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Questions and Answers

What is the primary cause of Croup?

  • Adenovirus
  • Parainfluenza virus (correct)
  • Rhinovirus
  • Influenza virus

    • What is the typical age range for Upper respiratory tract infections (URTIs)?

  • 2-6 years
  • 6-12 years
  • 1-5 years (correct)
  • 13-18 years

    • What is the common symptom of Croup that worsens at night?

  • Barking cough (correct)
  • Low grade fever
  • Sore throat
  • Cough

    • What is the primary management for children with Croup?

    <p>Give controlled supplementary oxygen</p> Signup and view all the answers

    Which of the following is NOT a common symptom of URTIs?

    <p>Chest pain</p> Signup and view all the answers

    What is the male to female ratio for Croup?

    <p>1.43:1</p> Signup and view all the answers

    Which of the following viruses is NOT commonly associated with URTIs?

    <p>Hepatitis virus</p> Signup and view all the answers

    What is the peak incidence of Croup?

    <p>2 years</p> Signup and view all the answers

    What is the recommended treatment for people with limited, localized impetigo who are not systemically unwell or at a high risk of complications?

    <p>Hydrogen peroxide 1% cream</p> Signup and view all the answers

    What is the typical duration of time before symptoms of measles appear after exposure?

    <p>10-12 days</p> Signup and view all the answers

    What is the characteristic of Koplik spots in measles?

    <p>Greyish/blue-white spots on the buccal mucosa</p> Signup and view all the answers

    What is the typical order of rash progression in measles?

    <p>Face, behind the ears, then the rest of the body</p> Signup and view all the answers

    What is the primary reason for school exclusion in impetigo?

    <p>To prevent transmission of the disease</p> Signup and view all the answers

    What is the first-line treatment for bullous impetigo?

    <p>Oral antibiotics</p> Signup and view all the answers

    What is the minimum duration of time a patient with impetigo must be excluded from school?

    <p>48 hours after commencing antibiotic treatment</p> Signup and view all the answers

    What is the characteristic association of measles?

    <p>Fever greater than 38.3°C with at least one of coryza, conjunctivitis, or cough</p> Signup and view all the answers

    Which of the following diseases is self-resolving and typically does not require antibiotics?

    <p>Measles</p> Signup and view all the answers

    What is the characteristic skin feeling of the rash in Scarlet Fever?

    <p>Rough, sandpaper-like</p> Signup and view all the answers

    Which of the following diseases has an incubation period of 2 weeks?

    <p>Rubella</p> Signup and view all the answers

    What is the treatment for Scarlet Fever?

    <p>Phenoxymethylpenicillin for 10 days</p> Signup and view all the answers

    What is the characteristic location of the rash in Measles?

    <p>Trunk, spreading outwards</p> Signup and view all the answers

    Which of the following diseases is caused by an exotoxin?

    <p>Scarlet Fever</p> Signup and view all the answers

    How long should children with Scarlet Fever be kept off school after starting antibiotics?

    <p>24 hours</p> Signup and view all the answers

    What is the characteristic feature of the tongue in Scarlet Fever?

    <p>Strawberry appearance</p> Signup and view all the answers

    What is the primary cause of gastric outlet obstruction in pyloric stenosis?

    <p>Hypertrophy of the pyloric muscle</p> Signup and view all the answers

    Which of the following is a risk factor for necrotising enterocolitis?

    <p>Intrauterine growth restriction</p> Signup and view all the answers

    What is the characteristic of vomiting in pyloric stenosis?

    <p>Projectile vomit</p> Signup and view all the answers

    What is the primary management for necrotising enterocolitis?

    <p>Withhold oral feeds for 10-14 days and replace with parenteral nutrition</p> Signup and view all the answers

    Which of the following is a feature of necrotising enterocolitis?

    <p>Abdominal tenderness</p> Signup and view all the answers

    What is the imaging modality of choice for pyloric stenosis?

    <p>Ultrasound</p> Signup and view all the answers

    What is the Male to Female ratio for pyloric stenosis?

    <p>4:1</p> Signup and view all the answers

    What is the benefit of antenatal steroids in relation to necrotising enterocolitis?

    <p>It is a protective factor</p> Signup and view all the answers

    What is the primary characteristic of Group I in the Catterall classification for Legg-Calvé-Perthes disease?

    <p>Involvement of the anterior epiphysis only</p> Signup and view all the answers

    What is the typical age range for Slipped upper femoral epiphysis?

    <p>8-15 years</p> Signup and view all the answers

    What is the primary management for patients with severe symptoms and severe deformities of Perthes disease?

    <p>Surgical management to correct deformities</p> Signup and view all the answers

    What is the key examination finding in Slipped upper femoral epiphysis?

