Respiratory Flashcards
What is croup
laryngotracheobronchitis
inflammation of the upper airway usually due to parainfluenza viral infection
age group affected by croup
6mth - 3 yr
symptoms and signs of croup
barking cough stridor dyspnoea fever cyanosis fatigue hoarse voice usually following having a cold
red flags / severe signs of croup
cyanosis / grey / pale drooling altered mental state absent breath sounds / quieter than before fatigue resp distress
how can croup be classified
mild
moderate
severe
impending resp failure
management of croup
paracetamol, rehydrate
mild - PO DXM and rest at home + SAFETY NET
mod-severe - admit, and give supplementary O2 and steroids
PO DXM / neb budesonide / IM DXM
what is epiglottitis and what is the usual cause
inflammation and swelling of the epiglottis
HiB bacterial infection
other causes include: strep penumoniae, viral, trauma, smoking
age group affected by epiglottitis
2-6 yr
symptoms and signs of epiglottitis
sore throat odynophagia + dysphagia stridor and breathing difficulties fever irritability hoarse voice decreased oral intake classic 'tripod' positioning drooling cherry red epiglottis
RF for epiglottitis
non HiB vaccination
immunocompromised
management of epiglottitis
admit
ABCDE
secure the airway - O2 mask, intubation, tracheostomy
FBC, CRP, throat swab and culture, Xray/CT
IV antibiotics - ceftriaxone (chloramphenicol)
in paediatrics what must be done before administering chloramphenicol
check plasma levels
what is bronchiolitis
inflammation of the bronchioles
causes of bronchiolitis
respiratory syncytial virus RSV - most common
rhinovirus
parainfluenza virus
RF for bronchiolitis
<6 wk premature immunocompromised other chronic conditions - neuro, cardiac, resp small for age
bronchiolitis is the most common infection in neonates and is usually self limiting, true or false
true
bronchiolitis is more common in children >2yo, true or false
false, it is more common in <2yo
asthma is more likely if >2yo
symptoms and signs of bronchiolitis
tachypnoea fever increased work of breathing: nasal flaring, intercostal recession, tracheal tug, abdominal breathing wheeze crepitations
red flags for bronchiolitis
apnoea or severe tachypnoea difficulty feeding cyanosis / grey grunting SaO2 < 92%
investigations are required to make a diagnosis of bronchiolitis, true or false
false, it is a clinical diagnosis
management of bronchiolitis
main principles: oxygenation and hydration as it is self limiting
mild - self limiting at home
mod - severe - admit, fluids, O2 support
impending resp failure - CPAP, NG feeding
antibiotics should be given in bronchiolitis, true or false
false!
asthma triad
airway inflammation
airway hyper responsiveness
reversible airway obstruction
pathology of asthma
bronchocontstriction
chronic airway inflammation
airway remodelling
BM thickening
submucosal collagen deposition
smooth muscle hypertrophy
