Pediatric Lung Dz Flashcards
Croup (Laryngotracheobronchitis)
Infxn causing inflammation of the larynx, trachea and bronchi.
Most often the parainfluenza virus.
6 months to 3 years most common age
Croup key cough
Barking cough and stridor
Croup Tx
Generally steroids are used
Dexamethasone .6mg/kg IM one dose
If stridor at rest:
O2, nebulized racemic oxygen
Epiglottitis
A true medical emergency
Most commonly H flu type B
Sudden onset!
Epiglottitis S/S
Fever Dysphagia Drooling Hot potato voice Soft stridor
Epiglottitis Tx
Do not examine
Obtain lateral neck x-ray
Prepare to intubate
Cherry red swollen epiglottis =?
Epiglottitis
How long can RSV survive on countertops?
6 hours
Bronchiolitis
Inflammatory process of smaller lower airways, usually caused by RSV.
Can progress to respiratory failure
Presents w/ fever, URI, tachypnea, wheezing
Bronchiolitis Tx
Controversial
Airway support, O2
Pneumonia
Most peds cases are viral
Tachypnea, elevated WBC
Variable CXR
Pneumonia Tx
Antibiotics
Bronchodilators?
Fluids, O2
Pertussis (Whooping Cough)
Making a comeback
Caused by bordetella pertussis
Fear is respiratory failure secondary to coughing in the small infant.
Pertussis presentation
Mild start … leading to whoop cough in 2 weeks. The cough is described as paroxysmal
When to suspect pertussis
Not immunized
Classic presentation
Cough for >2 wks
Nasal swab for culture
Pertussis Tx
Erythromycin for 14 days
Azithromycin for 5-7 days
Cystic Fibrosis
1 in 1,600 caucasian births Dz of the exocrine gland system Defective chloride channels Highly viscous secretion Leads to relative dehydration, abnormal mucociliary clearance
What is the adult carrier rate for CF?
1 in 32 adults are a carrier
What can diagnose CF?
Sweat chloride test
CF clinical features
Respiratory insufficiency
Pulm fibrosis, obstruction, frequent infxns chronic sinusitis
Pancreatic insufficiency
Malabsorption of fats and proteins, failure to thrive, rectal prolapse
CF pulmonary Tx
Bronchodilators
Mucolytics (acetylcysteine)
Steroids
Abx
CF Pancreatic Tx
Pancreatic enzyme supplements
Vitamin supplements
High-caloric protein diet
CF primary morbidity
Obstructive lung dz
Median survival = 31 yrs
Respiratory distress syndrome of the newborn
Common problem of preterm infants
Deficiency in pulmonary surfactant
Major cause of death in premature infants
Neonatal RDS presentation
Tachypnea
Nasal flaring
Expiratory grunting
Cyanosis
Is CF obstructive or restrictive?
Obstructive
What is Neonatal RDS also called?
Highline membrane Dz
What does a neonate have potentially viable lungs?
28 wks
Neonatal RDS Tx
Steroids
Surfactant
CPAP
