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Systems: Respiratory AB > Paediatric Lower Respiratory Tract Infections > Flashcards

Paediatric Lower Respiratory Tract Infections Flashcards

1
Q

What are examples of lower respiratory tract infections in children?

A
  • Tracheitis
  • Pneumonia
  • Bronchitis
  • Bronchiolitis
  • Empyema
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2
Q

What are the common bacterial infective agents?

A
  • Strep pneumoniae
  • Haemophilus influenzae
  • Marxella catarrhalis
  • Mycopasma pneumoniae
  • Chlamydia pneumoniae
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3
Q

What are the common viral infective agents?

A
  • RSV
  • Parainfluenza III
  • Influenza A and B
  • Adenovirus
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4
Q

What is tracheitis?

A
  • Inflammation of the trachea

- Croup that does not get better

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5
Q

What organisms cause tracheitis?

A

Staph or strep

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6
Q

How is tracheitis treated?

A

Augmentin

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7
Q

How does tracheitis present?

A
  • Fever
  • Sick child
  • Barking cough
  • Stridor
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8
Q

What is bronchitis?

A

Endobrachial infection

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9
Q

What organisms cause bronchitis?

A
  • Haemophilus

- Pneumococcus

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10
Q

How does bronchitis present?

A
  • Loose rattly cough with URTI
  • Post-tussive vomit- ‘glut’
  • Child very well
  • Sounds like Darth Vader
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11
Q

What is the chest free of inn bronchitis?

A

Wheeze and creps

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12
Q

What is the mechanism of bacterial bronchitis?

A
  • Disturbed mucociliary clearance
  • Minor airway malacia
  • RSV/adenovirus
  • Infection secondary
  • Lack of social inhibition
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13
Q

What is the normal duration of bronchitis cough?

A

A couple of weeks

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14
Q

What is the natural history of bacterial bronchitis?

A
  • Following URTI
  • Lasts 4 weeks
  • Improves with successive Winters
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15
Q

What is the criteria for persistent bacterial bronchitis?

A
  • Wet cough
  • More than 1 month
  • Remission with antibiotics
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16
Q

What are the 3 steps to ‘treating’ bacterial bronchitis?

A
  • Make the diagnosis
  • Reassure
  • Do not treat
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17
Q

What is bronchiolitis?

A

A LRTI affecting infants primarily

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18
Q

What is the prevalence of bronchiolitis?

A

Affects 30-40% of infants

19
Q

What is the presentation of bronchiolitis?

A
  • Nasal stuffiness
  • Tachypnoea
  • Poor feeding
  • Crackles with/without wheeze
20
Q

What usually causes bronchiolitis?

A
  • RSV
  • Paraflu III
  • HMPV
21
Q

When is RSV most prevalent?

A

Over the Christmas period

22
Q

Who does bronchiolitis affect?

A

Under 12 months old

23
Q

What is the pattern of bronchiolitis?

A
  • It is a one off

- Does not recur

24
Q

What is the progression of bronchiolitis?

A
  • Child gets rapidly worse about day 2-5
  • Child stabilises but does not get better 5-7
  • Child recovers 7 days plus
25
Q

How is bronchiolitis managed?

A
  • Maximal observation

- Minimal intervention

26
Q

What investigations can be carried out for bronchiolitis?

A
  • Nasopharyngeal aspirate

- Oxygen saturations

27
Q

What investigations can be done but are quite frankly unnecessary?

A
  • Chest X-ray
  • Bloods
  • Bacterial cultures
28
Q

Why is a NPA carried out?

A

To identify the responsible organism so all patients can be place in one ward to minimise staff exposure

29
Q

What medications are proven to work with bronchiolitis?

A

NONE

30
Q

What medications do we know not to work on bronchiolitis?

A
  • Salbutamol
  • Ipratropium bromide
  • Adrenalin
  • Steroids
  • Antibiotics
  • Nebulised saline
31
Q

What are the typical symptoms of lower respiratory tract infections?

A
  • 48hrs
  • Fever-
  • Shortness of breath
  • Cough
  • Grunting
  • Reduced or bronchial breath sounds
32
Q

What symptom makes a bacterial cause unlikely?

A

Wheeze

33
Q

What are the common infective agents in LRTIs?

A
  • Viruses
  • Bacteria pneumococcus
  • Mycoplasma
  • Chlamydia
  • Mixed infection
34
Q

When should it be called pneumonia?

A
  • Signs are focal
  • Creps
  • High fever
35
Q

What should you call it if its not pneumonia?

A

LRTI

36
Q

What investigations are not routine in pneumonia?

A
  • Chest X-ray

- Inflammatory markers

37
Q

How should pneumonia be managed?

A
  • Nothing if symptoms are mild
  • Oral amoxicillin first line
  • Oral macrolide second choice
  • Only IV if vomiting
38
Q

What is pertussis characterised by?

A

Coughing fits with vomit and colour change

39
Q

Why is pertussis common despite vaccination?

A

Vaccination only reduces risk and severity but doe not prevent

40
Q

What is empyema?

A

A complication of pneumonia where there is an extension of infection into the pleural space

41
Q

How does a child with empyema present?

A

Chest pain and very unwell

42
Q

How is empyema treated?

A

IV Antibiotics +/- drainage

43
Q

How should most LRTIs be managed?

A

Maintenance of oxygenation, hydration and nutrition

Systems: Respiratory AB (39 decks)

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