Paediatric Respiratory

Question 1

What are the most common RTIs in children?

Answer 1

Rhinitis 
Tonsilitis 
Otitis media 
Pharyngitis 
Epiglottitis
Pneumonia/itis 
Bronchitis 
Empyaema 
Bronchiolitis 
Croup

Question 2

What are the viral agents that cause upper respiratory tract infections?

Answer 2

Adenovirus
Influenza A, B
Para’flu I, III
RSV
Rhinovirus

Question 3

What are the bacterial agents that cause upper respiratory tract infections?

Answer 3

H influenzae
M catarrhalis
(Mycoplasma)
(S aureus)
Streptococci (B haemolytic, S pyogenes, Non haemolytic, S pneumoniae)

Question 4

What are the clinical features of otitis media?

Answer 4

Erythema

Bulging drum

Question 5

What is the treatment for otitis media?

Answer 5

Analgesics

Augmentin

Question 6

What is the treatment for tonsillitis/pharyngitis?

Answer 6

10 days penicillin

Dont give amoxycillin

Question 7

What are the symptoms of croup?

Answer 7

Coryza
Stridor
Hoarse voice
“Barking” cough

Question 8

What agent usually causes croup?

Answer 8

Paraflu 1

Question 9

What is the treatment for croup?

Answer 9

Oral dexamthasone

Question 10

What agent usually causes epiglottitis?

Answer 10

H influenzae type B

Question 11

What are the symptoms of epiglottitis?

Answer 11

Stridor

Drooling

Question 12

What is the treatment for epiglottitis?

Answer 12

Intubation and antibiotics

Question 13

What are the common bacterial agents that cause lower respiratory infections?

Answer 13

Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Mycoplasma pneumoniae
Chlamydia pneumoniae

Question 14

What are the common viral agents that cause lower respiratory infections?

Answer 14

RSV
Parainfluenza III
Influenza A and B
Adenovirus

Question 15

What is the treatment for tracheitis?

Answer 15

Augmentin

Question 16

What agent usually cause tracheitis?

Answer 16

Staph or strep

Question 17

What agent usually causes bronchitis?

Answer 17

Haemophilus

Pneumococcus

Question 18

What are the symptoms of bronchitis?

Answer 18

Loose rattly cough

Post-tussive vomit

Question 19

What are the features of bacterial bronchitis?

Answer 19

First winter bad
Second winter better
Third winter fine

Question 20

What is the criteria for persistent bacterial bronchitis?

Answer 20

Wet cough
More than 1 month
Remission with antibiotics

Question 21

What agents usually cause bronchiolitis?

Answer 21

RSV
Paraflu III
HMPV

Question 22

What are the symptoms of bronchiolitis?

Answer 22

Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze

Question 23

What are the general symptoms of a LRTI?

Answer 23

48hrs 
Fever 
SOB 
Cough 
Grunting 
Reduced or bronchial breath sounds

Question 24

What is the treatment for community acquired pneumonia?

Answer 24

Oral amoxycillin
Oral macrolide
Only IV if vomiting

Question 25

What are the symptoms of pertussis?

Answer 25

Coughing fits Vomiting Colour change

Question 26

What is empyema?

Answer 26

Complication of pneumonia | Extension of infection into pleural space

Question 27

What are the symptoms of empyema?

Answer 27

Chest pain | Very unwell

Question 28

What is the treatment for empyema?

Answer 28

Antibiotics | Drainage

Question 29

What are the symptoms of asthma?

Answer 29

``` Wheeze Cough SOB Variable/reversible Responds to treatment ```

Question 30

What are the triggers for asthma?

Answer 30

URTI Exercise Allergen Cold weather

Question 31

What mechanism causes the wheeze to occur in asthma?

Answer 31

Bronchoconstriction Airway wall thickening Luminal secretions

Question 32

What is the differential diagnosis for asthma?

Answer 32

``` Foreign body Cystic fibrosis Immune deficiency Ciliary dyskinesia Crop ```

Question 33

What is used to measure control of asthma?

Answer 33

``` SANE Short acting beta agonist/week Absence nursery/school Nocturnal symtoms/week Excertional symtoms/week ```

Question 34

What are the classes of medications used in asthma?

Answer 34

``` Short acting beta antagonist Inhaled corticosteroids Long acting beta antagonist Leukotrine receptor antagonist Theophyllines Oral steroids ```

Question 35

What is the management for asthma?

Answer 35

Start on low dose ICS | Review after 2 months

Question 36

When would an asthma programme need to be stepped up from SABA?

Answer 36

Using inhaled B2 agonist 3 times a week or more

Question 37

What is added on to a SABA?

Answer 37

Low dose ICS

Question 38

What is step 3 of asthma management?

Answer 38

Add on LABA Add on LTRA Increase ICS dose

Question 39

What are the adverse effects of ICS?

Answer 39

Height suppression Oral candidiasis Adrenocortical suppression

Question 40

What should be considered when giving a LABA?

Answer 40

Don't use without ICS | Use as fixed dose inhaler

Question 41

What are the delivery systems used for asthma medication?

Answer 41

MDI/spacer | Dry powder device

Question 42

What other management plans can help with asthmas symptoms?

Answer 42

Stop tobacco smoke exposure | Remove environmental triggers (cat, dog)

Question 43

How is an mild asthma attack treated?

Answer 43

SABA via spacer with prednisolone

Question 44

How is a moderate asthma attack treated?

Answer 44

SABA via nebuliser and prednisolone

Question 45

How is a severe asthma attack treated?

Answer 45

``` IV salbutamol IV aminophylline IV magnesium (nebuliser) IV hydrocortisone Intubate and ventilate ```