Acute Inflammatory Airway Obstruction Flashcards
Defines the narrowest portion of the upper airways in children <10 yrs
Cricoid cartilage
Bark-like or brassy cough
Croup
Harsh, high-pitched respiratory sound which is usually inspiratory but can be biphasic
Stridor
Most acute infections of the upper airway are caused by ___ with the exception of diphtheria, bacterial tracheitis, and epiglottitis
Viruses
Account for ~75% of infectious upper airway obstruction
Parainfluenza
Croup peaks at what age
2 y/o
Croup is aka
Laryngotracheobronchitis
MCC of pediatric epiglottitis in vaccinated children
S. pyogenes, S. pneumoniae, S. aureus; Hib has been reduced due to vaccination
MCC of croup
Viruses
MC form of upper airway osbtruction
Croup
Barking cough, hoarseness, inspiratory stridor
Croup
T/F Symptoms of croup are worse at night
T
T/F Croup is a clinical diagnosis and does not require a radiograph of the neck
T
Radiographs of the neck in croup can show the typical ___
Subglottic narrowing or steeple sign
Accepted treatment for moderate to severe croup which causes constriction of the precapillary arterioles through β-adrenergic receptors, causing fluid resorption and decreased edema
Nebulized racemic epinephrine
T/F Effectiveness of oral corticosteroids in viral croup is well-established
T
Upper airway obstruction: Drooling with hyperextended neck in an attempt to maintain the airway
Acute epiglottitis
Upper airway obstruction: Tripod position
Acute epiglottitis
Upper airway obstruction: Stridor is a late finding
Acute epiglottitis
T/F In acute epiglottitis, no other family members are ill with acute respiratory symptoms
T
Upper airway obstruction: Cherry red epiglottis
Acute epiglottitis
T/F Diagnosis of acute epiglottitis REQUIRES visualization of a large cherry red swollen epiglottis by laryngoscopy
T
Classic radiographic picture of child who has epiglottitis
Thumb sign
T/F Establishing an airway is indicated in patients with epiglottitis regardless of degree of apparent respiratory distress
T
Reason why it is necessary to establish an airway in epiglottitis regardless of degree of respiratory distress
As many as 6% of children without an artificial airway die compared to <1% with artificial airway
T/F Children with epiglottitis are intubated for 2-3 days because response to antibiotics is usually rapid
T
Choices for empiric therapy of epiglottitis
IV Ceftri, Cefotax, Merop (BECAUSE 10-40% of Hib are resistant to Ampicillin)
Indications for household members prophylaxis in cases of epiglottitis
1) <48 months of age incompletely immunized 2) <12 months with no primary vaccination series 3) Immunocompromised child
Medication used for prophylaxis in cases of epiglottitis
Rifampin
MCC of acute infectious laryngitis
Virus
Upper airway obstruction: Hoarseness and loss of voice may be out of proportion to systemic signs and symptoms
Acute infectious laryngitis
MC isolated pathogen in bacterial tracheitis
S. aureus
T/F Bacterial tracheitis often follows a viral respiratory infection
T
Upper airway obstruction: Brassy cough, high fever, and “toxicity” with respiratory distress immediately or after a few days of apparent improvement
Bacterial tracheitis
Most important ddx for acute infectious laryngitis
Bacterial tracheitis
MC complication of acute infectious laryngitis
Extension of infectious process to involve other regions of the respiratory tract including the middle ear, terminal bronchioles, or pulmonary parenchyma
Major pathologic feature of bacterial tracheitis
Mucosal swelling at the level of the cricoid cartilage
