Chest Examination Signs in Children

Questions and Answers

Which sign is typically associated with lateralization chest signs in pneumonia?

Increased breath sounds

Bronchial breath sounds

Decreased heart rate

Dullness to percussion (correct)

In infants less than 6 years old, which of the following symptoms might indicate pneumonia?

Fever and malaise (correct)

Persistent cough with phlegm

Severe chest pain

Painless hematuria

What is a characteristic feature of Staphylococcus aureus pneumonia in infants?

Chronic cough

Empyema (correct)

Loss of appetite

Bilateral wheezing

Which organism is often responsible for afebrile pneumonia in infants aged one to three months?

Chlamydia trachomatis Signup and view all the answers

What is essential for the definitive diagnosis of pneumonia?

Sputum for culture Signup and view all the answers

Which imaging study is often utilized in the diagnosis of pneumonia?

Chest x-ray Signup and view all the answers

What laboratory finding is typically elevated in a patient with pneumonia?

White blood cell count Signup and view all the answers

What might indicate the presence of Mycoplasma pneumonia on a peripheral blood film?

Cold agglutinins Signup and view all the answers

What is the primary cause of bronchiolitis in infants?

Respiratory syncytial virus (RSV) Signup and view all the answers

Which age group is most commonly affected by bronchiolitis?

Infants between 3-6 months Signup and view all the answers

What symptom typically lasts a few days before other respiratory issues develop in bronchiolitis?

Mild upper respiratory tract infection Signup and view all the answers

What might be heard on examination of a patient with bronchiolitis?

Wheezing and rhonchi Signup and view all the answers

What is a potential consequence of complete airway obstruction in bronchiolitis?

Atelectasis Signup and view all the answers

Which factor is NOT associated with an increased risk of bronchiolitis?

Being breast-fed Signup and view all the answers

What chest x-ray finding indicates bronchiolitis?

Hyperinflation of the lung Signup and view all the answers

What physiological change occurs due to bronchiolar obstruction?

Ball valve respiratory obstruction Signup and view all the answers

What is a common treatment for bronchiolitis in infants experiencing respiratory distress?

Cool place and humidified oxygen Signup and view all the answers

Which invasive procedure is NOT mentioned in the context of immune compromised hosts?

CT scan Signup and view all the answers

Which condition is characterized by repeated episodes and may have a family history?

Bronchial asthma Signup and view all the answers

What is the drug of choice if Streptococcus pneumonia is susceptible?

Crystalline penicillin Signup and view all the answers

Which of the following is a criterion for admission in cases of moderate or severe bronchiolitis?

Presence of chronic lung disease Signup and view all the answers

What may indicate the need for ventilatory help in infants with bronchiolitis?

Impending respiratory failure Signup and view all the answers

For children younger than 6 years with mild to moderate illness, which antibiotic can be given at home?

Amoxicillin Signup and view all the answers

What is a key sign that an infant may be ready for discharge after treatment for bronchiolitis?

Feeding well Signup and view all the answers

Which condition is an indication for hospitalization in pneumonia?

Empyema Signup and view all the answers

Which supportive treatment is mentioned for severe dyspnea or cyanosis?

Oxygen therapy Signup and view all the answers

What is a critical factor in assessing prognosis during the first three days of bronchiolitis?

The occurrence of apneic attacks Signup and view all the answers

What should be done if a child shows failure to respond to oral antibiotics?

Hospitalization Signup and view all the answers

In managing bronchiolitis, which should be avoided in irritable infants?

Sedation Signup and view all the answers

What is an advised feeding method for infants with bronchiolitis?

Small, frequent feeds Signup and view all the answers

Which age group may be treated with macrolides if Mycoplasma pneumonia is likely?

Children aged 6 years and above Signup and view all the answers

Which of the following conditions does NOT require adequate fluid intake to be maintained?

Mild illness Signup and view all the answers

What is the primary cause of bronchiolitis obliterans?

Adenovirus Signup and view all the answers

Which symptom is NOT commonly associated with a lung abscess?

Recurrent headaches Signup and view all the answers

Which diagnostic procedure is most likely to reveal the presence of anaerobic bacteria in a lung abscess?

Sputum culture Signup and view all the answers

Which of the following might lead to the development of lung abscesses?

Overwhelming local defenses by virulent microorganisms Signup and view all the answers

What is the standard treatment approach for bronchiolitis obliterans?

