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Peds > Laryngeal/Tracheal infections > Flashcards

Laryngeal/Tracheal infections Flashcards

1
Q

Obstructive sleep apnea sxs

A

Snoring, gasping, apnea 30-45 s

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2
Q

Obstructive sleep apnea Dx

A

Sleep study

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3
Q

Obstructive sleep apnea Tx

A
  • Adenoidectomy w/ possible tonsillectomy

- CPAP

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4
Q

Vocal cord dysfunction sxs

A

chocking sensation, stridor

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5
Q

Vocal cord dysfunction Dx

A

Dont respond to albuterol in the office (no obstruction on spirometry)

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6
Q

Vocal cord dysfunction Tx

A

Speech therapy, reassurance

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7
Q

Asthma sxs

A

Cough (nocturnal), wheezing, chest tightness, triggers

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8
Q

Asthma risk factors

A

Viral infections
tobacco smoke
pollution
family hx

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9
Q

Asthma xtics

A
  • Inflammation
  • Hyper-responsiveness
  • Reversible obstruction
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10
Q

Asthma Dx

A
  • Hx

- Pulmonary function test (spirometry)- FEV/FVC decreased = obstructive; improves with bronchodilator

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11
Q

At what age can you perform spirometry on a child

A

5yr and over (younger and the results aren’t accurate)

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12
Q

Asthma Tx

A
  • Short acting bronchodilators
  • Inhaled corticosteroids
  • Long acting bronchodilators (w/ inhaled corticosteroid)
  • Leukotriene antagonists
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13
Q

When you need more than just rescue bronchodilator

A

Rule of twos
>2x /wk
>2x /night
>2 refills/yr

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14
Q

Effects of corticosteroids

A

Minimal: Bone density (high doses)
Normal: growth achievement
Mostly safe

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15
Q

Infant respiratory distress syndrome xtics

A

Deficiency of surfactant at birth

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16
Q

Infant respiratory distress syndrome sxs

A

Rest distress (tachypnea, nasal flaring, grunting, cyanosis) w/in minutes - hrs after birth to 2-3days

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17
Q

Infant respiratory distress syndrome Dx

A

Blood gases = hypoxic

CXR= ground glass appearance

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18
Q

Infant respiratory distress syndrome risk factors

A
  • Premie

- Diabetic mom

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19
Q

Infant respiratory distress syndrome Tx

A

O2, IV fluids (surfactant)

Glucocorticoids 24hr before birth

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20
Q

Pneumonia

A

consolidation of alveolar spaces - parenchymal infection

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21
Q

Pneumonia etiology

A

Viral (1-3mo, 3-12mo,2-5yrs), Bacterial (5-18yrs)

& atypicals

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22
Q

Pneumonia sxs

A

Fever, cough (myalgia if viral) abdominal pain-older chn/not feeding well,restless-infants

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23
Q

Afebrile pneumonia

A

Think Chlamydia

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24
Q

conjunctivitis w/ pneumonia

A

Think chlamydia

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25
Q

Pneumonia exam findings

A

Tachypnea, tachycardia, fever, decreased O2 sats, Rales, Rhonchi, dull to percussion, wheezing (atypical/viral)

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26
Q

Pneumonia Dx

A
  • CXR (not required)

- Blood culture (if toxic/admission)

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27
Q

Pneumonia Tx (outpatient)

A

Empirical w/ follow up
infant/preschool- Amox/2nd-3rd gen Ceph/Clinda
School age- Amox/Azithro/Doxy for atypical

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28
Q

Pneumonia Tx (inpatient)

A

Ampicillin/sulbactam 200mg/kg/24hr q6h
Cefuroxime 150mg/kg/24hr q8h
Ceftriaxone 50-100mg/kg/24hr q12-24h

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29
Q

When to admit

A

At any age if

  • Family can’t take care of child
  • Comorbidities
  • Family can’t come back for follow up
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30
Q

Vaccines against Pneumonia

A
  • Strep pneumonia
  • Varicella
  • Measles
  • H influenza
  • Influenza
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31
Q

pertussis

A

Prolonged cough that can cause vomiting.

