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Respiratory > Peds LRTIs > Flashcards

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
Q

What is the treatment for Bordetella pertussis?

A

Erythromycin 40 mg/kg q 6 hours for 14 days

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26
Q

How long should you isolate patients for with Bordetella pertussis?

A

5 days

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27
Q

What are the ssx of influenza?

A
  • High fever
  • Myalgias
  • Non-productive cough
  • HA
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28
Q

What is the viral family of influenza?

A

RNA orthomyxovirus

29
Q

What age group is most affected with the flu?

A

School ages children

30
Q

How long are children infectious for after ssx appear? What about immunocompromised children?

A

10 days

weeks to months if immunocompromised

31
Q

Is the flu abrupt or gradual onset?

A

Abrupt

32
Q

How often do febrile seizures occur in children hospitalized for the flu?

A

20%

33
Q

What is the most common complication of the flu?

A

Strep pneumoniae

34
Q

What is Reye syndrome?

A

Systemic disorder of mitochondrial function that occurs during of after a viral illness

35
Q

What are the two viruses that can set off Reyes syndrome?

A

Flu

varicella

36
Q

What is the treatment for Reyes syndrome?

A

Supportive

37
Q

What are the metabolic changes with Reyes syndrome?

A

Hypoglycemia
Hyperammonemia
LFTs increased

38
Q

How do you diagnose the flu?

A

Rapid nasal swab

39
Q

How do you treat the flu?

A

Supportive

40
Q

True or false: you should vaccinate ALL children with underlying chronic disease for the flue

A

True

41
Q

What age is appropriate for the flu?

A

6 months and older

42
Q

What are the ssx of bronchiloitis (RSV)?

A

Rhinorrhea
Sneezing
Sudden worsening of a cough

43
Q

What viral family is RSV?

A

Paramyxoviridae

44
Q

What are the two proteins on RSV virus and what are their functions?

A

G protein -attachment

F- fusion protein

45
Q

What is RSV?

A

Bronchiolitis

46
Q

By what age are virtually all children have an infection with RSV?

A

2 years

47
Q

How long can RSV survive on fomites?

A

12 hours

48
Q

What are the signs of RSV?

A

Tachypnea rhinorrhea
Low grade fever
OM

49
Q

What is the pathognomonic finding of a CXR with RSV?

A

Segmental atelectasis

Air trapping

50
Q

What is the treatment for RSV?

A

Maintain nasal airway

Supportive

51
Q

What is the only thing you should do with RSV?

A

Supportive

no CXR, albuterol, viral swabs etc

52
Q

Cough, tachypnea, bilateral conjunctivitis, without fever under 4 months of age = ?

A

Chlamydia trachomatis

53
Q

What percent of children born to mothers with chlamydia infections will get pneumonia?

A

30-50%

54
Q

What is the usual presentation of chlamydia trachomatis (age, ssx)?

A

1-3 months old

Cough, tachypnea, NO fever

55
Q

What are the CXR findings with chlamydia trachomatis?

A

Hyperinflation, but no significant findings

56
Q

What are the CBC findings with chlamydia trachomatis?

A

WNL but with peripheral eosinophilia

57
Q

What is the treatment for chlamydia trachomatis?

A

Oral Erythromycin

58
Q

High fever, cough, lethargy, tachypnea, low oxygen sat, L shift CBC, = ?

A

Strep Pneumoniae

59
Q

What does the CXR show with strep pneumonia in kids?

A

Lobar or segmental consolidation

“round” pneumonia

60
Q

What does the CBC should with pneumonia?

A

Leukocytosis with a L shift

61
Q

What is the treatment for strep pneumonia in children?

A

Ampicillin

62
Q

When are IV abx indicated for strep pneumonia?

A

If severe

63
Q

What are the ssx of mycoplasma pneumonia? What age?

A

Mild LRTI ssx

Usually school age

64
Q

How common is mycoplasma pneumonia in children less than 3-4 yo?

A

Rare

65
Q

How do you diagnose mycoplasma pneumoniae?

A

Cold agglutinins test

Mycoplasma titers

66
Q

What is the most common symptom with mycoplasma pneumonia?

A

Intractable nonproductive cough

67
Q

What is the abx of choice for mycoplasma pneumonia? Why?

A

Macrolides

lack a cell wall

68
Q

Why treat mycoplasma pneumonia with a macrolide and cephalosporin?

A

Macrolide for mycoplasma

Cephalosporin for strep pneumonia

Respiratory (34 decks)

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