W3 - URTI and LRTI in Children Flashcards by F D

Describe the clinical presentation of EBV glandular fever

Fever
Swollen/tender glands
Sore throat
Rash
Headache
Tiredness/weakness
Loss of appetite
Enlarged spleen/liver

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Describe the clinical presentation of sinusitis

Cheek pain/swelling/tenderness
Blocked/runny nose
Reduced sense of smell
Green/yellow snot
Sinus headache
Fever
Toothache
Facial pain
Bad breath
Irritability

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Describe the clinical presentation of croup

Asthma symptoms
Coryza
Stridor
Hoarse/barking cough

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Describe the clinical presentation of rhinitis

Sneezing
Itchy nose
Runny/blocked nose
Itchy/red/watery eyes
Cough
Itchy roof of mouth

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Describe the clinical presentation of tonsillitis

Sore throat
Problems swallowing
Fever
Coughing
Headache
Earache
Tiredness
Swollen/painful glands
Pus-filled spots on tonsils
Bad breath

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Describe the clinical presentation of laryngitis

Croaky/losing voice
Cough
Need to clear throat
Fever
Poor feeding
Stridor

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Describe the clinical presentation of otitis media

Earache
Fever
Being sick
Lack of energy
Slight hearing loss
Pulling/tugging/rubbing ear
Poor feeding
Cough or runny nose
Loss of balance
Red eardrum

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Describe the clinical presentation of pharyngitis

Sore throat
Difficulty swallowing
Fever
Swollen/red tonsils
Swollen/tender glands

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Describe the clinical presentation of epiglottitis

Sore throat
Pain when swallowing
Difficulty breathing
Stridor
Fever
Irritability/restlessness
Muffled/hoarse voice
“Sniffling” position
Drooling

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Which 7 common URTIs can present with fever?

EBV glandular fever
Sinusitis
Tonsilitis
Laryngitis
Otitis media
Pharyngitis
Epiglottitis

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Which 4 common URTIs can present with cough?

Rhinitis
Croup
Laryngitis
Otitis media

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Which URTI can present with “sniffling” position?

Epiglottits

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Which URTI can present with a barking cough?

Croup

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Which URTI can present with pus-filled spots on tonsils?

Tonsillitis

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Which 2 URTIs can present with bad breath?

Tonsillitis
Sinusitis

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Which URTI can present with red eardrum and loss of balance?

Otitis media

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Which 3 URTIs can present with swollen glands?

Pharyngitis
Tonsillitis
EBV glandular fever

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Which 3 URTIs can present with a runny or blocked nose?

Sinusitis
Rhinitis
Otitis media (runny)

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What commonly causes glandular fever?

EBV

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What 3 bacteria commonly cause sinusitis?

Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis

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What 2 viruses commonly cause rhinitis?

Rhinovirus
Adenovirus

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What 2 bacteria commonly cause tonsilitis?

Strep pyogenes
Staph aureus

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What 4 things commonly cause otitis media?

Parainfluenza
Influenza
Adenovirus
Rhinovirus

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What 2 things commonly cause pharyngitis

Strep pyogenes
Staph aureus

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What commonly causes epiglottitis

Haemophilus influenzae

What commonly causes croup

Parainfluenza I

What 5 bacteria commonly cause illness in kids, and what type are they?

Pneumococcus Haemophilus Staph Moraxella Strep pyogenes Commensals

What 5 virusees commonly cause illness in kids?

EBV Rhinovirus Adenovirus Parainfluenza Influenza

In 2018, URTIs and LRTIs were responsible for what % of hospital admissions in Scotland?

37%

What 3 supportive therapies are key for helping children with URTIs?

Oxygenation Hydration Nutrition

What 5 side effects are associated with antibiotic use

Diarrhoea Oral thrush Nappy rash Allergic reaction Multi-resistance

Regardless of whether the culprit is bacteria or virus, what 4 things can we offer those with URTIs?

Sugary fluids Analgesia Antipyretic Time (with review)

Which URTI is most very common, which 4 are common and which one is rare?

Rhinitis - very common Tonsilitis, pharyngitis, croup, otitis media - common Epiglottitis - rare

How can we investigate tonsillitis and pharyngitis?

Throat swab

What 2 clinical signs can we look for in epiglottitis?

Stridor and drooling

Rhinitis is most common in what months (and what weeks are these)?

Aug-March (W35-W10)

Rhinitis is a prodrome to what other 4 conditions?

Pneumonia Bronchiolitis Meningitis Septicaemia

What medicine can we give for tonsilitis and pharyngitis, and what should we not give?

Give: either nothing or 10 day penicillin Don't give amoxycillin (rash)

How can we manage otitis media?

Pain needs analgesia, possibly antibiotics Amoxicillin if child is under two and bilateral or systemically unwell

How can we manage epiglottitis?

Intubation Antibiotics

Name common LRTIs

Tracheitis Bronchitis (and bacterial bronchitis) Bronchiolitis Pertussis Empyema Pneumonia

Name 5 common symptoms of LRTI and cause

48 hrs duration Fever >38.5 SOB Cough Grunting Usually viral and commensal bacteria

What causes tracheitis?

Staph or strep

What causes bronchitis?

Haemophilus Pnemococcus

What causes bacterial bronchitis?

RSV Adenovirus

What causes bronchiolitis

RSV Sometimes Paraflu III, HMPV

At what age is bronchitis common

1-4

What causes bacterial bronchitis?

Disturbed mucocilary clearance leading to minor airway malacia

What things make broncholitis more likely?

Being born after 1 Aug Having older siblings

2 signs/symptoms of tracheitis

Fever Sick child

How do you treat bronchiolitis?

Antibiotics

4 symptoms of bronchitis

Loose rattly cough Post-tussive vomit No wheeze Child very well, parents worried

Name 6 symptoms of bronchiolitis

Nasal stuffiness Tachypnoea Poor feeding Crackles +/- wheeze Low grade fever

Name 3 symptoms of whooping cough

Coughing fits Vomiting Colour change

2 symptoms of empyema

Chest pain Very unwell

How do you treat empyema?

Antibiotics +/- drainage

How do you investigate (and not!) bronchiolitis in kids?

Oxygen sats for severity No routine need for CXR, bloods or bacterial culture

How do you treat bronchiolitis

Nursing in same area (NPA) Max observation, minimum intervention No medications proven to work

How do you treat bronchitis?

Diagnose Reassure Don't treat cough (it's needed as an immune defence)

Name 4 bacteria causing LRTI

Strep pneumoniae Haemophilus influenza Moraxella catarrhalis Mycoplasma pneumoniae

Name 7 viral causes of LRTI

Rhinovirus RSV Parainfluenza III Influenza Adenovirus Coronavirus Human Meta Pneumo Virus

In children, should (or rather, could) you treat the following with antibiotics, and if so, which one? Tracheitis Bronchitis LRTI/Pneumonia Bronchiolitis Empyema

Tracheitis - Augmentin Bronchitis - No LRTI/Pneumonia - if 2 day cough, fever and focal signs, give oral amoxycillin Bronchiolitis - No Empyema - IV antibiotics

Name 4 safety netting features for LRTI

Breathing rate increases Fluid intake reduces to 50-70% of normal Less responsive Fever doesn't settle