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Peds LRTIs Flashcards

1
Q

Where does the LRT begin?

A

Sublaryngeal

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2
Q

What are the major LRTIs?

A 
Bronchiolitis
Larnygotracheobronchisits
Tracheitis
Bronchitis
Pneumonia
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3
Q

What is the definition of pneumonia?

A

Infection of the lung parenchyma, specifically the gas exchange unit

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4
Q

What percent of all pediatric deaths result from pneumonia?

A

18%

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5
Q

What accounts for most LRTIs in children?

A

Viruses (90%)

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6
Q

What is the main bacterial cause of LRTIs?

A

Strep pneumoniae

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7
Q

What is the pathophysiology of pneumonia? (2)

A

Deposition of and subsequent replication of viral or bacterial agents in the respiratory tract mucosa or the lung can be seeded hematogenous spread

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8
Q

How do viral infections predispose to the development of pneumonia?

A

Impair host defenses, leading to secondary bacterial pneumonia

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9
Q

Recurrent pneumonias should be suspicious for what?

A

Immune disease or change in physiology

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10
Q

What are the 3 major signs of pneumonia?

A

Fever
Cough
Tachypnea

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11
Q

What is the most sensitive and specific sign of pediatric pneumonia? How sensitive/specific?

A

Tachypnea–really, really sensitive, but not so specific

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12
Q

What are the lung findings of pneumonia?

A

-Rales and rhonchi

Decreased breath sounds

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13
Q

What is the best non-verbal finding of pneumonia? Why?

A

Refusal to eat d/t breathing problems

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14
Q

How is it kids can have pneumonia, but have normal sounds?

A

Hearing sounds from the other side

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15
Q

What are the two best signs of pneumonia in kids younger than 5 yo?

A

Tachypnea

Retractions

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16
Q

Post tussive emesis = ?

A

Bordetella pertussis

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17
Q

True or false: humans are the only known host of Bordetella pertussis

A

True

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18
Q

What is the gram stain and morphology of Bordetella pertussis?

A

Gram negative pleomorphic bacilli

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19
Q

What is the incubation period of Bordetella pertussis?

A

6 days

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20
Q

What are the three stages of Bordetella pertussis?

A
  1. Catarrhal phase (non-specific ssx)
  2. paroxysmal phase (coughing)
  3. Convalescent phase (decreasing coughing)
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21
Q

How do you diagnose Bordetella pertussis?

A

Clinical picture

Leukocytosis with absolute lymphocytosis

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22
Q

What are the CXR findings of Bordetella pertussis?

A

Perihilar infiltrates
Atelectasis
Emphysema

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23
Q

How do you confirm Bordetella pertussis?

A

Nasopharyngeal swab for PCR

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24
Q

When should you hospitalize pts with Bordetella pertussis?

A
  • If less than 6 mo

- IVF or oxygen needed

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25
What is the treatment for Bordetella pertussis?
Erythromycin 40 mg/kg q 6 hours for 14 days
26
How long should you isolate patients for with Bordetella pertussis?
5 days
27
What are the ssx of influenza?
- High fever - Myalgias - Non-productive cough - HA
28
What is the viral family of influenza?
RNA orthomyxovirus
29
What age group is most affected with the flu?
School ages children
30
How long are children infectious for after ssx appear? What about immunocompromised children?
10 days weeks to months if immunocompromised
31
Is the flu abrupt or gradual onset?
Abrupt
32
How often do febrile seizures occur in children hospitalized for the flu?
20%
33
What is the most common complication of the flu?
Strep pneumoniae
34
What is Reye syndrome?
Systemic disorder of mitochondrial function that occurs during of after a viral illness
35
What are the two viruses that can set off Reyes syndrome?
Flu | varicella
36
What is the treatment for Reyes syndrome?
Supportive
37
What are the metabolic changes with Reyes syndrome?
Hypoglycemia Hyperammonemia LFTs increased
38
How do you diagnose the flu?
Rapid nasal swab
39
How do you treat the flu?
Supportive
40
True or false: you should vaccinate ALL children with underlying chronic disease for the flue
True
41
What age is appropriate for the flu?
6 months and older
42
What are the ssx of bronchiloitis (RSV)?
Rhinorrhea Sneezing Sudden worsening of a cough
43
What viral family is RSV?
Paramyxoviridae
44
What are the two proteins on RSV virus and what are their functions?
G protein -attachment | F- fusion protein
45
What is RSV?
Bronchiolitis
46
By what age are virtually all children have an infection with RSV?
2 years
47
How long can RSV survive on fomites?
12 hours
48
What are the signs of RSV?
Tachypnea rhinorrhea Low grade fever OM
49
What is the pathognomonic finding of a CXR with RSV?
Segmental atelectasis | Air trapping
50
What is the treatment for RSV?
Maintain nasal airway | Supportive
51
What is the only thing you should do with RSV?
Supportive | no CXR, albuterol, viral swabs etc
52
Cough, tachypnea, bilateral conjunctivitis, without fever under 4 months of age = ?
Chlamydia trachomatis
53
What percent of children born to mothers with chlamydia infections will get pneumonia?
30-50%
54
What is the usual presentation of chlamydia trachomatis (age, ssx)?
1-3 months old | Cough, tachypnea, NO fever
55
What are the CXR findings with chlamydia trachomatis?
Hyperinflation, but no significant findings
56
What are the CBC findings with chlamydia trachomatis?
WNL but with peripheral eosinophilia
57
**What is the treatment for chlamydia trachomatis?**
**Oral Erythromycin**
58
High fever, cough, lethargy, tachypnea, low oxygen sat, L shift CBC, = ?
Strep Pneumoniae
59
What does the CXR show with strep pneumonia in kids?
Lobar or segmental consolidation "round" pneumonia
60
What does the CBC should with pneumonia?
Leukocytosis with a L shift
61
What is the treatment for strep pneumonia in children?
Ampicillin
62
When are IV abx indicated for strep pneumonia?
If severe
63
What are the ssx of mycoplasma pneumonia? What age?
Mild LRTI ssx | Usually school age
64
How common is mycoplasma pneumonia in children less than 3-4 yo?
Rare
65
How do you diagnose mycoplasma pneumoniae?
Cold agglutinins test | Mycoplasma titers
66
What is the most common symptom with mycoplasma pneumonia?
Intractable nonproductive cough
67
What is the abx of choice for mycoplasma pneumonia? Why?
Macrolides | lack a cell wall
68
Why treat mycoplasma pneumonia with a macrolide and cephalosporin?
Macrolide for mycoplasma | Cephalosporin for strep pneumonia

Respiratory (34 decks)

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