Pediatric Acute Respiratory infections

Question 1

Vocal Apparatus of the larynx, consisting of the vocal folds of the mucous membrane investing the vocal ligament and vocal muscle on each side.

Answer 1

Glottis

Question 2

5Ps of History

Answer 2

Prodrome and onset
Prior state of health
Presence of Fever
Precious Treatment
Playing with small toys

Question 3

Maximizes airway and use of accessory muscles (head leaning forward, neck extended, elbows on knees, mouth open, tongue out)

Answer 3

tripod position

Question 4

tripod position indicates?

Answer 4

Epiglotitis

Question 5

triad of Epiglotitis

Answer 5

Drooling, dyspnea, dysphagia

Question 6

normal RR (<2 moths)

Answer 6

<60 rpm

Question 7

normal RR (2-12 months)

Answer 7

<50 rpm

Question 8

normal RR (1-5 years)

Answer 8

<40 rpm

Question 9

normal RR (68 years)

Answer 9

<30 rpm

Question 10

Most toxic infectious pathology of the supraglottic area

Answer 10

Epiglotitis

Question 11

radiographic sign or epiglotitis

Answer 11

Thumb sign

Question 12

Most benign infectious pathology of the RT

Answer 12

Viral laryngotraheobronchitis

Question 13

Also called the wine bottle sign, Refers to the tapering of the upper trachea on a frontal chest radiograph

Answer 13

Steeple sign

Question 14

Inflammation from the distal trachea to medium and large sized bronchi

Answer 14

Bronchitis (also called as tracheobronchitis)

<3 weeks - acute
>3 weeks - chronic
>4 episodes/year - recurent

Question 15

Etiology of Acute bronchitis

Answer 15

Mostly Viral (adeno, Influ B, Parainflu type 3, TSV, rhinovirus)

Question 16

Clinical manifestations of acute bronchitis

Answer 16

cough 3-4 days after URTI
rhonchi, wheezing
symptoms resolve withiin 3 weeks

Question 17

Pathophysiology of Bronchiolitis

Answer 17

edema and accumulation of cellular debris

Question 18

Triad of Bronchiolitis

Answer 18

Tachypnea, Chest retractions, Wheezing

-most common <2 years

Question 19

Etiologic agent for Bronchiolitis

Answer 19

RSV

Question 20

Therapy for Bronchilitis

Answer 20

Supportive (Humidified 30-40% oxygen)
Anti viral (Ribavirin)
Beta 2 agonists

Question 21

What symptom or sign is the best predictor of pneumonia among children?

Answer 21

Tachypnea

Question 22

Sole criterion to define pneumonia in children (WHO)

Answer 22

Tachypnea

Question 23

Who shall be considered as having pneumonia?

Answer 23

patient presenting with cough and or respiratory difficulty plus:
@ ER- Tachypnea (pt 3-5months), fever at any age, <93% o2 sat.

@OPD - tachypnea, and fever

Question 24

The presence of pneumonia should be determned sing CXR in a patient presenting with?

Answer 24

*cough and Respiratory difficulty in the ff. conditions:
degydration, presence of severe malnutrition (<7 years old)

*high grade fever and leukocytosis aged 3 to 24 months without respiratory symptoms

Question 25

Who will require admission (pneumonia)

Answer 25

pCAP C and pCAP D patients <5yrsold(B) and >5 years old (D) with xray without effusion, lung abscess, air leak or multilobar consolidation

Question 26

diagnostics for pCAP C (should be done)

Answer 26

GSCS of pleural fluid | ABG and pulse ox

Question 27

What is the single most important factor in determining the etiology of pediatric pneumonia?

Answer 27

AGE

Question 28

Common pathogen for pneumonia (Newborns)

Answer 28

Group B

Question 29

Common pathogen for pneumonia 1-3 month

Answer 29

Viruses, Chlamydia, Ureaplasma, Bordetella

Question 30

Common pathogen for pneumonia 1-12 months

Answer 30

Viruses, S. aures, S, pneumoniae, Moraxella, H, Influ

Question 31

Common pathogen for pneumonia 1- 5 years

Answer 31

Viruses, S. pneumoniae, M. pnneumoniae, C. pneumoniae

Question 32

Common pathogen for pneumonia > 5 years

Answer 32

S. pneumoniae, M, Pneumoniae, C, pneumoniae

Question 33

When is antibiotic recommended? for pCAP A or B

Answer 33

Pt. >2 years old (D) | high grade fever without wheeze (D)

Question 34

When is antibiotic recommended? pCAP C

Answer 34

alveolar consolidation om CXR is present (D) | May be administered: elevated CRP, procaltinonin and WBC count

Question 35

Empiric antibiotics? pCAP A or B

Answer 35

Oral amoxicillin (40-50mg/kg/day in 3 doses) Azithromycin 10mkd x 3 days Clarithromycin 15mkd x 7 days

Question 36

Empiric antibiotics? pCAP C with complete primary Hib vaccine

Answer 36

PEN G (100 000 units/kg/day) in 4 doses

Question 37

Empiric antibiotics? pCAP C with incomple primary HiB vaccine

Answer 37

Ampicillin 100mg/kg/day in 4doses

Question 38

Empiric antibiotics? >15 years

Answer 38

BLIC, cephalosporin, or carbapenem

Question 39

Antiviral?

Answer 39

oseltamivir

Question 40

when can switch therapy in bacterial pneumonia be started?

Answer 40

pCAP C. Switch from IV to oral after 3 days if 1. Responding to initial therapy 2. Able to feed/tolerate oral medication 3. No pulmonary or extrapulmonary complications 4. no oxygen support Amoxcillin (40-50mk/day) for 4 days

Question 41

When is the patient considered to be responding?

Answer 41

Decrease in respiratory signs and or defervesence within 72 hours