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Respiratory > Pediatric Upper Respiratory Diseases > Flashcards

Pediatric Upper Respiratory Diseases Flashcards

1
Q

What are the ssx of sinusitis?

A

Rhinitis with mucus that starts clear and then becomes cloudy or colored

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2
Q

What are the three types of sinusitis?

A

Persistent
Severe
Worsening

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3
Q

True or false: the mucus color is not significant

A

True

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4
Q

What is a persistent sinusitis?

A

lasts for 10 days or more

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5
Q

What are the characteristics of severe sinusitis?

A

Fever over 102.2 F that lasts for 3 days in a row

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6
Q

What is the progression of sinusitis?

A

Steadily increase

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7
Q

What is the progression of recurrent URI?

A

Sinusoidal (occurring and recurring)

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8
Q

How many cold will children get in the first year of life?

A

6-8

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9
Q

When are abx indicated?

A

10 days without improvement

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10
Q

What is the formal name of croup?

A

Laryngotracheobronchitis

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11
Q

What is the typical age range for croup?

A

between 6 months and 6 years old

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12
Q

What is the classical presentation of croup?

A

Middle of the night with inspiratory stridor, barky cough, and stridor

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13
Q

HOw long does viral croup last for?

A

3-7 days, with peak ssx first 1-2 nights

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14
Q

Which gender is more often affected with croup?

A

boys

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15
Q

What is virus causes croup?

A
  • Parainfluenza virus type 1

- RSV also

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16
Q

What is the bacterial cause of croup? How common is this?

A

Mycoplasma pneumonia

Rare

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17
Q

How do you diagnose viral croup?

A

Clinical presentation and maybe a XR of the neck

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18
Q

What is the classic XR sign with croup? What is the sensitivity of this?

A

Steeple sign

Only about 50% of cases

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19
Q

What is the treatment for croup? (2)

A
  • Dexamethasone

- Racemic Epi by neb

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20
Q

When is epi indicated fro croup?

A

Respiratory distress

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21
Q

What is the corticosteroid used for croup?

A

Dexamethasone

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22
Q

When is hospitalization indicated for croup?

A

If need repeated doses of epi for stridor

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23
Q

What is the most common cause of epiglottitis?

A

HiB

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24
Q

What are the ssx of epiglottitis?

A

Sudden onset of fever, respiratory distress, and total airway occlusion within hours

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25
Q

What is the position that patients with epiglottitis take?

A

Tripod

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26
Q

When is epiglottitis most common?

A

1-8 years old

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27
Q

What is inflamed with epiglottitis?

A

Epiglottis
Arytenoids
Arytenoepiglottici area
Vocal cords

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28
Q

Should you use a tongue depressor to check for epiglottisi?

A

No

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29
Q

Should you attempt x-ray or lab work with epiglottisi?

A

No

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30
Q

What should you do with a pt who is in respiratory distress from epiglottitis?

A

Gather anesthesiologist, ENT, and ped surgeon

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31
Q

What is the classic XR finding with epiglottitis?

A

Thumb sign

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32
Q

What is the most common infectious agent that causes bacterial trachititis?

A

Staph Aureus

33
Q

What is bacterial tracheitis?

A

Inflammation of the trachea, causing mucosal swelling at the level of the cricoid cartilage

34
Q

What is the major consequence of bacterial tracheitis?

A

Airway obstruction

35
Q

What are the ssx of bacterial tracheitis?

A

brassy cough, fever, and toxicity

36
Q

How do you make the diagnosis of bacterial tracheitis?

A

Presentation
High fever
Copious secretions
Leukocytosis w/ L shift

37
Q

What is the treatment for bacterial tracheitis?

A

Intubation and anti-staph abx

38
Q

What age is FB aspiration most common?

A

1-3

39
Q

What are the ssx of FB aspiration?

A

rapid onset of wheezing/stridor

40
Q

Stridor comes from what part of the airway?

