Peds Lung Disease Flashcards
Croup
- aka
- what is this?
- what causes this?
- common in what age group?
- sx
aka: laryngotracheobronchitis
what is this:
-infection causing inflamm of the layrnx, trachea, and bronchi
Caused by parainfluenza virus, could also be caused by RSV, influenza virus, and adenovirus
Common in 6mo to 3 years
sx: URI sx, barking cough and stridor, paroxysmal cough(where they cant stop)
Whats the difference between stridor and wheezing?
Wheeze: inspiratory and expiratory, continuous high pitch sound.
Stridor: high pitched, piercing sound, usually on inspiration, obstruction in upper airway.
How do you differntiate croup from epiglotitis?
Croup: during day child appears well, they dont look that sick. Nighttime worsening of croupy cough and stridor, excess respiratory muscle use while breathing. Parainfluenza virus of the larynx, trachea, and bronchi.
Epiglotitis: inflamm of the epiglottis, life threatening, toxic ill appearing child, drooling all over, stoic, cant swallow, dog sniffing position, hot potato talk. Caused from H. Flu.
When do you worry about hospitalizing children with croup?
-when they are not responding to tx.
When are croup sx the worst?
-during the night, night 3 to be exact.
Croup Tx
At home:
-breathe cool moist air(opens up bronchi), bring child outside to the porch/patio/deck/front stoop/back stoop.
In the ER:
- Steroids for inflamm. (Dexamethasone)
- if barking cough, no stridor at rest: supportive therapy, hydration, minimal handling, cold air
- stridor: O2, nebulized racemic epinephrine
- if sx resolve within 3hrs of steroid and epinephrine use they can be d/c’d
- Hospitalize if recurrent epinephrine tx are required or if resp distress persists.
If child with croup comes to clinic post day 1 or cough youre going to give them what medication?
-steroids; dexamethasone to help with nights 2 and 3, which are the worst.
Why do we not see epiglottitis anymore?
Nowadays we are seeing it in adults, whats the bug?
- vaccinations, HIB vaccince.
- Strep.
Epiglottitis
- cause
- what is this?
- sx
- PE findings
Cause: H. flu type B
What this is: sudden* inflammation of the epiglottis
sx:
-fever, dysphagia, drooling, hot potato voice, inspiratory
retractions, soft stridor
-PE: cherry red spot at the back of the throat
Tx of Epiglottitis
-do not examine this patient!
- get a stat portable x-ray of neck(maybe)
- PREPARE TO INTUBATE!!
- call your peds anesthesia
-start emperic abx once they are intubated, get swab and cultures to tailor your abx.
What does a neck radiograph show in epiglottitis?
thumb print sign on x-ray
Bronchiolitis
- what is this?
- caused by?
- who does this most commonly affect?
- sx
- aka(less sever bronchiolitis)
What is this: inflammatory response of the smaller lower airway, highly contagious!
Caused by RSV, also by adenovirus and parainfluenza virus (though its less common)
-affects the young! your children! watch out, before it gets you too!
Sx: fever, URI sx, tachypnea, and wheezing (expiratory and inspiratory)
-aka: happy wheezer
Bronchiolitis
-Tx
Tx:
- supportive care
- generally the prognosis is excellent.
- Ribavirin against RSV is usually reserved for severly ill or imunocompromised patients (inhaled)
- Palivizumab- non vaccine, injection of abys given monthly to help high risk infants from severe RSV disease.
Bronchiolitis:
-what populations of ppl are at greater risk of poorer outcomes of this disease? (such as respiratory failure)
infants with congenital heart disease, chronic lung dz, and immunodeficiencies
Bronchitis
- what is this?
- sx
- lung sounds
- cause
- tx
what is this: infection that attacks the bronchiol tubes which lead to the lungs. swelling and mucous.
sx: URI sx with cough and malaise, dry cough to productive over time.
lung sounds: coarse bronchial sounds
cause: most of the time its viral
Does the presence of mucopurulent sputum imply a bacterial infection?
no