URTI & LRTI in Children Flashcards
(29 cards)
What are the clinical signs of tonsilitis/pharyngitis?
Swollen tonsils
Sore throat
Difficulty swallowing
Tender lymph nodes
What are the clinical sign of the common cold (rhinitis)?
Runny/blocked nose
General malaise
Cough
Sneezing
Itchy/red/watery eyes
What can rhinitis lead onto?
Pneumonia
Bronchiolitis
Meningitis
Septicaemia
What are the clinical signs of EB virus?
Fatigue
Malaise
Fever
Sore throat
Generalised lymphadenopathy
What are the clinical signs of glandular fever?
High temp
Sore throat
Swollen lymph nodes
Fatigue
Other symptoms
- Muscle aches
- General unwell
- Chills/sweats
- Loss of appetite
What are the clinical signs of otitis media (ear infection)?
Red/inflamed ear drum
Bulging drum
Common and self-limiting
Secondary infection with pneumococcus/H’ flu
Spontaneous rupture of drum
**Antibiotic treatment usually unhelpful
What are the different types of organism that cause infection?
Primary
Facultative
Opportunistic
Explain Primary microorganisms?
Highly invasive
Explain facultative microorganisms?
Need assistance to cause infection but are mostly independent.
Explain opportunistic microorganisms
Look for damage and take advantage of it
- Increase chance of ordinary infection
- Infection by organisms not normally capable of producing disease in patients with intact lung defences
- Low grade bacterial pathogens, CMV, pneumocystis jirovecii, other fungi and yeasts
What organisms commonly cause pneumonia?
Strep. pneumonia
Chlamydophila pneumonia
Mycoplasma pneumonia
Legionella
Staph aureus
Moraxella catarrhalis
Chlamydophila psittaci
Coxiella burnetii
Viruses - influenza
What are the side effects of antibiotics?
Diarrhoea
Oral thrush
Nappy rash
Allergic reaction
Multi resistance
What are the supportive therapies used in tandem with antibiotics?
Adequate hydration
Bronchodilators - for dyspnoea
Ibuprofen/paracetamol - for fever control
Rest
What is bronchitis?
Endobronchial infection causing inflammation of bronchi
What are the symptoms of bronchitis?
Loose rattly cough
- Cycles of cough that almost resolve
Post tussive-vomit (glut = sputum)
Chest free of wheeze/creps
Children are generally well
What is the mechanism for bronchitis?
Disturbed mucocilliary clearance (Secretions pool and need to be coughed up)
- Minor airway malacia
- RSV/adenovirus
Lack of social inhibition (child doesn’t care that they sound snotty/raspy)
Bacterial infection/overgrowth in secondary
What is the natural history of bronchitis?
Following URTI
Lasts 4 weeks
60-80% respond
First winter is bad, second is better and third is fine
What are the signs of pneumonia?
Creps
High fever
Signs are focal (in one area)
Otherwise call it LRTI as the word pneumonia causes great anxiety
What investigations do you do for CAP?
Chest X-Ray
Inflammatory markers
What are the management options for CAP?
Nothing if symptoms are mild
Oral amoxicillin first line
Oral macrolide second choice (if allergic)
Only IV if patient vomiting
Explain a complication of pneumonia
Empyema
- Extension of infection into pleural space
- Chest pain and very unwell
- Management = Antibiotics +/- drainage
- Good prognosis
What is bronchiolitis?
Inflammation and condensation of the small airways primarily affecting young children and babies.
What are the symptoms of bronchiolitis?
Nasal stuffiness
Tachypnoea
Poor feeding
Crackles +/- wheeze
What is the predictability of bronchiolitis like?
Day 1-2 = well
Day 2-5 = getting worse
Day 5-7 = stabilised
Day 7+ = recovery
