118 Questions
What is the primary cause of Croup?
Parainfluenza virus
What is the typical age range for Upper respiratory tract infections (URTIs)?
1-5 years
What is the common symptom of Croup that worsens at night?
Barking cough
What is the primary management for children with Croup?
Give controlled supplementary oxygen
Which of the following is NOT a common symptom of URTIs?
Chest pain
What is the male to female ratio for Croup?
1.43:1
Which of the following viruses is NOT commonly associated with URTIs?
Hepatitis virus
What is the peak incidence of Croup?
2 years
What is the recommended treatment for people with limited, localized impetigo who are not systemically unwell or at a high risk of complications?
Hydrogen peroxide 1% cream
What is the typical duration of time before symptoms of measles appear after exposure?
10-12 days
What is the characteristic of Koplik spots in measles?
Greyish/blue-white spots on the buccal mucosa
What is the typical order of rash progression in measles?
Face, behind the ears, then the rest of the body
What is the primary reason for school exclusion in impetigo?
To prevent transmission of the disease
What is the first-line treatment for bullous impetigo?
Oral antibiotics
What is the minimum duration of time a patient with impetigo must be excluded from school?
48 hours after commencing antibiotic treatment
What is the characteristic association of measles?
Fever greater than 38.3°C with at least one of coryza, conjunctivitis, or cough
Which of the following diseases is self-resolving and typically does not require antibiotics?
Measles
What is the characteristic skin feeling of the rash in Scarlet Fever?
Rough, sandpaper-like
Which of the following diseases has an incubation period of 2 weeks?
Rubella
What is the treatment for Scarlet Fever?
Phenoxymethylpenicillin for 10 days
What is the characteristic location of the rash in Measles?
Trunk, spreading outwards
Which of the following diseases is caused by an exotoxin?
Scarlet Fever
How long should children with Scarlet Fever be kept off school after starting antibiotics?
24 hours
What is the characteristic feature of the tongue in Scarlet Fever?
Strawberry appearance
What is the primary cause of gastric outlet obstruction in pyloric stenosis?
Hypertrophy of the pyloric muscle
Which of the following is a risk factor for necrotising enterocolitis?
Intrauterine growth restriction
What is the characteristic of vomiting in pyloric stenosis?
Projectile vomit
What is the primary management for necrotising enterocolitis?
Withhold oral feeds for 10-14 days and replace with parenteral nutrition
Which of the following is a feature of necrotising enterocolitis?
Abdominal tenderness
What is the imaging modality of choice for pyloric stenosis?
Ultrasound
What is the Male to Female ratio for pyloric stenosis?
4:1
What is the benefit of antenatal steroids in relation to necrotising enterocolitis?
It is a protective factor
What is the primary characteristic of Group I in the Catterall classification for Legg-Calvé-Perthes disease?
Involvement of the anterior epiphysis only
What is the typical age range for Slipped upper femoral epiphysis?
8-15 years
What is the primary management for patients with severe symptoms and severe deformities of Perthes disease?
Surgical management to correct deformities
What is the key examination finding in Slipped upper femoral epiphysis?
Obligatory external rotation on hip flexion
What is the percentage of bilateral slip in Slipped upper femoral epiphysis?
20%
What is the primary investigation of choice for Slipped upper femoral epiphysis?
X-ray
What is the characteristic deformity of Slipped upper femoral epiphysis?
Postero-inferior displacement of the femoral head epiphysis
What is the primary goal of surgical management in Slipped upper femoral epiphysis?
To return the femoral head to the correct position and fix it in place
What is a risk factor for Bronchiolitis?
Having parents who smoke
What is a symptom of respiratory distress in Bronchiolitis?
Nasal flaring
According to NICE guidelines, when should a child with Bronchiolitis be referred to hospital immediately?
If they have apnoea or severe respiratory distress
What is a common symptom of Bronchiolitis in infants?
Difficulty with breastfeeding
What is a characteristic of wheezing in Bronchiolitis?
It is heard on auscultation
What is a factor that NICE guidelines recommend clinicians consider when deciding whether to refer a child with Bronchiolitis to hospital?
The respiratory rate of the child
What is a sign of severe respiratory distress in Bronchiolitis?
Cyanosis
What is a risk factor for Bronchiolitis that is related to siblings?
Having siblings who attend nursery or school
What is the approximate duration of measles?
7-10 days
Which of the following diseases is caused by a virus?
Rubella
What is the characteristic of the rash in Scarlet Fever?
Red-pink, blotchy, macular rash
How long should children with measles be excluded from school?
Until 4 days after symptoms resolve
What is the treatment for Scarlet Fever?
Penicillin V for 10 days
What is the incubation period of Rubella?
2 weeks
Which of the following diseases is spread by respiratory droplets?
Rubella
What is the characteristic of the skin in Scarlet Fever?
Rough, sandpaper-like
What is the recommended treatment for people with limited, localized impetigo who are not systemically unwell or at a high risk of complications?
Hydrogen peroxide 1% cream
What is the characteristic of Koplik spots in measles?
They are greyish/blue-white spots on buccal mucosa
What is the typical duration of time before symptoms of measles appear after exposure?
