Bronchiolitis Flashcards
1
Q
What is bronchiolitis?
What is it caused by?
A
- Inflammatory of the bronchioles
- commonest serious respiratory infection of infancy.
- It is most commonly caused by Respiratory syncytial virus (RSV) - 80% of cases
- But can be caused by a variety of viruses such as parainfluenza virus, adenovirus, influenza virus, human metapneumovirus, rhinovirus and mycoplasma pneumoniae
2
Q
Which age range is bronchiolitis most common in and how common is it?
A
- Very common 2-3% of all infants - admitted during winter
- Can happen from birth to 15 months. Rare after 1 years old
3
Q
What are the signs and symptoms of bronchiolitis?
A
Symptoms:
- Initially 2-3days coryzal symptoms followed by:
- Respiratory distress (rapid, shallow breathing, grunting sounds, subcostal & intercostal recessions)
- Increasing breathlessness
- Poor feeding
- May be pyrexial
- Dry cough
Signs on examination:
- wheeze (high pitched) and crackles throughout chest
- Subcostal & intercostal recessions
- Hyperinflated chest
- Prolonged expiration
- Cyanosis or pallor
- Sharp dry cough
- SOB
4
Q
What patients are more at risk of severe bronchiolitis?
A
- Cystic fibrosis
- Congential heart disease
- Premature
- Chronic lung disease
5
Q
What is the treatment for Bronchiolitis?
A
- No curative treatment, disease is self limiting.
- Supportive treatment:
- O2 via nasal cannula/mask/head box
- Concentration determined by pulse oximetry
- NG tube to aid feeding
- O2 via nasal cannula/mask/head box
Most infants recover within 2 weeks
6
Q
What advise would you give to parents about how to care for a child with bronchiolitis?
A
- Supportive
- Warning signs for admission
- Infection risk
- What to expect
7
Q
What investigations could you do?
A
- PCR of respiratory secretions to show RSV (via nasopharyngeal aspirate)
- CXR can show hyperinflation, air trapping and focal atelectasis (collapsing of part of the lung)
- PULSE OXIMETRY will be done
Investigations are rarely done
