1What are the three phases of a cough?
Deep inspiration, glottic closure, and sudden glottic opening.
2Which nerve can trigger coughing when the ear canal is stimulated?
Arnold’s nerve, an auricular branch of the vagus nerve.
3How often do healthy children cough each day, on average?
About 11 times per day.
4How many respiratory infections per year are common in children under five?
About 6–8 infections.
5Which conditions are associated with a paroxysmal cough?
Pertussis, cystic fibrosis, and foreign body aspiration.
6Which infection is classically associated with a staccato cough in infants?
Chlamydia infection.
7Which condition is associated with a wheezy or tight cough?
Asthma.
8What conditions commonly cause nocturnal cough?
Asthma, postnasal drip, and allergy.
9What cough pattern is characteristic of bronchiectasis?
A productive cough, often prominent in the early morning.
10Which type of cough often disappears during sleep?
Habit cough.
11What is the most common cause of noisy breathing in young infants?
Laryngomalacia.
12What is laryngomalacia?
Dynamic collapse of supraglottic structures during inspiration.
13Does yellow or green sputum alone prove bacterial infection?
No; sputum color alone does not establish bacterial infection.
14What contributes to the yellow-green color of sputum?
Myeloperoxidase released from leukocytes.
15What do infants usually do with respiratory secretions rather than expectorate them?
They swallow them.
16What is wheezing?
A continuous musical breath sound associated with narrowed airways.
17What is stridor?
A high-pitched sound caused by upper airway obstruction.
18Where is the obstruction usually located in inspiratory stridor?
The supraglottic or glottic region.
19Where is the obstruction often located in biphasic stridor?
The subglottic region.
20What is stertor?
A low-pitched noisy breathing sound from nasal, nasopharyngeal, or oropharyngeal obstruction.
21What does grunting in a child suggest?
Respiratory distress; it can occur in neonatal respiratory distress syndrome.
22Where is central cyanosis best recognized?
On the tongue and mucous membranes.
23What is the most common origin of chest pain in adolescents?
Musculoskeletal causes.
24Which associated symptom raises concern for cardiac chest pain?
Syncope.
25What is a common cause of hemoptysis in children?
Acute lower respiratory infection, often pneumonia.
26What does unilateral foul-smelling nasal discharge suggest?
A nasal foreign body.
27What do intercostal retractions indicate?
Increased work of breathing or respiratory distress.
28What is trepopnea?
Dyspnea that varies with lateral body position.
29What are crackles?
Brief, discontinuous, nonmusical breath sounds.
30What early vital-sign changes can accompany hypoxia?
Tachypnea and tachycardia.
31What neurological changes can accompany hypercarbia?
Confusion and drowsiness.
32Which household exposure increases a child’s risk of respiratory infection?
Parental smoking.
33Which structures make up the upper respiratory tract?
The nasal cavity, nasopharynx, pharynx, and larynx.
34Which structures make up the lower respiratory tract?
The trachea, bronchi, and lungs.
35What does the eustachian tube connect?
The nasopharynx and the middle ear.
36Why are young children prone to otitis media?
Their eustachian tubes are shorter and more horizontal, facilitating movement of secretions.
37What is the most common viral cause of the common cold?
Rhinovirus.
38What are the characteristic symptoms of the common cold?
Rhinorrhea and nasal obstruction with mild systemic symptoms.
39How is the common cold transmitted?
Through direct contact and respiratory particles.
40What is the mainstay of common cold treatment?
Supportive and symptomatic care.
41What is rhinitis medicamentosa?
Rebound nasal congestion from prolonged use of topical nasal decongestants.
42What are common complications of a cold in children?
Otitis media, sinusitis, and asthma exacerbation.
43Which paranasal sinuses are present at birth?
The maxillary and ethmoid sinuses.
44At what age do frontal sinuses become apparent according to the lecture?
About 7–8 years.
45What organisms commonly cause acute bacterial sinusitis in children?
Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
46What persistent symptom pattern suggests acute bacterial sinusitis?
Nasal discharge or daytime cough lasting more than 10 days without improvement.
47What severe initial presentation suggests acute bacterial sinusitis?
High fever with purulent nasal discharge for at least 3 consecutive days.
48How is uncomplicated acute bacterial sinusitis generally diagnosed?
Clinically, from the history and examination.
49What first-line antibiotic for bacterial sinusitis is named in the lecture?
Amoxicillin; actual selection depends on current local guidance.
50Which sinus is commonly associated with orbital complications of sinusitis?
The ethmoid sinus.
51What is Pott’s puffy tumor?
Frontal bone osteomyelitis with an associated subperiosteal abscess.
52What serious intracranial complications can sinusitis cause?
Meningitis, cavernous sinus thrombosis, and intracranial abscess or empyema.
53What is the most common overall cause of pediatric pharyngitis?
Viruses.
54Which bacterial pathogen is important in pediatric pharyngitis because of its complications?
Group A Streptococcus.
55What features favor viral rather than streptococcal pharyngitis?
Cough, rhinorrhea, hoarseness, conjunctivitis, or oral ulcers.
56Which virus is associated with pharyngoconjunctival fever?
Adenovirus.
57Which virus is associated with herpangina?
Coxsackievirus.
58Which virus causes infectious mononucleosis with fatigue and lymphadenopathy?
Epstein–Barr virus.
59What clinical pattern suggests streptococcal pharyngitis?
Sudden sore throat and fever with tonsillar inflammation and anterior cervical lymphadenopathy.
60Does tonsillar exudate alone prove streptococcal infection?
No; viral infections can also cause tonsillar exudate.
61What is the reference standard for confirming group A streptococcal pharyngitis?
Throat culture.
62What should follow a negative rapid antigen test in a symptomatic child when group A strep is suspected?
A confirmatory throat culture.
63What is a first-line antibiotic for confirmed streptococcal pharyngitis?
Penicillin; amoxicillin is also commonly used.
64How long is penicillin treatment for streptococcal pharyngitis typically given?
10 days.
65What nonsuppurative complications can follow group A streptococcal pharyngitis?
Acute rheumatic fever and poststreptococcal glomerulonephritis.
66What is a peritonsillar abscess also called?
Quinsy.
67What finding suggests a peritonsillar abscess?
Asymmetric peritonsillar swelling, often with uvular deviation.
68What major functional problems may indicate tonsillectomy?
Obstruction of breathing or swallowing, including obstructive sleep apnea.
69What is acute otitis media?
An acute infection of the middle ear with effusion and signs of inflammation.
70What is otitis media with effusion?
Middle-ear fluid without signs or symptoms of acute infection.
71What otoscopic finding strongly supports acute otitis media?
A bulging tympanic membrane with middle-ear effusion.
72What antibiotic is commonly first-line for acute otitis media when antibiotics are indicated?
Amoxicillin.
73What is the characteristic finding in otitis externa?
Marked ear pain when the pinna or tragus is manipulated.
74What is the most common pathogen associated with otitis externa in the lecture?
Pseudomonas aeruginosa.
75What is the most prominent symptom of acute infectious laryngitis?
Hoarseness.
76What pattern is characteristic of spasmodic croup?
Sudden nighttime barking cough and stridor, often without a preceding infectious prodrome.
77What symptoms strongly suggest acute epiglottitis?
Fever, drooling, dysphagia, stridor, and a tripod posture.
78What is the first priority in suspected epiglottitis?
Urgent controlled airway management by an experienced team.
79Why should the throat not be forcibly examined in suspected epiglottitis?
Agitation or examination can precipitate complete airway obstruction.
80What lateral neck radiograph finding is associated with epiglottitis?
The thumb sign.