Upper respiratory tract infection- children

Question 1

what are the possible viral infective agents for URTIs?

Answer 1

adenovirus, influenza A/B, para’flu I, III, RSV, rhinovirus

Question 2

what are the possible bacterial infective agents for URTIs?

Answer 2

H influenzae, M catarrhalis, (mycoplasma), (s. aureus), streptococci (progenies/ pneumoniae)

Question 3

why is history of patient complaint particular important for URTIs? (and review by parents or clinicians should be done)

Answer 3

the patient could either be seen before, during or after the illness peaked

Question 4

when is rhinitis common?

Answer 4

very common during the winter months

Question 5

what is the particularity of rhinitis?

Answer 5

self-limiting condition but prodrome to other illnesses

Question 6

what other illness could rhinitis lead to?

Answer 6

pneumonia, bronchiolitis, meningitis, septicaemia

Question 7

what colour is the ear drum in physiological conditions?

Answer 7

light

Question 8

what colour is the ear drum with otitis media?

Answer 8

pink (erythema), also bulging

Question 9

how common is otitis media?

Answer 9

very common

Question 10

is otitis media self-limiting?

Answer 10

yes

Question 11

what complications are there to otitis media?

Answer 11

secondary infection, spontaneous rupture of drum

Question 12

what causes otitis media?

Answer 12

primary viral infection (AB don’t work)

Question 13

when do you treat otitis media?

Answer 13

• severe uni/ bilateral otitis media lasting over 6 months, severe pain lasting over 48 hours
• none-severe bilateral 6-23 months

Question 14

when do you keep a closer look on otitis media? what is to be prescribed?

Answer 14

non severe OM in older children, prescribe AB therapy or offer observation with close follow-up based on joint decision-making with the parent/ caregiver

Question 15

what should you treat otitis media with? what to avoid?

Answer 15

analgesia works for sure, AB may only work after 24 hours, by which time the pain will have been largely reduced (side-effects for not much benefit?)

Question 16

what is the difficulty about tonsillitis/ pharyngitis?

Answer 16

not know if it is viral or bacterial

Question 17

how to find out if tonsillitis/ pharyngitis is viral or bacterial?

Answer 17

throat swab -> do nothing or 10 days penicillin

Question 18

what AB should you avoid with tonsillitis/ pharyngitis?

Answer 18

amoxicillin

Question 19

what is the difficulty about otitis media?

Answer 19

to treat or not to treat

Question 20

what is the difficulty about rhinitis?

Answer 20

anticipating the fact it is a prodrome to other illnesses

Question 21

what is the difficulty about croup/epiglottitis? ?

Answer 21

do not confuse croup and epiglottis

Question 22

how do you treat croup (LTB)?

Answer 22

oral dexamethasone

Question 23

how do you treat epiglottitis?

Answer 23

intubation and AB

Question 24

which is more common? croup (LTB) or epiglottitis?

Answer 24

croup (LTB)

Question 25

which is more dangerous? croup (LTB) or epiglottitis?

Answer 25

epiglottitis

Question 26

what is the infective agent for croup (LTB)?

Answer 26

para’flu I

Question 27

what are the symptoms for croup (LTB)?

Answer 27

coryza++, stridor, hoarse voice, “barking” cough

Question 28

what is the infective agent for epiglottitis?

Answer 28

H influenza type B

Question 29

what are the symptoms for epiglottitis?

Answer 29

stridor, drooling

Question 30

what is usually meant by self-limiting? which treatment usually doesn’t help?

Answer 30

viral (AB don’t usually help)

Question 31

how common are URTIs in children?

Answer 31

very common