Respiratory Flashcards
Learn respiratory topics in pediatrics
CP of Streptococcal pneumonia
- Infant
+Symptom
- rapid onset
- fever
- cough
- respiratory distress
- restless
+Sign
- temperature more 39°c
- sign of respiratory distress
- dullness of one lobe
- no breath sound
- branchial breathing
- fine crackling rales
- abdominal distention
- hepatomegally
- Child
+Symptom
- high fever
- shaking chil
- dry cough
- chest pain
+Sign
- sign of consolidation
Complication of Strep. pneumonia
- Pleural effusion
- Empyema
- Lung abscess
Ttt of Strep. pneumonia
- Ab: Amoxicillin 50mg/kg/day
- Oxygen therapy
- Hydration
- Anti pyretic
Causative organism of Strep. pneumonia
Neonate : group B streptococci, E.coli
4-16w : S. aureus, S. pneumonia, H. influenza
up to 5y : S. pneumonia, H. influenza
over 5y : S. pneumonia.
Definition stridor
Inspiratory harsh sound
caused by air passing through a partial obstructed larynx/trachea
and increase on crying
Causes of Stridor
- Obstruction:
- lumen: FB, mucus
- wall: angioedema, laryngitis
- pressure from outside: retrosternal goiter, mediastinal tumour. - Neuromascular:
- tetany
- ricket
- hypocalcium - Congenital:
- laryngomalacia *malacia=weak
- tracheomalacia
Breath holding attack. Give Definition, CP & Management.
Def:
- Benign condition occur at 6m-6y with sequence of attack.
- due to disturbance of infant and child.
CP:
- disturbance of child
- crying
- holding breath for few second
- cyanosis/pale
- ass. with few muscle jerk
- precipitate when child upset.
Management:
- investigation
- good mentality
- normal EEG, ECG, Echo
- may ass. with Iron deficiency anemia.
- treatment
- assurance of mother.
Definition CROUP Syndrom
Group characterise by
- brassy cough
- inspiration stridor
- hoarsness
- sign of respiration distress
due to laryngeal obstruction
Sign of respiratory distress
- Tachypnea
- Grunting
- working alae nasi
- retraction of intercostal, subcostal
group of CROUP Syndrome
- acute laryngotracheobronchitis
- acute diphtheric laryngitis
- acute spasmodic laryngitis
- acute epiglotitis
- bacterial tracheitis
What is commonest CROUP Syndrome?
Acute laryngotracheobrochitis
What the cause and clinical picture of acute LTB?
- cause by Parainfluenza virus 1, 2
- Child 6 month- 3 years old
- Symptom of URTI less 5 days
- Characters of CROUP Synd.
- restless
- increase RR, HR
- Worst at night
Treatment of acute LTB?
- Humidification
- face mask to prevent drying of secretion around larynx - Epinephrine
- racemic epinephrine inhalation therapy
- racemic epinephrine solution
(0. 5ml + 2.5ml normal saline, then nebulized for 15 min) - Steroid
- Dexamethasone Na Phosphate 0.5mg/kg - Inhalation
- tracheostomy
The most serious CROUP Syndrome?
Acute epiglottitis
Cause and clinical picture of acute epiglotitis?
- Cause by H. influenza type B
- child 2-7 years old
- rapid progressive airways obstrustion
- high fever (39-40°c)
- aphonia
- moderate respiratory distress + stridor
- characted by sitting, learning forward, open mouth, protruded tongue
- character of croup synd.
Diagnosis of Acute Epiglotitis
- direct laryngoscopy
- red cherry swollen epiglotis
- radiography: thumb sign
- CBC: leucocytosis
- blood culture: +ve influenza
Treatment of Acute Epiglotitis
- Tracheostomy
- Parenteral Ab therapy
- cefriaxone
- ampicillin
- Racemic epinephrine
- Corticosteroid
Definitin of Tachypnea
Rapid breathing where are
- infant (0-2 month) : more 60 breath/min
- infant (2- 12 month) : more 50 breath/min
- child (more 12 month) : more 40 breath/min
Etiology of brochiolitis
- below 2 years old
- peak in winter
- common: Respiratory syncytial virus
- Parainfluenza virus
- influenza virus
- adenovirus
Clinical picture of Bronchiolitis
- rhinorrhea
- tachypnea
- severe respiratory distress
- expiratory wheeze
- apnea
Complication of bronchiolitis
- Otitis media
- Dehydration
- Pneumonia
- Wheezy chest
Brochiolitis: investigate and treatment?
- Investigate:
- xray: hyperinflation - Ttt:
- hositalization
- humidified oxygen for hypoxemia
- iv fluid
- B-agonist, theophyline
- Antiviral therapy: Ribavirin inhalation
