Pediactrics Flashcards
cough
brainstem reflex
cough receptors
middle ear, sinuses, pericardium, diphragm, phaynx, larynx, trachea, major bronchi
phases of cough
inspiration
compression
exhalation
chronic cough in ped
cough more than 3-4 weeks**
cough after eating
overfeeding - decreased with less food
GERD - if with vomiting
TEF - no vomiting - worse with feeding
cough with cyanosis not relieved by O2
requires thorough cardiac evaluation
possible R to L shunt
cough with tachypnea and fever
sepsis
RSV
infants at higher risk
-preterm, cyanotic heart disease, immunodeficient
staccato cough first few months
chlamydia trachomatis pneumonia
spells with apnea
pertussis
wet cough
bronchiectasis
rigid bronchoscopy
to see foreign body AND remov\e it
flexible - cannot remove
sore throat, fever, HA, no cough or rhinorrhea
strep pharyngitis
work up with rapid strep and back up culture if negative
NO COUGH OR RHINORRHEA
PE - exudative pharyngitis, tender anterior cervical lymph nodes, scarlatiniform rash, pastias lines
drooling, dysphagia, dysphonia, dyspnea, tripod position
epiglottitis
examine airway under anesthesia***
can compromised airway, don’t be stupid
barking cough, inspiratory stridor
croup
-paryngotracheitis
cause - parainfluenza, influenza, RSV, adenovirus
steeple sign on neck Xray
croup tx
inhaled racemic epinephrine
- reduce stridor within 30 minutes
- most immediate benefit
upper resp followed by lower resp infection, increased resp effort - tachypnea, nasal flaring, chest retractions, wheezing, crackles
bronchiolitis
RSV, rhinovirus
bronchiolitis admit to hospital?
if hypoxic - O2 sat < 90%
-or dehydrated
HA, malaise, low grade fever, adolescent, mildly productive cough, wheezing and dyspnea, scattered rales and wheezes
mycoplasma pneumonia
premature baby
respiratory distress syndrome
hyaline membane disease
CXR for respiratory distress
hyperinflation
air bronchograms
diffuse granularity
can look like group B strep as well
-so give antibiotics
prematurity
decreased surfactant
hypoxemia and CO2 retention
acidosis, hypoperfusion
endo and epithelial damage
fibrin > hyaline membrane formation
tx CMV
gangciclovir
CMV
DNA herpesvirus
massive enlargement of affected cells with inclusions in cells
most common congenital viral infection
CMV
hearing impairment**, mental retardation, cerebral palsy
transmission of CMV
prenatal or natal infection (cervical/vaginal infections
breast milk
sheds CMV
also blood transfusion and organ transplants
sensorineural hearing loss
in CMV infants
30-65% of asymptomatic patients
coombs negative hemolytic anemia
not immune mediated
intracranial calcificaitons
CMV
bronchopulmonary dysplasia
premature infants with following RDS
-developed CXR with coarse, streaky infiltration with small ares of emphysema and occasionally appeared cystic
babies on ventilators - O2 is strong oxidizer - high pressure on lungs also damages
baby on ventilator
bronchopulmonary dysplasia
stage 1 BPD
2-3 days after birth CXR granular appearances
stage 2 BPD
4-10 days after birth X-ray shows complete opacification of lungs
stage 3 BPD
10-20 days after birth X-ray shows round cystic lucencies with alternating opacities
stage 4 BPD
1 month after birth CXR shows enlargement of lucencies and increasing strands of opacity
bubbly lung
stress and cytokine
increase surfactant production