10-12 days
What is the characteristic association of measles?
Fever, coryza, or cough
What is the primary management for patients with bullous impetigo?
Oral antibiotics first-line
What is the characteristic location of the rash in measles?
On the face, then spreads to the rest of the body
What is the primary reason for school exclusion in impetigo?
Until lesions are crusted and healed
What is the typical order of rash progression in measles?
Face, then behind the ears, then spreads to the rest of the body
What is the primary purpose of the Ortolani test in Developmental Dysplasia of the Hip?
To relocate a dislocated femoral head
At what age do most unstable hips tend to spontaneously stabilise in Developmental Dysplasia of the Hip?
3-6 months
What is the typical age range for Perthes disease?
4-8 years
What is the male to female ratio for Perthes disease?
5:1
What is the primary feature of Perthes disease?
Disruption of blood flow to the femoral head
What is the typical presentation of Perthes disease?
Slow onset of pain in the groin or hip
What is the investigation of choice for Perthes disease?
X-ray
What is the management of choice for children younger than 4-5 months with Developmental Dysplasia of the Hip?
Pavlik harness
Which of the following is a complication of necrotising enterocolitis?
Intussusception
Which of the following is a feature of bronchiolitis?
Lower respiratory tract infection
What is the primary goal of management in children with Perthes disease?
To prevent further deformity of the hip
Which of the following is a risk factor for hip problems in babies?
All of the above
Which of the following is a characteristic of viral exanthemas?
Rash is often widespread and symmetrical
What is the primary cause of gastric outlet obstruction in infants?
Hypertrophic pyloric stenosis
Which of the following is a complication of Slipped upper femoral epiphysis?
Osteoarthritis
Which of the following is a characteristic of Croup?
Symptoms worsen at night
What is the age group most commonly affected by Bronchiolitis?
Under 2 years old
What is the primary factor that puts a child at risk of developing Bronchiolitis?
Being breast fed for less than 2 months
What is the typical season when Bronchiolitis is most common?
Winter and Spring
What is the male to female ratio for Bronchiolitis?
1:1
What is the primary cause of Bronchiolitis?
Viral infection
Which of the following is a risk factor for Bronchiolitis?
Smoke exposure at home
What is the primary pathophysiological mechanism of Bronchiolitis?
Viral infection of the bronchioles
What is the dosage of oral dexamethasone that can be used as an alternative treatment for Croup?
0.15 mg/kg
What is the characteristic of a child with severe Croup according to the CKS guidelines?
Seal-like barking cough with stridor and sternal/intercostal recession associated with agitation or lethargy
What is the respiratory rate that is indicative of severe respiratory distress in Croup?
Over 70 breaths/minute
What is the treatment of choice for emergency situations in Croup?
Nebulised adrenaline
What is the characteristic of impending respiratory failure in Croup?
Minimal barking cough with asynchronous chest wall and abdominal movement
What is the significance of decreased chest wall recession in a child with Croup?
It is a sign of worsening respiratory failure
What is the purpose of contacting an anaesthetist in the emergency management of Croup?
To assess airway concerns
What is the typical duration of the catarrhal phase in whooping cough?
1-2 weeks
What is the typical trigger for the paroxysmal phase of whooping cough?
Noise
What is the primary reason for hospital admission in whooping cough?
Significant breathing difficulties
What is the recommended antibiotic treatment for whooping cough within 21 days of onset?
Macrolide or co-trimoxazole
What is the characteristic sound associated with the paroxysmal phase of whooping cough?
Whoop
What is the typical duration of the convalescent phase of whooping cough?
2-3 weeks
What is the most common time for the paroxysmal phase of whooping cough to occur?
At night
What is the primary cause of hand, foot, and mouth disease?
Coxsackie A16 and Enterovirus 71
What is the characteristic of the skin lesions in non-bullous impetigo?
Golden, crusted skin lesions
What is the duration of exclusion from nursery, school, or work for suspected and confirmed cases of whooping cough?
Until completed 48 hours of appropriate antibiotic treatment
What is the management of hand, foot, and mouth disease?
Conservative management with analgesia, antipyretics, adequate nutrition, and hydration
What is the characteristic of bullous impetigo?
Fluid-filled vesicles that burst to form a golden crust
What is the age range most affected by hand, foot, and mouth disease?
Children under 10 years
What is the causative organism of impetigo?
Staphylococcus aureus or Streptococcus pyogenes
What is the duration of isolation required for children with measles after their symptoms resolve?
4 days
What is the characteristic of the skin in Scarlet Fever?
Rough 'sandpaper' skin
What is the mode of transmission of Rubella?
Respiratory droplets
What is the characteristic of the rash in Rubella?
A blotchy, red-pink, macular rash
What is the treatment for Scarlet Fever?
Phenoxymethylpenicillin (Penicillin V)
What is the duration of isolation required for children with Scarlet Fever after starting antibiotics?
24 hours
What is the incubation period of Rubella?
2 weeks
What is the characteristic of the tongue in Scarlet Fever?
Strawberry tongue
What is the characteristic of the rash in Measles?
Flat, macular lesions
What is the duration of the rash in Measles?
7-10 days
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
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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