LRTI

Question 1

What is bronchiolitis?

Answer 1

A lower respiratory tract infection primarily affecting the small airways (bronchioles), common in infants and young children.

Question 2

What is the most common cause of bronchiolitis?

Answer 2

Respiratory syncytial virus (RSV), responsible for >50% of cases.

Question 3

What are the typical symptoms of bronchiolitis?

Answer 3

Fever, cough, nasal flaring, retractions, wheezing, and respiratory distress.

Question 4

What is the peak age for bronchiolitis hospitalization?

Answer 4

Between 2 and 6 months of age.

Question 5

What is the seasonal pattern of bronchiolitis?

Answer 5

Most common in winter and spring.

Question 6

What are the risk factors for severe bronchiolitis?

Answer 6

Prematurity, chronic lung disease, congenital heart disease, and immunodeficiency.

Question 7

What is the primary treatment for bronchiolitis?

Answer 7

Supportive care, including oxygen, hydration, and nasal suctioning.

Question 8

What is the role of bronchodilators in bronchiolitis?

Answer 8

They may be used in some cases, but their effectiveness is debated.

Question 9

What are the complications of bronchiolitis?

Answer 9

Dehydration, respiratory failure, apnea, and secondary bacterial infections.

Question 10

What is pneumonia?

Answer 10

An inflammation of the lung parenchyma, usually caused by infections.

Question 11

What is the most common bacterial cause of pneumonia in children?

Answer 11

Streptococcus pneumoniae (pneumococcus).

Question 12

What are the common viral causes of pneumonia in children?

Answer 12

RSV, influenza virus, parainfluenza virus, and adenovirus.

Question 13

What are the risk factors for pneumonia in children?

Answer 13

Lack of exclusive breastfeeding, malnutrition, low birth weight, and indoor pollution.

Question 14

What is the pathogenesis of viral pneumonia?

Answer 14

Viral infection causes airway obstruction, atelectasis, and hypoxemia.

Question 15

What is the pathogenesis of bacterial pneumonia?

Answer 15

Bacterial infection leads to local edema, inflammation, and lobar consolidation.

Question 16

What are the clinical manifestations of pneumonia?

Answer 16

Fever, cough, tachypnea, retractions, and hypoxemia.

Question 17

What is the WHO definition of pneumonia?

Answer 17

Cough and fast breathing (≥50 breaths/min for infants 2-12 months, ≥40 breaths/min for children 1-5 years).

Question 18

What is the treatment for bacterial pneumonia?

Answer 18

Antibiotics such as amoxicillin, cefuroxime, or ceftriaxone.

Question 19

What is the treatment for viral pneumonia?

Answer 19

Supportive care, as antibiotics are not effective against viruses.

Question 20

What are the complications of pneumonia?

Answer 20

Pleural effusion, empyema, bacteremia, and meningitis.

Question 21

What is recurrent pneumonia?

Answer 21

Two or more episodes in a single year or three or more episodes ever, with radiographic clearing between occurrences.

Question 22

What are the causes of recurrent pneumonia?

Answer 22

Cystic fibrosis, immunodeficiency, ciliary dyskinesia, and anatomic abnormalities.

Question 23

What is slowly resolving pneumonia?

Answer 23

Persistence of symptoms or radiographic abnormalities beyond the expected time course.

Question 24

What is empyema?

Answer 24

An accumulation of pus in the pleural space, often complicating bacterial pneumonia.

Question 25

What are the stages of empyema?

Answer 25

Exudative, fibrinopurulent, and organizational stages.

Question 26

What is the treatment for empyema?

Answer 26

Antibiotics, drainage with tube thoracostomy, and sometimes fibrinolytic therapy.

Question 27

What is a lung abscess?

Answer 27

A localized area of purulent material in the lung, often due to aspiration or infection.

Question 28

What are the common organisms causing lung abscesses?

Answer 28

Anaerobic bacteria (e.g., Bacteroides) and aerobic bacteria (e.g., Staphylococcus aureus).

Question 29

What is the treatment for lung abscess?

Answer 29

Parenteral antibiotics for 2-3 weeks, followed by oral antibiotics for 4-6 weeks.

Question 30

What is bronchiectasis?

Answer 30

Irreversible abnormal dilation and distortion of the bronchial tree, often due to chronic infection.

Question 31

What are the common causes of bronchiectasis?

Answer 31

Cystic fibrosis, primary ciliary dyskinesia, and recurrent infections.

Question 32

What are the clinical manifestations of bronchiectasis?

Answer 32

Chronic cough, copious purulent sputum, hemoptysis, and recurrent infections.

Question 33

What is the diagnostic test for bronchiectasis?

Answer 33

High-resolution CT (HRCT) scan of the chest.

Question 34

What is the treatment for bronchiectasis?

Answer 34

Antibiotics for acute exacerbations, chest physiotherapy, and sometimes surgery.

Question 35

What is pleurisy?

Answer 35

Inflammation of the pleura, often accompanied by pleural effusion.

Question 36

What are the types of pleurisy?

Answer 36

Dry (plastic), serofibrinous (serosanguineous), and purulent (empyema).

Question 37

What are the clinical manifestations of pleurisy?

Answer 37

Pleuritic chest pain, cough, and respiratory distress.

Question 38

What is the treatment for pleurisy?

Answer 38

Treatment of the underlying cause, such as antibiotics for bacterial infections.

Question 39

What is the most common cause of pleural effusion in children?

Answer 39

Bacterial pneumonia.

Question 40

What is the diagnostic approach to pleural effusion?

Answer 40

Chest X-ray, ultrasound, and thoracentesis for fluid analysis.

Question 41

What is the treatment for pleural effusion?

Answer 41

Antibiotics, drainage, and sometimes fibrinolytic therapy.

Question 42

What is the role of imaging in pneumonia?

Answer 42

Chest X-ray confirms the diagnosis and may show complications like effusion or abscess.

Question 43

What is the role of blood cultures in pneumonia?

Answer 43

Positive in only 10% of children with pneumococcal pneumonia.

Question 44

What is the role of sputum culture in pneumonia?

Answer 44

Of little value in young children due to difficulty in obtaining a good sample.

Question 45

What is the role of viral testing in pneumonia?

Answer 45

Isolation of virus or detection of viral genome/antigen in respiratory secretions.

Question 46

What is the role of serology in pneumonia?

Answer 46

Useful for diagnosing atypical pneumonia (e.g., Mycoplasma pneumoniae).

Question 47

What is the role of oxygen therapy in pneumonia?

Answer 47

Indicated for children with hypoxemia to maintain oxygen saturation >90%.

Question 48

What is the role of corticosteroids in pneumonia?

Answer 48

Not routinely recommended, but may be used in severe cases or with complications.

Question 49

What is the role of chest physiotherapy in pneumonia?

Answer 49

Not routinely recommended, but may help in certain cases like bronchiectasis.

Question 50

What is the role of vaccination in preventing pneumonia?

Answer 50

Pneumococcal and Hib vaccines significantly reduce the incidence of bacterial pneumonia.

Question 51

What is the role of hand hygiene in preventing pneumonia?

Answer 51

Reduces the risk of respiratory infections, including pneumonia.

Question 52

What is the role of breastfeeding in preventing pneumonia?

Answer 52

Exclusive breastfeeding for the first 6 months reduces the risk of pneumonia in infants.

Question 53

What is the role of indoor air pollution in pneumonia?

Answer 53

A significant risk factor, especially in low-income countries.