Paed: Lungs

Question 1

List some inflammatory responses of Rhinovirusea….

Answer 1

1. Vasodilation (increased blood flow to basal submucosa = nasal stuffiness)
2. Incr. Vascular permeability
3. Production of mucous

Symptoms a result of innate immunity rather than viral infection

Question 2

At what age can cough and cold syrups be recommended to children?

Answer 2

From 6 years old

Question 3

Home remedies for treating viral infections

Answer 3

Honey = small benefit (over 1)

Question 4

Name the 4 Upper RTI

Answer 4

1. Rhinitis (common cold)
2. Sinusitis (rhino-sinusitis)
3. Pharyngitis (tonsillitis)
4. Otitis media

Question 5

Main symptoms of the 4 upper RTI

1. Rhinitis (common cold)
2. Sinusitis (rhino-sinusitis)
3. Pharyngitis (tonsillitis)
4. Otitis media

Answer 5

1. Rhinitis (common cold)
   = nasal discharge
2. Sinusitis (rhino-sinusitis)
   = pus + sinus pain
3. Pharyngitis (tonsillitis)
   = sore throat
4. Otitis media
   = earache

Question 6

Name the 4 Lower RTi

Answer 6

1. Croup
2. Bronchiolltis (0-12m)
3. Bronchitis
4. Pneumonia

Question 7

Main symptoms of lower RTI

1. Croup
2. Bronchiolltis (0-12m)
3. Bronchitis
4. Pneumonia

Answer 7

1. Croup
   = bark, strider, hoarse cry
2. Bronchiolltis (0-12m)
   = SOB, WHEEZE
3. Bronchitis
   = COUGH
4. Pneumonia
   = WHEEZE

Question 8

Name the 4 sinuses

Answer 8

1. Ethmoid = Bridge of nose
2. Maxillary = around the cheeks
3. Frontal = forehead = UNTIL 7
4. Sphenoid = located deep in the face
   = DOSENT DEVELOP TILL ADOLESCENTS.

Question 9

Will sinusitis respond without antibiotics? For how long?

Answer 9

Yes, for 2 weeks (typically)

Question 10

Red aga for sinusitis?

Answer 10

1. 7-10 days of mucopurulent discharge
2. Focal pain
3. Poor response to decongestants

4.. tenderness/ tooth pain

Question 11

When to refer child with tonsillitis?

Answer 11

1. Fever over 38
2. Tender Cervical Lymphadenopathy
3. Tonsillitis exudate/ white spots on tonsils
4. No cough, but sore through, difficulty swallowing

Question 12

Red flags for Otitis Media

Answer 12

1. Fever over 38
   2 ear discharge
   3 ear fullness
   4 blocked ears

Question 13

Treatment of Otitis Media in children

Answer 13

“Wait qnd see” prescription antibiotics (observe for 2 days)

Question 14

Croup

If significant Stridor at rest then give?

Answer 14

Oral prednisolone 1mg per kg

Question 15

During croup, which airway is narrowed?

Answer 15

Subglottic airway

Question 16

Pathophysiology of Bronchiolitis

Answer 16

Inflammation of bronchioles

Question 17

Symptoms of Bronchiolitis?

Answer 17

Rhinitis

Tachypnea

Wheezing

Poor feeding, crackles in chest

Low Spo2 (less 92%)

** risk factor for ASTHMA

Question 18

Are antibiotics and CS useful to treat Bronchiolitis?

Question 19

Main symptoms for Bronchitis?

Answer 19

COUGH

Question 20

Most common cause if Bronchitis?

Answer 20

VIRAL!!!

INFLUENZA (common)
RSV
ADENOVIRUS

Question 21

Acute treatment for
VIRAL INDUCED WHEEZING

Answer 21

Bronchiodilators

Oral steroids

Evidence..
(ICS for a week unproven,
Montelukast has evidence for allergic rhinitis but not for viral induced Wheezing)

Question 22

Key feature of asthma

Answer 22

Wheeze

Question 23

At what age can asthma be diagnosed?

Answer 23

From 6 years (can perform a spirometry)

-too young before 12 months
-no degree of certainty between 1 to 5

Question 24

Are antibiotics needed in Whooping Cough?

Answer 24

Yes!
Initiated as soon as possible and within 3 weeks of onset of cough

Question 25

When are children with whooping cough considered non infections

Answer 25

After 5 days of antibiotic treatment OR 3 days from onset of cough if untreated

Question 26

Is Whooping Cough a notifiable disease?

Answer 26

Yes!!!!

Question 27

When should pregnant mums vaccinate for Whooping cough

Answer 27

At third trimester

Question 28

Why less COVID 19 in children?

Answer 28

1. Lower numbers of ACE2 receptors 2. Higher IFN-1 and neutrophil response

Question 29

What is MULTI SYSTEM INFLAMMATORY SYNDROME MSIS

Answer 29

Rare complication in children with COVID19 Causes inflammation in organs Symptoms include Fever Bloodshot eyes Stomach ache, vomiting, diarrhoea Large lymph nodes in neck Neck pain Strawberry tongue Swollen hands Irritable Or excessively sleepy