pediatric allergy in a nutshell Flashcards
what is the main pathophysiology in asthma ?
bronchial hyperresponsiveness
what are the Th1 type cytokines ?
IL2
IL 12
IL 18
TNF beta
what are the TH2 type cytokines ?
IL 4
IL 5
IL 9
IL 13
what factors favor the Th1 phenotype of asthma ?
having older siblings who also suffer from asthma
early exposure to day care
rural environment
what factors favor the Th2 phenotype of asthma ?
widespread use of antibiotics
urban environments
what does the hygiene hypothesis claim ?
men el a5er environments that are too clean but the child at a higher risk of developing asthma
what are the general features of asthma ?
obstructive lung disease recurrent episodes completely reversible normal between episodes symptoms worse at night responds to bronchodilators
what are the types of wheezes in preschool children?
viral episodic wheezing ( triggered by viral infection)
multiple trigger wheeze
asthma
what are some important physical findings in asthmatic children ?
no clubbing with asthma allergic rhinitis atopic dermatitis harrison sulcus in prolonged asthma patients expiratory wheezes
what is the normal peak expiratory volume ?
should be above 70%
how is a diagnosis of asthma made ?
mainly clinical and based on history exclusion of other causes chest x-ray ( to rule out other causes) CBC and IgE levels PEFR FEV1 spirometry and reversibility testing
what treatment can be used for an acute attack of asthma ?
bronchodilators SABA - salbutamol
or anticholinergic bronchodilator - ipratropium bromide
what can be used for preventative therapy of asthma ?
inhaled corticosteroids such as budesonide LABA - salmeterol LTRA - montelukast Anti IgE monoclonal AB - omalizumab oral steroids - prednisolone
what are the availbale inhaler devices ?
metered dose inhaler
dry powder inhaler
nebulizer
what is the cause of otitis media ?
either bacterial or viral
bacterial - moraxella
viral- RSV
what is the presentation and complication of otitis media ?
fever , earache and cough
complication - otitis media with effusion
what is the presentation of tonsillitis ?
fever chills headache and GI disturbances
red tonsils with exudate on examination
what is the main causative organism of tonsillitis ?
group a beta hemolytic strep
EBV
what is the most common causative organism in bronchiolitis ?
RSV
what is the treatment for bronchiolitis ?
humidified oxygen and supportive therapy
what is the causative organism in pneumonia id diff age groups ?
neonates - group b strep 1-3 months - chlamydia and and mycoplasma in a febrile RSV in febrile 3m- 5 years : RSV 5-18 years : M. pneumoniae S. pneumonia C. pneumonia
what is the difference in radiology between viral and bacterial pneumonia ?
viral pneumonia - interstitial
bacterial pneumonia - lobar pneumonia
what does UL pneumonia mimic
what does LL Pneumonnia mimic ?
UL - meningitis
LL - appendicitis
what is the main caustaive organism of croup ?
parainfluenza
