Pulmonary Flashcards
Leading cause of infant hospitalization
Acute bronchiolitis
Peak age of acute bronchiolitis
6 mo
Age most common for bronchiolitis
First 2 years
Monoclonal antibody used for acute bronchiolitis, particularly seasonally.
“Synagis”
Can you treat acute bronchitis with antibiotics?
No, usually not. 90% viral
“Seal like” cough.
CROUP
Age for group.
36mo-7yrs
Main at home treatment for coup.
Cool humidifier
“Steeple sign”
CROUP
Common differential for croup
Epiglottis
Sx: Use accessory muscles. Strider.
Exam: Cyanosis. Tachypnea
CXR: Steeple sign
CROUP
Cause high mortality in infants and elderly
Influenza
What can happen to young children who have a viral infection when you give them aspirin?
Reye syndrome 30% mortality
Tests for influenza
Rapid influenza diagnostic tests
Reverse transcriptase polymerase chain reaction
Most common type of Influenza in humans
A
Is the cough in influenza productive or non-productive?
Non-productive
What particular exposure can lead to acute bronchitis in children?
Smoking
“Whooping cough”
Pertussis
Is pertussis bacterial or viral?
Bacterial. “Bordetella pertusis”-highly contagious!
Diagnosis for pertussis?
Culture and PCR-nasal swab
Tx for pertussis
Azithromycin!
Keep elevate to cough stuff out.
Supportive care
Caseating granuloma in the apical lung
TB
TB is caused by_________
Mycobacterium-obligate aerobe-“LIKES O2!”
HOw long does acute bronchitis usually last?
5 days and up to 3-4 weeks
Risk factors for acute bronchitis:
Smoking.
Exposure.
Compromised immune system
Acute bronchiolitis occurs mostly in_______
Infants-leading cause of infant hospitalization
What virus causes acute bronchiolitis?
Respiratory Syncytial Virus
What season is RSV most common?
Winter Oct-Jan
What can happen to children with RSV later in life?
Persistence of airway activity
Risk factors for acute bronchiolitis:
<3 mo
Low birth weight
Low socioeconomic group
Crowded living
Sx of bronchiolitis
Wheezing
URI Sx
Cough
Irritability
Poor feeding
Apnea
Exam findings of bronchiolitis:
Tachypnea
Nasal flaring
Fine rales
Wheezing
Hypoxia
Main diagnostic test for bronchiolitis?
RSV rapid viral antigen testing-nasal swab
Tx for bronchiolitis
Humidified 02
Bronchodilator
Nebulized hypertonic saline
Nasal and oral auctioning
Nebulized Ribavirin-broad-spectrum antiviral agent-severe cases!
Monoclonal antibody for acute bronchiolitis?
Palivizumab (Synagis)
A viral infection of the LARYNX, TRACHEA, & the UPPER BRONCHIAL TREE.
Croup
How long do Sx of croup usually last?
5-7 days
Are labs needed for Croup?
Not usually
What is nebulized race ic epinephrine used for?
Tx of croup
How long is the incubation period of influenza?
1-4 days
How long does viral shedding last for influenza?
5-10 days
What virus causes influenza?
Orthomyxovirus-invades airway and respiratory tract cells
Which test will allow you to determine if influenze is A or B?
Reverse transcription-polymerase chain reaction testing or viral culture of nasopharyngeal. CRITERION STANDARD!
In which patients with influenza would you get a CXR?
Elderly or high risk w/ pulmonary symptoms
Should pregnant women get flu vaccines?
Yes, ALL!
When would you use neuraminidase inhibitors with influenza?
Within 24-48 hrs. Really only useful for those @ the highest risk.
What is the criterion standard for diagnosis of pertussis?
Nasopharyngeal swab for culture of B. Pertussis-takes a long time to get results
What is a test you can do in the office to diagnose pertussis in a later stage?
PCR assays and antigen detection
