Bronchiolitis Flashcards

1
Q

What is bronchiolitis?

A

inflammatory obstruction of the bronchioles (small airways)

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2
Q

What is the most common cause of bronchiolitis?

A

Respiratory syncytial virus (RSV)

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3
Q

In which season is bronchiolitis most common?

A

Winter

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4
Q

What patient age group does bronchiolitis affect?

A

infants (mainly children under 1)

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5
Q

Why is it viruses affect infants’ bronchioles more so than adult bronchioles?

A

the airways of infants are very small to begin with and when there is even the smallest amount of inflammation and mucus, it has a significant effect on the infant’s ability to circulate air to the alveoli and back out

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6
Q

Give two sounds created by airway obstruction in brochiolitis:

A

1) wheeze
2) crackles on auscultation

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7
Q

Give 8 clinical presentations associated with bronchiolitis:

A

1) coryzal symptoms
2) signs of respiratory distress
3) dyspnoea
4) tachypnoea
5) poor feeding
6) mild fever (under 39 degrees C)
7) apnoea
8) wheeze and crackles on auscultation

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8
Q

What are coryzal symptoms?

A

Acute, inflammatory contagious symptoms associated with upper respiratory tract infections

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9
Q

Give 4 examples of coryzal symptoms:

A

1) runny nose
2) sneezing
3) mucous in throat
4) watery eyes

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10
Q

Give 7 signs of paediatric respiratory distress:

A

1) raised respiratory rate
2) tracheal tugging
3) abdominal airway noises
4) use of accessory muscles
5) cyanosis
6) nasal flaring
7) head bobbing

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11
Q

Name 3 accessory muscles that may be used in paediatric respiratory distress:

A

1) sternocleidomastoid
2) abdominal muscles
3) intercostal muscles

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12
Q

Give 3 abnormal airway noises that may be associated with paediatric respiratory distress:

A

1) wheeze
2) grunting
3) stridor

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13
Q

What is wheeze?

A

whistling sound typically heard on expiration caused by narrowed airways

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14
Q

What is grunting?

A

An “uh” sound during exhalation which reflects the child’s attempt to keep alveoli open caused by exhaling with the blottis partially closed to increase positive end-expiratory pressure

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15
Q

What is stridor?

A

high pitched inspiratory noise caused by obstruction of the upper airway

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16
Q

Describe the progression of bronchiolitis: (4)

A

1) it begins as an URTI with coryzal symptoms
2) half getting better spontaneously while the other half develop chest symptoms over the first 1-2 days
3) symptoms are generally worse on days 3-4
4) symptoms usually last 7 days

17
Q

True or false: children who have had bronchiolitis as infants are more likely to have viral induced wheeze during childhood

A

True

18
Q

Give 8 reasons for bronchiolitis admission:

A

1) aged under 3 months
2) any pre-existing conditions such as prematurity, Downs syndrome or CF
3) 50-75% or less of their normal intake of milk
4) clinical dehydration
5) respiratory rate above 70
6) oxygen saturations below 92%
7) moderate to severe respiratory distress such as recessions or head bobbing
8) apnoea

19
Q

Give the 4 types of supportive treatments offered for bronchiolitis management:

A

1) ensuring adequate nutritional intake
2) saline nasal drops and nasal suction
3) supplementary oxygen
4) ventilatory support (if required)

20
Q

Why should overfeeding be avoided in paediatric respiratory distress?

A

a full stomach restricts breathing movements

21
Q

Where is capillary blood glucose taken from in an infant?

A

big toe

22
Q

What antiviral is given in severe cases of bronchiolitis?

A

Ribavirin

23
Q

what is a Paramyxovirus?

A

Negative strand RNA virus

24
Q

What type of virus is RSV?

A

Paramyxovirus

25
Q

How is RSV transmitted?

A

respiratory droplets

26
Q

How is RSV infection diagnosed? (2)

A

1) genome detection
2) immunofluorescence of nasopharyngeal aspirates

27
Q

Give two ways that passive immunity can be given to high risk infants for RSV:

A

monthly administration of either
1) hyperimmune globulin against RSV
2) Palivizumbal (monoclonal antibody against RSV)

28
Q

What babies are offered monthly globulins/ Palivizumbal?

A

high risk e.g. premature and those with congenital heart disease