Peds-Lower Airway Flashcards
What is the Cause of pneumonia in kids?
Viruses, Strep Pneumo (pyogenic)
What are the clinical findings for pneumonia in kids?
Fever, cough, tachypnea (must have tachypnea)
Describe Pertussis
“intense cough”
humans only host
spread via droplets, contagious
Describe the three phases of Pertussis
Catarrhal phase - 1-2 weeks, runny nose, conjunctivitis, mild cough, wheeze, fever
Paroxysmal phase- 2-4 weeks, Post tussive emesis
Convalescent phase-1-2weeks, things calm down
How do you diagnose Pertussis?
clinical
Leukocytosis - 80-90%
CXR - perihilar infiltrates, atelectasis, emphysema
Nasopharyngeal swab
How do you treat Pertussis?
Hospitalize if infant, O2, ERYTHROMYCIN, Isolate pnt 5 days
What causes Influenze?
RNA orthomyxovirus, Types A,B,C
Describe Influenza
Spread in large droplets, school aged children, winter, Most infectious 24 hours b4 symptoms, can shed virus for months
What are the symptoms of Influenza?
Abrupt onset of fever, coryza, myalgia, headache, malaise, conjunctivitis, THE ENTIRE RESP TREE
What is Reye Syndrome?
systemic disorder of mitochondrial function that occurs during or after a viral illness
Posturing
How do you diagnose Reye syndrome?
hypoglycemia, hyperammonemia, increased liver enzymes
How do you treat reye syndrome?
limited, correct hypogycemia and treat ICP - supportive
How do you diagnose INfluenza?
Based on time of year, Rapid nasal swab (inf. A and B), blood count (normal WBC or mild leukopenia)
How do you treat Influenza?
Supportive - fluids, fever, rest
Neuraminidase inhibitors available for influ. a and b
Vaccinate all children
Describe RSV
Most common hospitalized in infants
in adults - prod symptoms similar to cold
all kids infected by 2 years
Lives 12 hrs on hard surfaces (shopping cart)
air trapping, segmental atelectasis
Its in paramyxoviridae family. attach (G prots), Fusion (F)
How does RSV present?
runny nose, sneezing, coughing for days, gets worse. respiratory distress, nasal flaring, suprasternal retractions
wheezing and rales
How do you treat RSV?
Maintain airway, hydration, ventilation.
DO NOT - viral testing, CXR, albuterol, oral steroids, antibiotics, chest percussion
How does Chlamydia Trachomatis Present?
Young child (
How is chlamydia trachomatis spread?
Sexually, also can be passed to newborn from mother.
There are treatments for pregnant people
How do you treat Chlamydia trachomatis?
Macrolides, tetracyclines, quinolones, sulfonamides.
Most Common: azithromycin for 5 days, or ERYTHROMYCIN (if evidence of chlamydia conjunctivitis) 14 days (orally)
Describe Strep Pneumo
most common cause of bacterial pneumonia
may see a round pneumonia
Increased WBC. segmental consolidation, tachypnea, fever
How do you treat Strep Pneumo?
Child hypoxic/resp distress-admit
ampicillin, ampicillin/sulbactam, cefuroxime, ceftriaxone IV until stable then 10 day oral abx
Child is stable - oral amoxicillin or clavulaninc acid, daily office visit until fever and tachypnea resolve
Describe Mycoplasma Pneumonia
Most common in school aged children
Rare before age 3-4
How do you diagnose Mycoplasma Pneumonia?
Cold aggutinins test, mycoplasma titers