    <p>Obligatory external rotation on hip flexion</p> Signup and view all the answers

    What is the percentage of bilateral slip in Slipped upper femoral epiphysis?

    <p>20%</p> Signup and view all the answers

    What is the primary investigation of choice for Slipped upper femoral epiphysis?

    <p>X-ray</p> Signup and view all the answers

    What is the characteristic deformity of Slipped upper femoral epiphysis?

    <p>Postero-inferior displacement of the femoral head epiphysis</p> Signup and view all the answers

    What is the primary goal of surgical management in Slipped upper femoral epiphysis?

    <p>To return the femoral head to the correct position and fix it in place</p> Signup and view all the answers

    What is a risk factor for Bronchiolitis?

    <p>Having parents who smoke</p> Signup and view all the answers

    What is a symptom of respiratory distress in Bronchiolitis?

    <p>Nasal flaring</p> Signup and view all the answers

    According to NICE guidelines, when should a child with Bronchiolitis be referred to hospital immediately?

    <p>If they have apnoea or severe respiratory distress</p> Signup and view all the answers

    What is a common symptom of Bronchiolitis in infants?

    <p>Difficulty with breastfeeding</p> Signup and view all the answers

    What is a characteristic of wheezing in Bronchiolitis?

    <p>It is heard on auscultation</p> Signup and view all the answers

    What is a factor that NICE guidelines recommend clinicians consider when deciding whether to refer a child with Bronchiolitis to hospital?

    <p>The respiratory rate of the child</p> Signup and view all the answers

    What is a sign of severe respiratory distress in Bronchiolitis?

    <p>Cyanosis</p> Signup and view all the answers

    What is a risk factor for Bronchiolitis that is related to siblings?

    <p>Having siblings who attend nursery or school</p> Signup and view all the answers

    What is the approximate duration of measles?

    <p>7-10 days</p> Signup and view all the answers

    Which of the following diseases is caused by a virus?

    <p>Rubella</p> Signup and view all the answers

    What is the characteristic of the rash in Scarlet Fever?

    <p>Red-pink, blotchy, macular rash</p> Signup and view all the answers

    How long should children with measles be excluded from school?

    <p>Until 4 days after symptoms resolve</p> Signup and view all the answers

    What is the treatment for Scarlet Fever?

    <p>Penicillin V for 10 days</p> Signup and view all the answers

    What is the incubation period of Rubella?

    <p>2 weeks</p> Signup and view all the answers

    Which of the following diseases is spread by respiratory droplets?

    <p>Rubella</p> Signup and view all the answers

    What is the characteristic of the skin in Scarlet Fever?

    <p>Rough, sandpaper-like</p> Signup and view all the answers

    What is the recommended treatment for people with limited, localized impetigo who are not systemically unwell or at a high risk of complications?

    <p>Hydrogen peroxide 1% cream</p> Signup and view all the answers

    What is the characteristic of Koplik spots in measles?

    <p>They are greyish/blue-white spots on buccal mucosa</p> Signup and view all the answers

    What is the typical duration of time before symptoms of measles appear after exposure?

    <p>10-12 days</p> Signup and view all the answers

    What is the characteristic association of measles?

    <p>Fever, coryza, or cough</p> Signup and view all the answers

    What is the primary management for patients with bullous impetigo?

    <p>Oral antibiotics first-line</p> Signup and view all the answers

    What is the characteristic location of the rash in measles?

    <p>On the face, then spreads to the rest of the body</p> Signup and view all the answers

    What is the primary reason for school exclusion in impetigo?

    <p>Until lesions are crusted and healed</p> Signup and view all the answers

    What is the typical order of rash progression in measles?

    <p>Face, then behind the ears, then spreads to the rest of the body</p> Signup and view all the answers

    What is the primary purpose of the Ortolani test in Developmental Dysplasia of the Hip?

    <p>To relocate a dislocated femoral head</p> Signup and view all the answers

    At what age do most unstable hips tend to spontaneously stabilise in Developmental Dysplasia of the Hip?

    <p>3-6 months</p> Signup and view all the answers

    What is the typical age range for Perthes disease?

    <p>4-8 years</p> Signup and view all the answers

    What is the male to female ratio for Perthes disease?

    <p>5:1</p> Signup and view all the answers

    What is the primary feature of Perthes disease?

    <p>Disruption of blood flow to the femoral head</p> Signup and view all the answers

    What is the typical presentation of Perthes disease?

    <p>Slow onset of pain in the groin or hip</p> Signup and view all the answers

    What is the investigation of choice for Perthes disease?

