Pediatric Respiratory Disease

Question 1

Croup

Answer 1

Inflammation of larynx, subglottic airway & large bronchi secondary to a viral infection

Question 2

Epiglottis

Answer 2

Rapid, progressive inflammation of epiglottis
Medical emergency
More common in adults vs children

Question 3

Signs/Symptoms of epiglottis: 3 D’s

Answer 3

Drooling,
Dysphagia,
Distress

Question 4

Bronchiolitis pathophysiology

Answer 4

RSV binds to bronchiolar epithelial cells, initiates an inflammatory response
Epithelial cell necrosis
Presence of edema with production of mucous/exudate
Bronchioles narrow, obstruction of airflow and air trapping

Question 4

Bronchiolitis tests and treatment

Answer 4

Investigations (CXR, labs) are not routinely recommended (only in severe cases)

Antibiotics, bronchodilators, oral corticosteroids are NOT recommended

Question 5

pathophysiology of CAP

Answer 5

Inflammation of parenchyma of lower respiratory tract
Begins with a viral URTI – impairs pulmonary defense mechanisms (inhibits phagocytosis, alters normal bacterial flora and mucociliary clearance)

Produces an immune response
Inflammation, fluid accumulation and cellular debris in airways - obstructs small airways

Collapse of alveoli, resulting in ventilation and perfusion mismatch

Question 6

1st line therapy for infants 3 mos. to 5 yrs and older with CAP

Answer 6

Amoxicillin 90 mg/kg/day divided TID x 5-10 days (shorter duration can be considered 3-5 days)

Question 7

prevention of CAP (vaccinations)

Answer 7

Vaccination for H. Influenza type B (Hib), pneumococcal