Question 6

how is pneumonia seen on a CXR

Answer 6

consolidation

Question 7

presentation of paeidatric pneumonia 7

Answer 7

cough -typically wet and productive

high fever- >38.5 degrees

tachypnoea

tachycardia

increased work of breathing

lethargy

delirium (acute confusion)

Question 8

state three characterisitc chest signs of pneumonia on examination

Answer 8

bronchial breath sounds

focal coarse crackles

dullness to precussion

Question 9

define bronchial breath sounds

Answer 9

harsh breath sounds

-equally loud on inspiratoin and expiration
-caused by consolidation of the lung tissue around the airways

Question 10

define focal coarse crackles

Answer 10

caused by air passing through sputum similar to using a straw to blow into a drink

Question 11

cause of dullness to precussion

Answer 11

due to lung tissue collapse ± consolidation

Question 12

investiagtions for pneumonia 6

Answer 12

CXR

sputum cultures

throat swabs for bacterial cultures

viral pcr

septic -> blood cultures

ABG -resp and metabolic acidosis and blood lactate levels

Question 13

first line penumonia managemnt 2

Answer 13

amoxicillin
oxygen- maintain sats above 92%

*-use IV if sepstic or problem with intestinal aborption

Question 14

additional pneumonia managemnt for atypical pneumonia

Answer 14

macrolide (erythromycin, clarithromycin or azithromycin)

Question 15

investigations if child is having recurrent LRTI 5

Answer 15

FBC

CXR

Serum ummunoglobulins

sweat test

HIV test

Question 16

investigations if child is having recurrent LRTI:
why test for FBC

Answer 16

check vairous levels of WBCs

Question 17

investigations if child is having recurrent LRTI:
why test for CXR

Answer 17

screen for structural abnormalties in the chest or scarring from the infection s

Question 18

investigations if child is having recurrent LRTI:
why test for serum immunoglobulins

Answer 18

test for low levels of certain antibody classes

-immunogoobulin G to previous vaccines
-some patinets cant convert IgM to IgG adn therefore do not have long term immunity

-this is called immunoglobulin class-switch recombination deficiency

Question 19

investigations if child is having recurrent LRTI:
why do a sweat test

Answer 19

cystic fibrosis

Question 20

investigations if child is having recurrent LRTI:
why test for HIB

Answer 20

especially if mums status is unknown or positive