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Year Three - Paediatrics > Bronchiolitis > Flashcards

Bronchiolitis Flashcards

1
Q

Is bronchiolitis an URTI or LRTI?

A

LRTI

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2
Q

What is bronchiolitis?

A

It is acute bronchiolar inflammation

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3
Q

What is the most common causative organism associated with bronchiolitis?

A

Respiratory syncytial virus (RSV) infection

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4
Q

What are the six risk factors of bronchiolitis?

A

Infants < 1 Years Old

Ex-Premature Infants

Congenital Heart Disease

Chronic Lung Disease

Respiratory Tract Infections

Winter Period

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5
Q

What is the peak age at which bronchiolitis tends to develop?

A

3-6 months old

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6
Q

What three respiratory tract infections are associated with bronchiolitis?

A

RSV

Mycoplasma

Adenovirus

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7
Q

What is a protective factor against RSV, and therefore bronchiolitis?

A

Maternal IgG

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8
Q

What are the nine clinical features of bronchiolitis?

A

Coryzal Features

Dry Cough

Mild Fever < 39°C

Dyspnoea

Feeding Difficulties

Wheeze, Fine Inspiratory Crackles

Tachypnoea

Respiratory Distress Features

Apnoeas

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9
Q

What are the four typical corzyal features?

A

Runny nose

Sneezing

Mucus in throat

Watery eyes

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10
Q

What is a wheeze?

A

It refers to a whistling sound caused by narrowed airways, typically heard during expiration

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11
Q

What does a wheeze indicate about the source of infection?

A

It is less likely to be a bacterial agent

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12
Q

What are the eight respiratory distress clinical features?

A

Tachypnoea

Accessory muscle use

Intercostal and subcostal recessions

Nasal flaring

Head bobbing

Tracheal tugging

Cyanosis

Abnormal airway noses

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13
Q

What are the three accessory muscles?

A

Sternocleidomastoid

Abdominal

Intercostal

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14
Q

What are apnoeas?

A

They are periods in which breathing stops

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15
Q

Describe the typical clinical presentation course of bronchiolitis

A

The onset is related to an upper respiratory tract infection (URTI), resulting in the development of coryzal features

Following onset, patient will then develop respiratory features after 1-2 days

These features usually persist for a period of 7-10 days, peaking on day 3 or 4

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16
Q

In most cases, how is bronchiolitis diagnosed?

A

Clinically

17
Q

How can we confirm a diagnosis of bronchiolitis?

A

We can conduct a nasopharyngeal aspirate to allow immunofluorescence testing

This confirms the presence of RSV infection

18
Q

How is bronchiolitis typically managed?

A

It can be managed at home, with safety netting advice on when to seek further medical attention

19
Q

What are the five immediate referral indications?

A

Tachypnoea > 70bpm

Apnoea

Severe Respiratory Distress

Central Cyanosis

Saturation < 92% On Air

20
Q

What are the three referral consideration indications?

A

Tachypnoea > 60bpm

Feeding Difficulties (<50-75% Intake)

Clinical Dehydration

21
Q

What are the four supportive management options for bronchiolitis?

A

Nasogastric Feeding

Saline Nasal Drops & Nasal Suctioning

Humidified Oxygen (Sats < 92%)

Ventilatory Support

22
Q

How is nasal suctioning used to manage bronchiolitis?

A

It clears nasal secretions, which is important before feeding

23
Q

What four management options of bronchiolitis have little evidence of effectivity?

A

Nebulised saline

Bronchodilators

Steroids

Antibiotics

24
Q

What is palivizumab?

A

It is a monoclonal antibody that targets RSV

25
Q

How can palivizumab be used as bronchiolitis prophylaxis?

A

It can be administered as a monthly injection in individuals who are at high risk of bronchiolitis development, such as those who are ex-premature and those with congenital heart disease.

26
Q

Why is palivizumab not considered a true vaccine?

A

This is due to the fact that it doesn’t stimulate the infant’s immune system

It provides passive protection by circulating the body until the virus is encountered, at which point it works as an antibody and activates the immune system to fight the virus

27
Q

Why does palivizumab need to be administered monthly?

A

The levels of circulating antibodies decreases over time

28
Q

What is a common complication of bronchiolitis?

A

Viral induced wheeze in childhood

Year Three - Paediatrics (29 decks)

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