    <p>X-ray</p> Signup and view all the answers

    What is the management of choice for children younger than 4-5 months with Developmental Dysplasia of the Hip?

    <p>Pavlik harness</p> Signup and view all the answers

    Which of the following is a complication of necrotising enterocolitis?

    <p>Intussusception</p> Signup and view all the answers

    Which of the following is a feature of bronchiolitis?

    <p>Lower respiratory tract infection</p> Signup and view all the answers

    What is the primary goal of management in children with Perthes disease?

    <p>To prevent further deformity of the hip</p> Signup and view all the answers

    Which of the following is a risk factor for hip problems in babies?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a characteristic of viral exanthemas?

    <p>Rash is often widespread and symmetrical</p> Signup and view all the answers

    What is the primary cause of gastric outlet obstruction in infants?

    <p>Hypertrophic pyloric stenosis</p> Signup and view all the answers

    Which of the following is a complication of Slipped upper femoral epiphysis?

    <p>Osteoarthritis</p> Signup and view all the answers

    Which of the following is a characteristic of Croup?

    <p>Symptoms worsen at night</p> Signup and view all the answers

    What is the age group most commonly affected by Bronchiolitis?

    <p>Under 2 years old</p> Signup and view all the answers

    What is the primary factor that puts a child at risk of developing Bronchiolitis?

    <p>Being breast fed for less than 2 months</p> Signup and view all the answers

    What is the typical season when Bronchiolitis is most common?

    <p>Winter and Spring</p> Signup and view all the answers

    What is the male to female ratio for Bronchiolitis?

    <p>1:1</p> Signup and view all the answers

    What is the primary cause of Bronchiolitis?

    <p>Viral infection</p> Signup and view all the answers

    Which of the following is a risk factor for Bronchiolitis?

    <p>Smoke exposure at home</p> Signup and view all the answers

    What is the primary pathophysiological mechanism of Bronchiolitis?

    <p>Viral infection of the bronchioles</p> Signup and view all the answers

    What is the dosage of oral dexamethasone that can be used as an alternative treatment for Croup?

    <p>0.15 mg/kg</p> Signup and view all the answers

    What is the characteristic of a child with severe Croup according to the CKS guidelines?

    <p>Seal-like barking cough with stridor and sternal/intercostal recession associated with agitation or lethargy</p> Signup and view all the answers

    What is the respiratory rate that is indicative of severe respiratory distress in Croup?

    <p>Over 70 breaths/minute</p> Signup and view all the answers

    What is the treatment of choice for emergency situations in Croup?

    <p>Nebulised adrenaline</p> Signup and view all the answers

    What is the characteristic of impending respiratory failure in Croup?

    <p>Minimal barking cough with asynchronous chest wall and abdominal movement</p> Signup and view all the answers

    What is the significance of decreased chest wall recession in a child with Croup?

    <p>It is a sign of worsening respiratory failure</p> Signup and view all the answers

    What is the purpose of contacting an anaesthetist in the emergency management of Croup?

    <p>To assess airway concerns</p> Signup and view all the answers

    What is the typical duration of the catarrhal phase in whooping cough?

    <p>1-2 weeks</p> Signup and view all the answers

    What is the typical trigger for the paroxysmal phase of whooping cough?

    <p>Noise</p> Signup and view all the answers

    What is the primary reason for hospital admission in whooping cough?

    <p>Significant breathing difficulties</p> Signup and view all the answers

    What is the recommended antibiotic treatment for whooping cough within 21 days of onset?

    <p>Macrolide or co-trimoxazole</p> Signup and view all the answers

    What is the characteristic sound associated with the paroxysmal phase of whooping cough?

    <p>Whoop</p> Signup and view all the answers

    What is the typical duration of the convalescent phase of whooping cough?

    <p>2-3 weeks</p> Signup and view all the answers

    What is the most common time for the paroxysmal phase of whooping cough to occur?

    <p>At night</p> Signup and view all the answers

    What is the primary cause of hand, foot, and mouth disease?

    <p>Coxsackie A16 and Enterovirus 71</p> Signup and view all the answers

    What is the characteristic of the skin lesions in non-bullous impetigo?

    <p>Golden, crusted skin lesions</p> Signup and view all the answers

    What is the duration of exclusion from nursery, school, or work for suspected and confirmed cases of whooping cough?

    <p>Until completed 48 hours of appropriate antibiotic treatment</p> Signup and view all the answers

    What is the management of hand, foot, and mouth disease?

    <p>Conservative management with analgesia, antipyretics, adequate nutrition, and hydration</p> Signup and view all the answers

    What is the characteristic of bullous impetigo?

    <p>Fluid-filled vesicles that burst to form a golden crust</p> Signup and view all the answers

    What is the age range most affected by hand, foot, and mouth disease?

