Bronchiolitis RSV respiratory syncytial virus

Question 1

define bronchiolitis?

Answer 1

acute inflammation of bronchioles in infants (under 1 year old)

Question 2

most common cause?

Answer 2

respiratory syncytial virus

Question 3

how does mum protect child from RSV?

Answer 3

Maternal IgG protects newborns from RSV

Question 4

what are bronchioles?

Answer 4

small airways

Question 5

who gets bronchiolitis in terms of age?

Answer 5

Under 1s

Question 6

is it common?

Answer 6

Very common

Question 7

when in the year it is most common?

Answer 7

winter

Question 8

disease course?

Answer 8

Gets worse for 3 days, then static for 3 days, then improves over 1-2 weeks

Question 9

Other viral causes for bronchiolitis ?

-2

Answer 9

Mycoplasma
adenoviruses
influenza

Question 10

is this a URTI or LRTI?

Answer 10

starts as URTI, can spread to LRTI

Question 11

Risk Factors?

-3

Answer 11

Crowded spaces; schools
underlying heart or lung condition; CF
premature birth

Question 12

advice on how parents can prevent it?

Answer 12

Wash hands, do not share toys, avoid crowded spaces

Question 13

symptoms?

Answer 13

Coryzal symptoms I 
Fever 
Dry cough 
SOB 
Eat less – kids do this when ill & sob

Question 14

Coryzal symptoms means infection is where?

Answer 14

URTI

Question 15

SOB means infection is where?

Answer 15

LRTI

Question 16

child eats less tells you what?

Answer 16

they are unwell/ feeling ill

Question 17

Wheeze caused by what?

Answer 17

airways narrowed

Question 18

crackles caused by what?

Answer 18

alveoli snapping open

Question 19

signs on auscultation?

Answer 19

Wheeze

Bilateral fine crackles

Question 20

how long should any viral fever in a child last?

Answer 20

last 5 days

Question 21

if a viral fever lasts longer than 5 days what does this tell you?

Answer 21

means something else going on (e.g. 2° bacterial infection)

Question 22

Signs of Resp Distress in children?

-4

Answer 22

Tachypnoea
Recession
Use accessory muscles
Expiratory grunt

Question 23

why is mucus made in bronchiolitis?

what sign do you hear because of this?

Answer 23

Inflamed small airways > make mucus

mucus > airways obstructed > hear wheeze

Question 24

is there fever?

Answer 24

yes

Question 25

why is premature birth a risk factor?

Answer 25

Premature birth > these babies have bronchopulmonary dysplasia > now any resp infection will be worse

Question 26

category of diagnosis?

Answer 26

clinical

Question 27

if resp distress what Ix do you do?

why?

Answer 27

capillary blood gas

check for resp acidosis

Question 28

is lots of SOB and RDS signs what Ix do you do?

why?

Answer 28

CXR

check pneumonia

Question 29

can bronchiolitis spread and cause pneumonia?

Answer 29

yes

Question 30

Ix used to check for RSV?

Answer 30

nasal swab - immunofluorescence on the secretion

Question 31

do you need Ix to diagnose bronchiolitis?

Answer 31

no

Question 32

1st line Mx for most kids?

main advice you give to parent?

Answer 32

just support and they will get better by themselves

keep drinking

Question 33

if child dehydrated or not drinking, what do you do?

Answer 33

IV fluids

Question 34

if child not eating, what do you do?

Answer 34

oropharynx tube

Question 35

if child has lots of airway secretions, what do you do?

Answer 35

suction

Question 36

when do you admit bronchiolitis child to hospital?

-3

Answer 36

Signs of Resp distress

Any apnoea (stop breathing in sleep)

Central cyanosis or < 92 O2 sats

Question 37

when do you consider admitting bronchiolitis child to hospital?
-2

Answer 37

not E+D

dehydrated