[2] Bronchiolitis Flashcards

1
Q

What is bronchiolitis?

A

A common LRTI that affects babies and young children under 2 years

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2
Q

How sever are most cases?

A

Mild

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3
Q

How long do mild cases last?

A

Clear up within 2-3 weeks

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4
Q

Do mild cases require treatment?

A

No

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5
Q

What is needed in sever cases?

A

Hospitalisation

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6
Q

What is the causative pathogen in 80% of cases?

A

RSV

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7
Q

What is RSV?

A

Respiratory Syncytial Virus

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8
Q

What other organisms can cause bronchiolitis?

A
  • Parainflueza virus
  • Rhinovirus
  • Adenovirus
  • Influenza
  • Human metapneumovirus
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9
Q

What are the risk factors for developing bronchiolitis?

A
  • Premature infants who develop bronchopulmonary dysplasia
  • Underlying lung disease e.g. CF
  • Congenital heart disease
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10
Q

What are the initial symptoms in bronchiolitis?

A

Coryzal symptoms

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11
Q

What symptoms follow the initial coryzal symptoms?

A

Dry cough and increasing wheezy breathlessness

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12
Q

What is the main reason for hospital admission in bronchiolitis?

A

Feeding difficulty due to increasing dyspnoea

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13
Q

What are the signs of bronchiolitis?

A
  • High-pitched wheeze
  • Tachypnoea
  • Tachycardia
  • Subcostal and intercostal recessions
  • Hyperinflation of the chest
  • Fine end-inspiratory crackles
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14
Q

What is the only routine recommended investigation in bronchiolitis?

A

Pulse oximetry

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15
Q

When may a CXR and blood gases be required in bronchiolitis?

A

When respiratory failure is suspected

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16
Q

What are the differentials for bronchiolitis?

A
  • Asthma
  • Pneumonia
  • Heart failure
  • Allergic reaction
  • Cystic fibrosis
17
Q

What are the indications for hospital admission?

A
  • Apnoea
  • Persistent SpO2 <90% on air
  • Inadequate oral fluid intake
  • Severe respiratory distress
18
Q

What constitutes inadequate oral intake?

A

50-75% normal volume

19
Q

What may indicate respiratory distress?

A
  • Grunting
  • Marked chest recession
  • RR > 70
20
Q

What does management involve?

A

Supportive including:

  • Humdified O2 via nasal cannulae
  • Fluids
  • Assisted ventilation - only in some cases
21
Q

How can fluids be given?

A

Via NG or IV

22
Q

What are the forms of assisted ventilation?

A
  • Non-invasive CPAP

- Mechanical ventilation

23
Q

What ward management requirements are essential in managing patients with bronchiolitis?

A

Good infection prevention techniques

24
Q

Why are good infection prevention techniques required in bronchiolitis management?

A

RSV is highly infective

25
Q

What infection prevention techniques can be employed?

A
  • Good hand hygiene
  • Cohort nursing
  • Gowns and gloves
26
Q

What prophylactic treatment can be given in children at high risk to reduce the number of hospital admissions?

A

IM Palivizumab

27
Q

What is Palivizumab?

A

A monoclonal antibody to RSV

28
Q

Why is Palivizumab not given to treat RSV?

A

It has a high number needed to treat and requires multiple IM injections

29
Q

What are the potential complications of bronchiolitis?

A
  • Respiratory distress
  • Dehydration
  • Recurrent apnoea
  • Permanent damage to airways