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Respiratory > EXAM #2: UPPER AIRWAY OBSTRUCTION IN KIDS > Flashcards

EXAM #2: UPPER AIRWAY OBSTRUCTION IN KIDS Flashcards

1
Q

What are the symptoms of the common cold?

A
  • Rhinorrhea
  • Sore throat
  • Sneezing
  • Coughing
  • Mild fever

*Resolving in 10 days

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2
Q

What are the symptoms of persistent sinusitis?

A

1) Rhinorrhea that becomes cloudy or colored
2) Daytime cough (worse night)

*Lasting for 10 days and does NOT improve

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3
Q

What are the distinguishing symptoms of a severe sinusitis?

A

1) Fever over 102.2 F for 3x days

2) Mucus that is thick, cloudy, or colored

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4
Q

In the first year of life, how many colds will a child get?

A

6-8

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5
Q

When are abx indicated for sinusitis?

A

10 days of sx with no improvement

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6
Q

What are the signs of laryngotracheobronchitis?

A

Prodrome followed by:

1) Stridor
2) Retractions of chest wall
3) Flaring of nostrils
4) Barking cough

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7
Q

What is the alternate name for laryngotracheobronchitis?

A

Viral croup

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8
Q

What age range is most common for viral croup?

A

6 months to 6 years

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9
Q

How is stridor defined?

A

Harsh, high-pitched INSPIRATORY sound

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10
Q

Why are kids susceptible to viral croup?

A

Anatomically smaller airway that gets inflamed

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11
Q

What virus most commonly causes croup?

A

Parainfluenza Type 1*

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12
Q

What is the differential diagnosis for croup?

A

1) Epiglottitis
2) Bacterial tracheitits
3) FB
4) Laryngomalacia
5) Retropharyngeal abscess

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13
Q

What is the classic x-ray finding associated with croup?

A

Steeple sign

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14
Q

What is the treatment for croup?

A

1) Humidification at HOME
2) Nebulized racemic epinephrine
3) Dexamethasone (IM or PO)

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15
Q

What patients with croup require hospitalization?

A

Stridor refractory to racemic epinephrine

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16
Q

What are the signs/sx. of epiglottitis?

A

1) Abrupt onset respiratory distress

2) High anxiety

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17
Q

Why is epiglottitis on the decline?

A

Haemophilus influenza type B vaccine

18
Q

What is the initial management for epiglottitis?

A

Calm environment with Mom

19
Q

If epiglottitis, what should you do?

A

Go to the OR to intubate, with preparation to do a tracheostomy

20
Q

What should you NOT do in a case of suspected epiglottitis?

A

1) NO tongue depressor
2) NO labs
3) NO x-ray

21
Q

What is bacterial tracheitis?

A

Essentially, bacterial infection of the trachea

22
Q

How old are kids that get bacterial tracheitis?

A

Under 3 y/o

23
Q

What is the presentation of bacterial tracheitis?

A

1) Brassy cough
2) High fever
3) Toxicity

*Possibly causing life threatening obstruction

24
Q

What most commonly causes bacterial tracheitis?

A

Staphylococcus aureus

25
Q

When is FB aspiration most common?

A

1-3 y/o

26
Q

What are the signs/symptoms of FB airway obstruction?

A

1) Cough
2) Stridor
3) Wheezing
4) Drooling
5) Respiratory distress

27
Q

How is the diagnosis of FB aspiration made?

A

1) Clinical suspicion
2) 2x view neck AND insp/expiratory films

*95% are radiolucent; thus, the insp/exp films are to see mediastinal shift/ impaired filling

28
Q

How do you tell the difference between a coin in the trachea vs. esophagus?

A

asdf

29
Q

What is a retorpharyngeal abscess?

A

Infection between the buccopharyngeal fascia and prevertebral fascia

*Lymph nodes in this region suppurate from extension

30
Q

What bacteria most commonly cause a retorpharyngeal abscess?

A

1) Strep pyogenes
2) Oral anaerobes
3) S. aureus

31
Q

What age group is a retropharyngeal abscess most common?

A

Less than 3 y/o b/c the prevertebral space is still open (closes around 3-4)

32
Q

What is the ddx for a retropharyngeal abscess in a child or adolescent?

A

Peritonsillar abscess

33
Q

What is the presentation for a retropharyngeal abscess?

A

1) Fever
2) Sore throat
3) Neck pain
4) Progressive dysphagia and respiratory distress

34
Q

What are the signs of a retropharyngeal abscess?

A

1) Torticollis
2) Trismus

*Plus drooling and stridor

35
Q

If you have a high suspicion for a retropharyngeal abscess, what should you do?

A

CT of the neck

36
Q

What is the treatment for a retropharyngeal abscess?

A

1) Drainage

2) Abx

37
Q

What is the most common cause of stridor in infancy?

A

Laryngomalacia

38
Q

What causes laryngomalacia?

A

1) Immaturity of the supporting structures around the larynx
2) Abnormal NM development

39
Q

What is the classic presentation for Laryngomalacia?

A

Stridor in an infant (under 6 months) that:

  • Worsens with agitation/ being supine
  • Improves with being prone
40
Q

What typically happens with laryngomalacia?

A

Resolution around 12-18 months

41
Q

How does the presentation of Tracheomalacia differ from Laryngomalacia?

A

Wheezing is more common

42
Q

What congenital abnormality is associated with Tracheomalacia?

A

TE fistula

Respiratory (35 decks)

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