Supportive care with steroids and bronchodilators Signup and view all the answers

Which imaging finding is associated with lung abscess diagnosis?

Cavity with or without fluid level on chest x-ray Signup and view all the answers

Which symptom is NOT associated with typical clinical manifestations of a lung abscess?

Nasal congestion Signup and view all the answers

What is a common complication seen in cases of bronchiolitis obliterans?

Progressive respiratory distress after a period of improvement Signup and view all the answers

Study Notes

Pneumonia in Children

Physical examination may reveal lateralized chest signs: decreased breath sounds, crepitations, tubular breath sounds, dullness to percussion, and egophony on the affected side.
Children under 6 years may show non-specific symptoms: fever, malaise, gastrointestinal issues, restlessness, and chills; respiratory signs may be minimal.
Common signs include tachypnea and grunting respiration; pneumonia signs can be subtle in infants, with no crepitations or rhonchi.
Causative organisms vary:
- Haemophilus influenzae type b can lead to bacteremia and other infections.
- Staphylococcus aureus in infants often leads to empyema and respiratory failure; may occur with skin lesions or maternal mastitis.
- Chlamydia trachomatis and RSV cause pneumonia in infants 1-3 months old.

Diagnosis of Pneumonia

Definitive diagnosis requires identifying the causative organism.
Sputum culture may not be easily obtained from children.
Chest X-ray may reveal lower consolidation, pleural effusion, or pneumopyothorax.
Elevated WBC counts with neutrophil predominance are common.
Blood cultures help in pathogen detection, while M. tuberculosis can be diagnosed via skin tests or sputum analysis.
Invasive diagnostic procedures (e.g., bronchoscopy, lung biopsy) are reserved for unusual or immunocompromised cases.

Treatment of Pneumonia

Treatment considerations include age, severity of illness, family illness history, and lab findings.
Mild to moderate illness in children under 6 can be managed at home with oral antibiotics (e.g., amoxicillin, ampicillin).
Severe cases may require hospitalization and IV antibiotics (e.g., cefotaxime, ceftriaxone).
Children over 6 with mild cases can be treated at home; severe cases necessitate IV third-generation cephalosporins.
Supportive treatments may include oxygen therapy, antipyretics, and ensuring adequate fluid intake.

Admission Criteria for Pneumonia

Indications for hospitalization include:
- Lack of response to oral antibiotics.
- Vomiting or inability to take oral medications.
- Lobar consolidation across multiple lobes.
- Respiratory distress and evidence of empyema or abscesses.

Bronchiolitis

Acute bronchiolitis is primarily caused by Respiratory Syncytial Virus (RSV) and is most common in males aged 3-6 months.
Higher risk is noted in non-breastfed infants living in crowded conditions with smoking mothers.
Clinical signs include mild upper respiratory symptoms evolving into wheezing, cough, and dyspnea.

Diagnosis and Admission Criteria for Bronchiolitis

Chest X-ray may show hyperinflation of lungs, scattered areas of consolidation, and increased lung translucency.
Admission criteria include risk factors like age < 3 months, previous severe bronchiolitis, and chronic diseases.

Treatment of Bronchiolitis

Hospitalize infants in respiratory distress; use humidified oxygen and intravenous fluids.
Bronchodilators may be used; steroids are sometimes harmful.
RSV immunoglobulin may be given as prevention for high-risk cases.

Bronchiolitis Obliterans

Chronic bronchiolitis characterized by endobronchiolar granulation and fibrosis; often follows a period of improvement with significant respiratory distress.
Supportive treatment using steroids and bronchodilators may be considered.

Lung Abscess

Lung abscess involves destruction of lung tissue leading to a cavity filled with purulent material.
Commonly caused by aspiration, pneumonia caused by pyogenic organisms, or obstruction (tumors/foreign bodies).
Symptoms include fever, malaise, anorexia, weight loss, cough possibly with hemoptysis, and foul-smelling sputum.

Diagnosis of Lung Abscess

Chest X-ray typically shows cavities with fluid levels and surrounding infiltrates.
Sputum cultures may reveal mixed anaerobic bacteria; CT scans aid in diagnosis.

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Description

This quiz covers physical examination findings related to chest signs in younger children, particularly those under 6 years of age. Topics include symptoms such as decreased breath sounds, dullness to percussion, and non-specific manifestations like fever and restlessness. Test your understanding of how these signs relate to pediatric respiratory conditions.