Respiratory disorders Flashcards
Bronchitis
Inflammation of____
Old ppl tx
Eval for ___ w peds
trachea, bronchi, bronchioles inflammation w cough up to 3wks, self limiting mostly viral
give abx if old w copd/chf
antitussive age
6yrs+
FDA=2yrs
Manufacturers=4yrs
Bronchitis tx
fluids, antipyretic, decongestant, cough suppressants
Albuterol/IGC
Olsetamivir <48hrs
NO mucolytics, NO honey <1, NO antitussive w COPD
honey not for <1yr
bronchitis abx only if a treatable cause is present
a.Pertussis/atypical bacteria
B. moraxella, chlamydia, mycoplasma
C.Abx failure in elderly/comorbidites)
Clarithromycin or azithromycin
Doxycycline
Quinolone
Chronic cough time
adults 8weeks+
children 4wks+
Chronic cough causes
upper airway cough syndrome/abnormalities, rhinitis w PND, postviral, asthma, GERD
Cough tx
fluticasone, budesonide;ppi; benzonatate (10+)
gabapentin
ICS only with asthma etc
Inflammation/obstruction of small airways =^resp effort/wheezing
Mostly in NB-2yrs, males
antibodies do NOT transfer from mom
Bronchiolitis
Bronchiolitis prevention for at risk pts
palivizumab inj
Bronchiolitis NG feedings avoid
hypotonic fluids d/y hyponatremia
Bronchiolitis tx
nothing proven to work, need respiratory score to use aerosols
Ribavirin for immunocompromised pts w severe RSV (toxic to nurses)
Bronchiolitis antimicrobials
severe resp distress w poss pna, worth risk, UTI, OM
Seal barking cough, inspiratory stridor
(Laryngotracheitis or laryngotracheobronchitis)
most common cause of upper airway obstruction or stridor in children
Croup
Croup caused by
most common type
most severe type
parainfluenza virus
most common-1
type 4=severe illness
Croup xray dx signs
steeple, or thumb sign
Normal supraglottic appearance
Croup tx
nebulized epi PO dexamethasone Budesonide Racemic epi for hospitalized pts if d/t flu=oseltamivir
Community acquired pneumonia causes A.Most common,2nd B.Smokers C.Aspiration D. Children E. Immunocompromised
A-mycoplasma pna, strep pna B- H.flu C-anaerobic bacteria D-viral E-pneumocystitis carinii
Findings w \_\_\_\_ Consolidation on percussion Egophony Bronchophony Whispered pectoriloquy Tactile fremitus
Community acquired pneumonia
CAP tx typical bacteria
Amoxicillin, amox-clavulanate
CAP tx healthy w/o recent Abx
amoxicillin or doxy
CAP tx healthy w recent abx
Resp fluoroquinolone
Or adv macrolide
Or adv macrolide +^amox-clav
CAP tx w comorbidity
Combo tx
Amox-Clav OR Cephalosporin
AND
Macrolide OR doxycycline
Bronchiolitis most common cause
No need to dx=over tx
RSV
CAP Atypical bacteria tx
Macrolide, doxycycline
CAP tx w comorbidity
Monotherapy
Resp. Fluoroquinolone
Levofloxacin, moxi, gemifloxacin
Hospitalization CURB65
Confusion Uremia RR vBP 65+
