LRTI Flashcards
What is bronchitis?
inflammation of the lining of the bronchial tubes
- Rare in children
- Viral infection
- Antibiotics not effective
- Confused with asthma
What is asthma?
a condition in which a persons airways become inflamed, narrow and swell and produce extra mucus which makes it difficult to breathe
Characteristic features of asthma?
- Common in children
- Familial
- Associated with eczema
- Confused with bronchitis
When is asthma diagnosed?
> 3 years and nearly all by the age of 7 years
What is the true definition of asthma?
Recurrent and REVERSIBLE bronchospasms
Clinical features of asthma?
- Recurrent cough
- worse at night
Historical points that may suggest that the child’s asthma is triggered by allergens?
- Seasonal nature: pollen
- Worse when exposed to a pet: Animal dander
- Worse when bed is made or carpets/furnisher is dusted: house dust mites
- Worse in damp house holds: moulds
Pathophysiology of asthma?
Trigger > Exacerbations > bronchi mucus, oedema, spasms > Bronchiole obstruction > air trapping OR collapse
Classification of asthma?
How it is classified?
Mild, Moderate, and Severe
- classified on frequency and Impact on activity
What are acute asthma exacerbations?
episodes of worsening asthma symptoms and lung function
- can be the presenting manifestation of asthma or occur in patients with a known asthma diagnosis in response to a trigger e.g. viral upper respiratory infection, allergen, air pollution etc
Treatment of acute exacerbation of asthma?
- bronchodialators
- steroids
- Goal is to stop the spasms and reduce inflammation
What bronchodialators are used in asthma?
- Mild: Salbutamol MDI 2-4 puffs
- Mod-Severe: Salbutamol nebuliser
What steroids are used in asthma?
Oral Prednisolone or IV Dexamethasone
If asthma is severe with impending death what do you use to treat?
- aminophyline
- magnesium
Note: aminophyline has a narrow therapeutic window necessitating close monitoring
Why is inhaled salbutamol preferred?
because adverse effects—tremor, prolonged tachycardia, and irritability—are less
What is the natural progression of an asthma attack?
Cough > Wheezing > Tachpynea > ”silent chest” > Lethargy > Hypocapnia > “Normalizing” of respiratory rate > Respiratory failure > Death
Why should you beware of an asthmatic child that looks like they are getting better?
are they getting better or getting tired?
What is status asthmaticus?
is an acute exacerbation of asthma that does not respond adequately to therapeutic measures and may require hospitalization
Treatment of mild asthma?
Salbutamol rescue Inhaler as needed
- teach guardian to identify triggers