A

Trachea

41
Q

Wheezing comes from what part of the airway?

A

Bronchus

42
Q

What spinal levels are at the beginning and end of the trachea?

A

C6 - T5

43
Q

How do you diagnose FB aspiration?

A

CXR and history

44
Q

What type of XR should be obtained for FB aspiration?

A

lateral and AP neck

45
Q

What do expiratory films show with a FB obstruction?

A

Air trapping on afected side and mediastinal shift to the unaffected side

46
Q

What do inspiratory films show with a FB obstruction?

A

Mediastinal shift back to affected side as the other lung aerates

47
Q

FB in the trachea are seen best with what view of the neck?

A

Lateral

48
Q

FBs in the esophagus are best seen with what view of the neck?

A

AP

49
Q

What is the treatment for FB aspiration?

A

Endoscopy

50
Q

Large airway on lateral neck XR is suspicious for what?

A

Retropharyngeal abscess

51
Q

Where do retropharyngeal abscesses usually occur?

A

Buccopharyngeal fascia and the prevertebral fascia

52
Q

What happens to the lymph nodes with a retropharyngeal abscesses?

A

Suppurate from extension of a bacterial pharyngeal infection

53
Q

What are the most common infectious agents for retropharyngeal abscesses?

A

Staph Aureus

54
Q

What age group is most commonly affected with retropharyngeal abscesses?

A

Children less than 3 years

55
Q

When does the prevertebral space close?

A

3-4 years

56
Q

What should always be in you ddx for retropharyngeal abscesses?

A

Peritonsillar abscess

57
Q

What are the symptoms of retropharyngeal abscesses?

A

Fever
Sore throat
Dysphagia
Respiratory distress

58
Q

What are the signs of a retropharyngeal abscesses? (3)

A

Toxic appearance
Torticollis
Trismus
Drooling

59
Q

Exam of the oropharynx with retropharyngeal abscesses will show what?

A

Posterior swelling which may be greater on one side than the other

60
Q

How do you diagnose a retropharyngeal abscesses?

A

Clinical history, CT if unsure

61
Q

What is the treatment for retropharyngeal abscesses?

A

Drainage and abx the cover gram positive organisms

62
Q

Stridor that disappears with lying prone = ?

A

Laryngomalacia

63
Q

What is the usual cause of subglottic stenosis?

A

Numerous Intubations at prematurity

64
Q

What is Laryngomalacia?

A

Immaturity of the supporting structure surrounding the larynx, and abnormal neuromuscular development

65
Q

What makes Laryngomalacia worse?

A

Crying
Agitation
supine position

66
Q

What is the voice/cry like with Laryngomalacia?

A

Nomal

67
Q

What is the prognosis for Laryngomalacia?

A

Resolves by 12-18 months

68
Q

What is the treatment for Laryngomalacia?

A
  • Reassurance if no respiratory failure

- Surgical intervention if bad

69
Q

What is tracheomalacia?

A

a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse especially when increased airflow is demanded.

70
Q

What are the ssx of tracheomalacia?

A

Wheezing more often than stridor

71
Q

When does the retropharyngeal space close?

A

3-4th year of life

72
Q

What is the most common cause of stridor in the newborn period?

A

Laryngotracheobronchitis

73
Q

What is the onset time for epiglottitis?

A

4-12 hours (quick)

74
Q

In which of the major LRTI in children does the patient appear toxic?

A

Epiglottitis

75
Q

Which way will a coin show on a CXR if it’s in the esophagus? Trachea?

A 
Esophagus = coronal plane
Trachea = sagittal plane
76
Q

If a child has trismus, drooling, and stridor, what should be in your ddx?

A

retropharyngeal abscess

77
Q

What is a major difference in the PE findings with a retropharyngeal abscess as compared to a peritonsillar abscess?

A

Peritonsillar will be off to one side

78
Q

What is the age of range for croup?

A

3 mo - 3 years

Respiratory (34 decks)

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