Bronchilitis

Question 1

What is bronchiolitis?

Answer 1

Inflammation and infection in bronchioles

Most commonly due to respiratory syncytial virus (RSV)

Question 2

What organism commonly causes bronchiolitis?

Answer 2

RSV : Respiratory syncytial virus

Question 3

What clinical features will bronchiolitis present with?

Answer 3

Coryzal symptoms
Respiratory distress (accessory muscles, nasal flaring, cyanosis)
Dyspnoea (laboured breathing)
Poor feeding
apnoeas

Wheeze and crackle on ascultation

Question 4

When to consider pneumonia in a bronchiolitis picture?

Answer 4

If high fever over 39
persistently focal crackles

Question 5

What investigation can be done

Answer 5

Immunoflourescence of nasopharyngeal secretions may show RSV

Question 6

How to manage bronchiolitis
- when do admit?

usually self limiting but if not?

Answer 6

Admission if:

respiratory distress (RR 60+, grunting)
Poor feeding
Sats 92 or cyanosed
clinical dehydration

Question 7

How to manage respiratory in admission?

Answer 7

Humidified oxygen
CPAP
Upper airway suction for excessive secretions
Fluids

Question 8

What can be given for prevention of further RSV for high risk kids>

BPD, CHD, <24 months with SCID

Answer 8

Palivizumab