MBBS viva · Paediatrics
Pneumonia in children — WHO severity and antibiotics viva
Viva on paediatric pneumonia: WHO fast breathing, severity tiers, oxygen, empirical antibiotics, complications and vaccines.
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"A toddler has cough, fever and chest indrawing. Classify and treat."
Q1: Definition and classification (2 min)
- Cough/difficulty breathing + age-specific tachypnoea.
- Thresholds: >50 (2–12 mo), >40 (1–5 y), >20 (>5 y).
- Pneumonia vs severe (indrawing) vs very severe (danger signs).[1]
Q2: Aetiology (1–2 min)
- Viral: RSV (esp. <1 y), influenza, others.
- Bacterial: S. pneumoniae; Hib reduced by vaccine; S. aureus if severe/cavitary; atypicals (Mycoplasma) in older children.
- TB and HIV in endemic/risk settings.
Q3: Management (3 min)
- Non-severe: oral amoxicillin 80–90 mg/kg/day × 5–7 days at home.
- Severe: oxygen if hypoxic; hospital; ampicillin 50 mg/kg q6h + gentamicin 7.5 mg/kg daily.
- Supportive care; CXR for complicated/hospitalised cases.
- Empyema: drainage ± tPA+DNase / VATS pathway.
Q4: Prevention and pitfalls (1–2 min)
- PCV, Hib, measles, influenza; breastfeeding; clean air.
- Pitfalls: missing hypoxaemia, using adult scores, delaying parenteral antibiotics in danger signs, ignoring foreign body/TB differentials.
Key phrases
- "Indrawing means severe — admit."
- "Ampicillin plus gentamicin; step down to high-dose amoxicillin."
- "SpO2 under 90 percent needs oxygen."
References1ShowHide
- [1]WHO. (missing) WHO, 2013.PMID 24006557