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Pediatrics > RSV and Bronchiolitis > Flashcards

RSV and Bronchiolitis Flashcards

1
Q

When does respiratory distress occur?

A

when the bodies metabolic demand for oxygen is not being met due to a failure of oxygenation or ventilation

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2
Q

How does respiratory distress present in children?

A

Increased WOB
Abnormal breathing pattern

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3
Q

What are some reasons that PEDs rapidly decompensate?

A

Smaller airways
Increased metabolic demand
Decreased respiratory reserve
Inadequate compensatory mechanisms

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4
Q

What is the most common cause of cardiac arrest in children?

A

Respiratory arrest

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5
Q

What is a decrease in respiratory rate in a child in respiratory distress a sign of?

A

Impending respiratory failure

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6
Q

What are the components of the pediatric assessment triangle?

A

Appearance
WOB
Circulation

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7
Q

What are the components of how a child appears?

A

Tone
interactiveness
consolability
speech/cry

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8
Q

What are the components of work of breathing?

A

Abnormal breath sounds
Abnormal positioning
Retractions
Nasal flaring

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9
Q

What are the components of circulation to the skin?

A

Pallor
Mottling
Cyanosis

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10
Q

What is considered a fever in PEDs?

A

100.4 F or 38 C

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11
Q

What are fevers typically a response to?

A

viral infection

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12
Q

When does the immune system mature?

A

2-3 months

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13
Q

What cultures would you get in a PED that has a fever?

A

Respiratory
Urine
Spinal Fluid

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14
Q

What is the main way to protect newbornes from viral infections?

A

TDAP vaccine
wash hands
dont kiss the baby

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15
Q

What is the virus responsible for whooping cough?

A

Bordetella pertussis

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16
Q

How is whooping cough transmitted?

A

droplets

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17
Q

What can whooping cough cause in infants?

A

apnea
minimal cough
seizures
PNA
respiratory failure
cardiac failure
death

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18
Q

When do RSV infections primarily occur?

A

fall and winter

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19
Q

What is the leading cause of lower respiratory infections in young children?

A

RSV

20
Q

how is RSV transmitted?

A

Cough and direct physical contact from infected individuals or objects

21
Q

Describe RSVs contagious level

A

highly contagious

22
Q

Why is RSV so contagious?

A

Can live on surfaces for 2-8 hours
Infected individuals can be contagious for up to 3 weeks

23
Q

What are risk factors associated with RSV?

A

childcare attendance
older siblings in school
exposure to environmental pollutants

24
Q

What factors are associated with more severe RSV infections?

A

Prematurity
Younger than 3 months
preexisting chronic lung disease
congenital heart disease
congenital immunodeficiency
family history of asthma

25
Q

Describe the pathophysiology of RSV

A

Begins in upper respiratory tract
Progresses rapidly over 1-2 days to diffuse small airway disease
Leads to edema of small airway and increased mucus production that

26
Q

What does the increased mucus production associated with RSV cause?

A

partial or complete obstruction of the airway leading to air trapping or alveolar collapse and PNA

27
Q

How can RSV be diagnosed?

A

Situationally dependent, if patient is comfortable and stable, no test needed
CBC
Serum electrolytes
urine analysis
ABGS
sputum culture
antigen testing
PCR assay
chest radiograph

28
Q

How does RSV present?

A

Cold like symptoms
Tachypnea, chest wall retractions
cyanosis
ear infection
dehydration

29
Q

how can you test for dehydration?

A

Dry diapers
dry mucus membranes

30
Q

What medication can be given for RSV?

A

Ribavirin (virazole)

31
Q

What is the leading cause of pediatric hospitalizations in the US?

A

Bronchiolitis

32
Q

What viral pathogens can cause bronchiolitis?

A

RSV, flu, parainfluenza etc

33
Q

Describe bronchiolitis pathophysiology

A

Infection of upper respiratory tract
Virus spreads from upper respiratory tract to the medium and small bronchi and bronchioles
Necrosis of the respiratory epithelium occurs and triggers an inflammatory response
Inflammation causes bronchiole obstruction

34
Q

What can the obstruction caused by inflammation and mucus in bronchiolitis cause?

A

Airtrapping
alveolar hyperinflation

35
Q

what is the most significant consequence of bronchiolitis?

A

Hypoxemia

36
Q

how is bronchiolitis diagnosed?

A

differential clinical diagnosis
Nasal swab to confirm viral infection
Thorough examination of patient and surrounding situation

37
Q

What is not recommended to diagnose bronchiolitis?

A

CXRs

38
Q

How does bronchiolitis clinically present?

A

rapid onset
lack of appetite
low grade fever
cough, dyspnea, wheezing, rhinorrhea
signs of respiratory distress
paradoxical breathing
periods of apnea

39
Q

What are none respiratory manifestations of bronchiolitis?

A

ititis media
myocarditis
superventricular and ventricular dysrhythmias

40
Q

How is bronchiolitis treated?

A

Supportive care
Supplemental oxygen
secretion clearance
chest PR
bronchodilators
corticosteroids

41
Q

What is the leading cause of death in children worldwide?

A

Flu

42
Q

How is the flu transmitted?

A

Droplet

43
Q

Describe the pathophysiology of the flu

A
  1. virus in host cells causes cellular dysfunction and degeneration resulting in inflammatory mediator release
  2. Targets epithelial lining of respiratory tract
44
Q

How is flu diagnosed?

A

Based on clinical symptoms of headache, fever, chills, muscle aches, weakness, fatigue, nasal congestion, sore throat and cough
Can also be diagnosed via viral cultures, and molecular tests

45
Q

What is the gold standard of flu diagnosis?

A

Viral cultures

46
Q

How is the flu best managed or treated?

A

via prevention from vaccination

Pediatrics (16 decks)

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