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OS 213 Respiratory EXAM 1 > Pediatric Acute Respiratory infections > Flashcards

Pediatric Acute Respiratory infections Flashcards

1
Q

Vocal Apparatus of the larynx, consisting of the vocal folds of the mucous membrane investing the vocal ligament and vocal muscle on each side.

A

Glottis

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2
Q

5Ps of History

A 
Prodrome and onset
Prior state of health
Presence of Fever
Precious Treatment
Playing with small toys
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3
Q

Maximizes airway and use of accessory muscles (head leaning forward, neck extended, elbows on knees, mouth open, tongue out)

A

tripod position

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4
Q

tripod position indicates?

A

Epiglotitis

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5
Q

triad of Epiglotitis

A

Drooling, dyspnea, dysphagia

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6
Q

normal RR (<2 moths)

A

<60 rpm

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7
Q

normal RR (2-12 months)

A

<50 rpm

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8
Q

normal RR (1-5 years)

A

<40 rpm

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9
Q

normal RR (68 years)

A

<30 rpm

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10
Q

Most toxic infectious pathology of the supraglottic area

A

Epiglotitis

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11
Q

radiographic sign or epiglotitis

A

Thumb sign

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12
Q

Most benign infectious pathology of the RT

A

Viral laryngotraheobronchitis

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13
Q

Also called the wine bottle sign, Refers to the tapering of the upper trachea on a frontal chest radiograph

A

Steeple sign

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14
Q

Inflammation from the distal trachea to medium and large sized bronchi

A

Bronchitis (also called as tracheobronchitis)

<3 weeks - acute
>3 weeks - chronic
>4 episodes/year - recurent

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15
Q

Etiology of Acute bronchitis

A

Mostly Viral (adeno, Influ B, Parainflu type 3, TSV, rhinovirus)

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16
Q

Clinical manifestations of acute bronchitis

A

cough 3-4 days after URTI
rhonchi, wheezing
symptoms resolve withiin 3 weeks

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17
Q

Pathophysiology of Bronchiolitis

A

edema and accumulation of cellular debris

18
Q

Triad of Bronchiolitis

A

Tachypnea, Chest retractions, Wheezing

-most common <2 years

19
Q

Etiologic agent for Bronchiolitis

A

RSV

20
Q

Therapy for Bronchilitis

A

Supportive (Humidified 30-40% oxygen)
Anti viral (Ribavirin)
Beta 2 agonists

21
Q

What symptom or sign is the best predictor of pneumonia among children?

A

Tachypnea

22
Q

Sole criterion to define pneumonia in children (WHO)

A

Tachypnea

23
Q

Who shall be considered as having pneumonia?

A

patient presenting with cough and or respiratory difficulty plus:
@ ER- Tachypnea (pt 3-5months), fever at any age, <93% o2 sat.

@OPD - tachypnea, and fever

24
Q

The presence of pneumonia should be determned sing CXR in a patient presenting with?

A

*cough and Respiratory difficulty in the ff. conditions:
degydration, presence of severe malnutrition (<7 years old)

*high grade fever and leukocytosis aged 3 to 24 months without respiratory symptoms

25
Q

Who will require admission (pneumonia)

A

pCAP C and pCAP D

patients <5yrsold(B) and >5 years old (D) with xray without effusion, lung abscess, air leak or multilobar consolidation

26
Q

diagnostics for pCAP C (should be done)

A

GSCS of pleural fluid

ABG and pulse ox

27
Q

What is the single most important factor in determining the etiology of pediatric pneumonia?

A

AGE

28
Q

Common pathogen for pneumonia (Newborns)

A

Group B

29
Q

Common pathogen for pneumonia 1-3 month

A

Viruses, Chlamydia, Ureaplasma, Bordetella

30
Q

Common pathogen for pneumonia 1-12 months

A

Viruses, S. aures, S, pneumoniae, Moraxella, H, Influ

31
Q

Common pathogen for pneumonia 1- 5 years

A

Viruses, S. pneumoniae, M. pnneumoniae, C. pneumoniae

32
Q

Common pathogen for pneumonia > 5 years

A

S. pneumoniae, M, Pneumoniae, C, pneumoniae

33
Q

When is antibiotic recommended? for pCAP A or B

A

Pt. >2 years old (D)

high grade fever without wheeze (D)

34
Q

When is antibiotic recommended? pCAP C

A

alveolar consolidation om CXR is present (D)

May be administered: elevated CRP, procaltinonin and WBC count

35
Q

Empiric antibiotics? pCAP A or B

A

Oral amoxicillin (40-50mg/kg/day in 3 doses)
Azithromycin 10mkd x 3 days
Clarithromycin 15mkd x 7 days

36
Q

Empiric antibiotics? pCAP C with complete primary Hib vaccine

A

PEN G (100 000 units/kg/day) in 4 doses

37
Q

Empiric antibiotics? pCAP C with incomple primary HiB vaccine

A

Ampicillin 100mg/kg/day in 4doses

38
Q

Empiric antibiotics? >15 years

A

BLIC, cephalosporin, or carbapenem

39
Q

Antiviral?

A

oseltamivir

40
Q

when can switch therapy in bacterial pneumonia be started?

A

pCAP C. Switch from IV to oral after 3 days if

  1. Responding to initial therapy
  2. Able to feed/tolerate oral medication
  3. No pulmonary or extrapulmonary complications
  4. no oxygen support

Amoxcillin (40-50mk/day) for 4 days

41
Q

When is the patient considered to be responding?

A

Decrease in respiratory signs and or defervesence within 72 hours

OS 213 Respiratory EXAM 1 (19 decks)

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