Peds Flashcards
Infant RDS (hyaline membrane disease) Epi
- Usually premature
- RF: mothers w/ DM, multifetal preg, C-section, fam hx
Infant RDS (hyaline membrane disease) Pathophys
- Surfactant def –> collapsed alveoli
Infant RDS (hyaline membrane disease) Sx
- Within minutes of birth: grunting, tachypnea, accessory muscle use, dusky, diminished breath sounds, falling BP
Infant RDS (hyaline membrane disease) Dx
- Clinical dx
- CXR: ground glass appearance
Infant RDS (hyaline membrane disease) Tx
- Frequent monitoring
- Warm humid O2
- Give surfactant
Infant RDS (hyaline membrane disease) Prevention
- Prevention: shot of beta methasone 48 hrs prior to delivery (23-34 wks)
Acute Bronchiolitis Epi
- Most common lower resp inf <2 y/o
Acute Bronchiolitis Etiology + Pathophys
- Usually acute viral (most common = RSV)
- Inflam of bronchioles
Acute Bronchiolitis Sx
- Rhinorrhea
- Cough
- Tachypnea
- Tachy
- Increased resp effort
Acute Bronchiolitis Dx
- H&P
- If <2 m/o eval for sepsis
Acute Bronchiolitis Tx
- Hydration
- O2
- Antivirals
Acute Bronchiolitis Prognosis
- Most fully recover
- Some continue to wheeze thru age 5+
RSV Epi
- Leading cause of infant death from viral inf
- Most have by age 2
- Esp. Oct-March
RSV Pathophys
- Airborne (large droplets)
- High risk of nosocomial inf
RSV Sx
- Adults: minor URI
- Peds: common cold sx, in distress, complications: AOM, bact pneumonia
RSV Dx
- Clinical
- RSV rapid antigen (to identify that it is in community)
RSV Tx
- None
RSV Prevention
- Hand washing
- Cohort care (providers treating pts)
- Synagis (giving antibodies for passive immunity–$$$)
Pediatric Asthma Epi
- Genetics
- Age
- Environment
- RF: M, AA, lower SES
Pediatric Asthma Pathophys
- Chronic inflam resulting in episodic airflow obstruction
Pediatric Asthma Sx
- Dry cough
- Expiratory wheezing
- SOB
- Chest tightness
- Sx worse at night
- Accessory muscle use
Pediatric Asthma Dx
- Recurrent wheezing (early childhood, viral trigger)
- Chronic (persists into adulthood, usually allergic trigger)
Pediatric Asthma Tx
- Monitoring
- Pt education
- Control factors that contribute to asthma
- Meds
Croup Epi
- 3 months - 5 y/o
- Late fall and winter
Croup Etiology + Pathophys
- Parainfluenza**, flu, RSV, adenovirus
- Airway resistance
Croup Sx
- 1-3 days of URI sx –> sudden onset upper airway obstruction
- Barky cough
- Hoarse
- Inspiratory stridor
- Worse at night
- Aggravated by crying
Croup Dx
- Xray: steeple sign
- Can be acute (viral URI) or spasmodic (allergic, resolves quickly)
Croup Tx
- At home: cool mist, steamy shower, freezer door, go outside
- In ED: nebulized epi, steroids
Croup Prognosis
- Usually 3-4 day course
Epiglottitis Etiology
- H. flu (now not as common w/ vaccine), strep
Epiglottitis Sx
- Fine one minute, sick the next
- High fever
- Sore throat
- Dyspnea
- Rapidly progressive resp obstruction
- Drooling
- Tripod position
Epiglottitis Dx
- Cherry red swollen epiglottis
- Xray: thumbprint sign
Epiglottitis Tx
- Send to ED
- Establish airway
- O2
- Culture –> abx
Pertussis Epi
- Vaccine
- Reportable
Pertussis Sx
Stages:
- Catarrhal: congestion, rhinorrhea
- Paroxysmal: inexorable paroxysms
- Convalescent: resolution
Pertussis Dx
- Absence of fever, malaise, sore throat
- Culture
- Leukocytosis
Pertussis Tx
- Humidify air
- Antimicrobial (erythro or azithro) to prevent spread
Pertussis Prognosis
- 6 wk course
- Complications: pneumonia, secondary inf, seizures, apnea
