LRTI: Bronchiolitis Flashcards

1
Q

What is Bronchiolitis? (3 things)

A
  1. Inflammation + infection of bronchioles (small airways of lungs)
  2. Usually viral
  3. Usually in infants
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2
Q

What is the pathophysiology of Bronchiolitis causing Narrow Aiways? (6 things)

A
  1. Lower Resp Tract cells infected
  2. Natural Killer cells attack
  3. Cytokines released
  4. Epithelial cells release Mucus
  5. Vasodilation + Fluid leaks
  6. Vessels swell –> Narrow airways (severe in infants who already have narrow airways)
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3
Q

What is the pathophysiology of Bronchiolitis causing Collapsed Aiways (Atelectasis) (3 things)

A
  1. Mucus + dead cells form Mucus plugs
  2. Air trapped
  3. Airways collapse (atelectasis)
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4
Q

What is the most common cause of Bronchiolitis?

A

Respiratory Syncytial Virus (80%)

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5
Q

What are the Risk Factors for Bronchiolitis? (7 things)

A
  1. Young age (under 2 yrs old)
  2. Nursery / Daycare attendance
  3. Exposure to smoking
  4. Premature birth
  5. Previous infections
  6. Low immunity (obv)
  7. Neuromuscular disorders
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6
Q

What are the CF of Bronchiolitis? (11 things)

A

Coryzal Symptoms: (typical Viral URTI symptoms) (happen first)

  1. Watery eyes
  2. Runny nose
  3. Sneezing
  4. Mucus in throat

Resp Distress Symptoms:

  1. Dry cough
  2. SOB / Tachypnoea
  3. Wheezing
  4. Cyanosis
  5. Using accessory muscles

Other:

  1. Mild fever
  2. Poor feeding
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7
Q

Which infants should be admitted to hospital w Bronchiolitis? (7 things)

A
  1. Apnoea (not breathing)
  2. Grunting
  3. RR over 70
  4. O2 sats under 92%
  5. Central yanosis
  6. Clinicaly dehydrated
  7. Age under 3 months

AGROCCA

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8
Q

What investigations can you do for sus Bronchiolitis? (3 things)

A
  1. CXR = patchy infiltrates + atelectasis
  2. PCR = suggests viral infection
  3. Immunofluorescence of nasopharyngeal secretions = will show RSV
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9
Q

What are the management options for Bronchiolitis? (5 things)

A

Most only need Supportive management:

  1. Fluids + NG tube for feeding
  2. Nasal suctioning / Saline nasal drops (to clear mucus)
  3. Humidified Oxygen (if O2 still under 92% sats)
  4. Intubation (if req)

Palivizumab (monoclonal antibody vs RSV, given monthly)

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10
Q

Who should you give Palivizumab to? (3 things)

A
  1. Prematurely born infants
  2. Congestige Heart Disease
  3. Chronic Lung Disease
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