CLIPP 12: 10 month with cough and wheeze Flashcards
Top 4 causes of wheeze in infants and toddlers
Viral bronchiolitis
Asthma
Foreign body aspiration
GERD
Scariest PE sign of respiratory distress?
Paradoxical breathing
Paradoxical breathing is almost always a sign of very severe respiratory distress due to respiratory muscle fatigue
Describe the catarrhal phase of pertussis
The initial catarrhal stage lasts 1-2 weeks and is characterized by upper respiratory tract infection symptoms
Describe the paroxysmal stage of pertussis
The paroxysmal stage that follows lasts 4-6 weeks and is characterized by repetitive, forceful coughing episodes followed by massive inspiratory effort, which results in the characteristic “whoop.” Infants generally do not develop a “whoop” due to relative weakness of their inspiratory effort
Describe the convalescent stage of pertussis
Episodic cough may persist for months.
Name one complication of pertussis
CNS apnea
Two most common causes of epiglottitis
staph and strep
Top two organisms causing CAP in school aged children
Mycobacterium pneumonia
Strep pneumo
WBCs in viral pneumonia?
Normal or slightly elevated
Laryngotracheobronchitis aka..
croup
Tx of croup?
Humidified air to reduce laryngospasm
Racemic aerosolized epinephrine can be used for acute improvement, and oral or IM dexamethasone can reduce the severity of symptoms
Stridor: narrowing relative to the thoracic inlet?
Above
Wheezing: narrowing relative to the thoracic inlet?
Below
What can be the cause of a focal wheeze?
Mucus plug
How to obstruction severity change wheeze?
Mild obstruction- expiratory wheeze
Increasingly severe obstruction- can become biphasic
Severe obstruction- wheeze is gone with little air movement