    <p>Children under 10 years</p> Signup and view all the answers

    What is the causative organism of impetigo?

    <p>Staphylococcus aureus or Streptococcus pyogenes</p> Signup and view all the answers

    What is the duration of isolation required for children with measles after their symptoms resolve?

    <p>4 days</p> Signup and view all the answers

    What is the characteristic of the skin in Scarlet Fever?

    <p>Rough 'sandpaper' skin</p> Signup and view all the answers

    What is the mode of transmission of Rubella?

    <p>Respiratory droplets</p> Signup and view all the answers

    What is the characteristic of the rash in Rubella?

    <p>A blotchy, red-pink, macular rash</p> Signup and view all the answers

    What is the treatment for Scarlet Fever?

    <p>Phenoxymethylpenicillin (Penicillin V)</p> Signup and view all the answers

    What is the duration of isolation required for children with Scarlet Fever after starting antibiotics?

    <p>24 hours</p> Signup and view all the answers

    What is the incubation period of Rubella?

    <p>2 weeks</p> Signup and view all the answers

    What is the characteristic of the tongue in Scarlet Fever?

    <p>Strawberry tongue</p> Signup and view all the answers

    What is the characteristic of the rash in Measles?

    <p>Flat, macular lesions</p> Signup and view all the answers

    What is the duration of the rash in Measles?

    <p>7-10 days</p> Signup and view all the answers

    Study Notes

    Impetigo

    • Highly contagious skin infection
    • Caused by Staphylococcus aureus or Streptococcus pyogenes
    • Two types: bullous and non-bullous
      • Bullous: fluid-filled vesicles on the skin, which burst to form a golden crust
      • Non-bullous: golden, crusted skin lesions
    • School exclusion required until lesions are crusted and healed or 48 hours after commencing antibiotic treatment

    Viral Xanthemas

    • Measles
      • Caused by measles virus
      • Symptoms start 10-12 days after exposure
      • Fever >38.3°C, with coryza, conjunctivitis, or cough
      • Koplik spots on buccal mucosa (pathognomic)
      • Rash starts on face, spreads to the rest of the body
    • Scarlet Fever
      • Caused by Group A Streptococcus (Streptococcus pyogenes)
      • Aerosol or droplet spread
      • Incubation period 2-5 days
      • Symptoms: sore throat, headache, fever, tender cervical lymphadenopathy, and malaise
      • Red-pink, blotchy, macular rash with rough "sandpaper" skin
    • Rubella
      • Caused by Rubella virus
      • Highly contagious and spread by respiratory droplets
      • Incubation period 2 weeks
      • Mild fever, joint pain, and sore throat
      • Enlarged lymph nodes behind ears and back of the neck
    • Other viral xanthemas:
      • Parvovirus B19
      • Roseola Infantum
      • Dukes' Disease

    Bronchiolitis

    • Viral infection of the bronchioles, common in children under 2 years old
    • Male to female ratio: 1:1
    • Risk factors:
      • Being breastfed for less than 2 months
      • Smoke exposure
    • Mainly occurs in winter and spring months
    • Symptoms: cough, wheeze, and respiratory distress

    Whooping Cough (Pertussis)

    • Upper respiratory tract infection caused by Bordetella Pertussis
    • Vaccines given at 2, 3, and 4 months, with a booster at 3 years and 4 months
    • Clinical features:
      • Catarrhal phase: rhinitis, conjunctivitis, irritability, sore throat, and low-grade fever
      • Paroxysmal phase: rapid, violent, and uncontrolled coughing fits
      • Convalescent phase: gradual improvement in cough frequency and severity
    • Management:
      • Arrange hospital admission for people with significant breathing difficulties or complications
      • Prescribe antibiotic treatment (macrolide first line or co-trimoxazole)
      • Exclude from nursery, school, or work for 48 hours after antibiotic treatment or 21 days from symptom onset

    Croup

    • Viral upper respiratory tract infection
    • Affects children aged 6 months to 3 years
    • Male to female ratio: 1.43/1.73
    • More common in autumn and spring seasons
    • Symptoms:
      • 1-4 day history of cough, progressing to "barking" cough
      • Stridor, respiratory distress, and agitation
    • Management:
      • Administer a dose of oral dexamethasone, inhaled budesonide, or intramuscular dexamethasone
      • Emergency: nebulised adrenaline, high-flow oxygen, and contact anaesthetist if airway concerns

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    Test your knowledge on the management and characteristics of viral upper respiratory tract infections, including upper airway suctioning, oxygen administration, and ventilator support. Learn about the causes, peak incidence, and affected age groups of these infections.

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