Upper respiratory tract Flashcards
What are the 6 signs of respiratory distress?
Tachypnea. Nasal flaring. Cyanosis. Chest retractions. Use of accessory muscles. Expiratory grunting.
Inspiratory stridor can be heard in?
croup
laryngomalacia
When auscultating a patient with croup what do you hear?
inspiratory stridor
crackles or rales
How to measure oxygen saturation in a patient?
Arterial blood gas: invasive.
Pulse oximetry: non-invasive
What causes epiglottis?
acute inflammation and edema of epiglottis that is caused by HIB Now it is rare, due to routine vaccination
At what age do we suspect epiglottis?
2-7 yrs.
List the clinical features of epiglottis ?
high-grade fever (bacterial infection)
muffled speech
dysphagia with drooling
sitting in tripod position with neck hyperextension.
Investigations of epiglottis?
CBC (leukocytosis)
blood culture (positive if it is caused by HIB)
chest X-ray shows the thumb sign
Why is a bronchoscopy contraindicated in epiglottis?
because airway obstruction and respiratory arrest can occur at any moment
Management of epiglottis?
patient is intubated and given IV 3rd generation cephalosporins (ceftriaxone).
Definition of croup?
It is an inflammation of larynx, trachea and bronchi
At what age croup occurs?
3 months to 3 years
most common cause of croup?
parainfluenza virus
clinical features of croup?
low-grade fever (viral infection)
inspiratory stridor
barky cough
sometimes crackles
Investigations of croup?
anterior-posterior view of neck X-ray will show the steeple sign.
Management of croup ?
mainly supportive (cool mist and fluids) Hospitalization is only indicated for children in respiratory distress.
Bacterial tracheitis causative organism?
S.aureus
Clinical features of Bacterial tracheitis?
high-grade fever(bacterial)
mucus and pus in trachea
stridor
Management of Bacterial tracheitis?
endotracheal intubation
IV anti-staphylococcal antibiotics
(oxacillin) → if there is resistance, vancomycin will be given.
why do infants have a higher risk for respiratory insufficiency?
They have smaller air passages that are less compliant but a more compliant chest wall
Alveolar development continues till what age?
90% of alveolar development occurs after birth (until age of 8)
when is a cough considered chronic?
> 4 weeks in children
Indications for tonsillectomy
Recurrent severe tonsillitis (>8 times a year)
Peritonsillar abscess
obstructive sleep apnea (remove adenoids)
will a tonsillectomy decrease the risk of pharyngitis?
it will NOT decrease risk of pharyngitis
