Respiratory Flashcards
Pathogenesis of croup?
Parainfluenza mostly. Sometimes RSV, influenza, others.
How does patient with croup present?
With viral prodrome, seal-like cough, inspiratory stridor
How to diagnose croup?
XR showing steeple sign
How to treat croup?
Supportive, if not responsive, treat with racemic epi and corticosteroids (especially if patient has stridor at rest)
Epiglottitis pathogenesis
H. Flu, but can also be caused by staph aureus
How does a patient with epiglottitis present?
Patient is sick as shit, 3-6 years old. Tripodding, drooling, febrile >104, rapid onset
How to diagnose epiglottitis?
XR showing thumbprint sign
How to treat epiglottitis?
DO NOT touch trachea. Take patient to OR for intubation. Give antibiotics.
Bacterial tracheitis pathogenesis?
Bacterial infection with strep pneumo or staph
How does patient with bacterial tracheitis present?
Has cold/flu like symptoms and suddenly becomes incredibly febrile with horrible sore throat and stridor.
How to diagnose bacterial tracheitis?
XR showing steeple sign, subglottic narrowing with hazy border.
How to treat bacterial tracheitis?
No response to racemic epinephrine. Culture and give antibiotics.
Retropharygneal abscess pathogenesis
Caused by bacterial infection (usually strep and staph)
How does patient with retropharyngeal abscess present?
Fever and drooling with hot potato voice. Patient likes to lie supine with neck extended.
Patient usually has unilateral lymphadenopathy.
How to diagnose retropharyngeal abscess?
Get a lateral XR, will show increased soft tissue swelling that expands up to 50% of vertebrae
How to treat retropharyngeal abscess?
I+D, culture. Give antibiotics for strep and staph, then based on culture.
Pathogenesis of peritonsillar abscess
Caused by staph and strep
Patient with peritonsillar abscess presentation?
Fever, drooling, hot potato voice. Patient has tonsillar shift with visible abscess.