32
Q

Pertussis mortality due to

A

Apnea

33
Q

Pertussis etiology

A

Bordatella pertussis

34
Q

Pertussis sxs

A

Paroxysmal coughing w/ inspiratory “whoop”

35
Q

Stages of pertussis

A
  1. Catarrhal (URI,fever; 1-2wks)
  2. Paroxyxmal cough w/post tussle emesis (2-6wks)
  3. Convalescent-recovering cough (10-12wks)
36
Q

Pertussis Dx

A

Nasopharyngeal culture (gold std)
CBC -elevated lymphocytes
CXR-subsegmental atelectasis

37
Q

Pertussis Tx

A

Macrolides- Azithro/Erythro

38
Q

RSV sxs

A

Cough, conjunctivitis, nasal congestion (a lot of mucus) fever

39
Q

Major complication of RSV

A

Bronchiolitis

40
Q

RSV Dx

A

Nasopharyngeal culture

41
Q

RSV Tx

A

*Prevention (wash hand, avoid infected etc)

42
Q

RSV prophylaxis

A

Palivizumab (high risk

43
Q

Bronchiolitis etilogy

A

RSV

Rhinovirus

44
Q

Bronchiolitis sxs

A

2-3day cold, low grade fever, wheezing, tachypnea, nasal flaring

45
Q

Bronchiolitis Dx

A
  • Based on sxs, time of year, age

- +/- nasopharyngeal swab (ER)

46
Q

Time of year when RSV is common

A

Winter (Nov-April)

47
Q

Bronchiolitis Tx

A

Supportive, duration 1-2wks, suction mucus,

Hospitalized if in need of airway support/increase fluids/oxygenation

48
Q

Cause of Cystic fibrosis

A

Autosomal recessive mutation in CFTR gene (Chloride channel transporter)

49
Q

What causes death in Cystic fibrosis

A

Recurrent lung infections

50
Q

Cystic fibrosis sxs

A

Persistent productive cough, viscous mucus secretion, hyperinflation of lungs on CXR

51
Q

Cystic fibrosis Dx

A

Sweat chloride > 60meq/L

52
Q

Bronchiectasis

A

Abnormal dilation of bronchi, walls damaged by inflammation

53
Q

Sxs of Bronchiectasis

A

Chronic cough and sputum (think cystic fibrosis)

54
Q

Dx bronchiectasis

A

Pulmonary fxn test- obstructive pattern

55
Q

Croup etiology

A

Parainfluenza, RSV

56
Q

Croup sxs

A

Barking seal like cough with inspiratory stridor, hoarseness, low grade fever

57
Q

Croup Dx

A

Clinical (CXR-steeple sign)

58
Q

Croup Tx

A

Mild: Supportive, cool mist, steam bath
Moderate: steroids, Dexamethasone 0.6mg/kg or Nebulized Epi
Severe: Airway support

59
Q

Croup predominant season

A

Fall & winter

60
Q

Epiglottitis etiology

A

Emergent

-Hemophilus influenza B

61
Q

Epiglottitis sxs

A

Rapid onset of high fever, muffled hot potato voice, 3Ds (drooling, dysphagia, distress), pain in ant part of neck

62
Q

Epiglottitis Dx

A

Clinical (CXR thumb sign - lateral neck)

63
Q

Epiglottitis Rx

A
  • Airway support
  • Steroids
  • Ceftriaxone for H influenzae
64
Q

Tracheomalacia

A

abnormal collapse of trachea due to not being well developed

65
Q

What exacerbates tracheomalacia

A

crying

66
Q

Tracheomlacia sxs

A

Barking cough, expiratory stridor

67
Q

Tracheomalacia Tx

A

self resolving, CPAP

68
Q

Foreign body aspiration sxs

A

Abrupt onset of cough, insp/exp stridor(upper airway) unilateral wheezing (lower airway)

69
Q

where so most foreign body aspirates end up

A

Right bronchus

70
Q

Foreign body dx

A

Bronchoscopy (may or may not show up on CXR) do if have high suspicion and -ve result on CXR

71
Q

Foreign body asp tx

A

Removal

72
Q

What aspirate is most fatal

A

Balloon

73
Q

most common respiratory disorder in chn

A

Asthma

74
Q

most common cause of LRI in chn

A

RSV

75
Q

Most common fatal autosomal dominant recessive disease

A

CF

76
Q

Leading cause of death in can under 5yo worldwide

A

Pneumonia

Peds (11 decks)

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