URTI and Upper Respiratory Problems Flashcards
Common respiratory tract infections?
- Rhinosinusitis
- Acute pharyngitis
- AOM
- Retropharyngeal and Lateral pharyngeal (parapharyngeal) abscesses
- Tonsilitis and adenoiditis
- Acute inflammatory Upper airway obstruction
Note: Children <2yr in child-care centers have more URTI and LRTI than do age-matched children not in child care.
Causes of rhinosinusitis?
- Rhinoviruses
- coronaviruses
- HMPV
Causes of acute pharyngitis?
- viruses
- GABHS
- 30% of URTI
Causes of AOM?
- S. pneumoniae
- nontypeable Haemophilus influenzae
- Moraxella catarrhalis
Causes of acute inflammatory upper airway obstruction?
- Croup
- epiglottitis
- laryngitis
- Bacterial tracheitis
What is otitis media?
Inflammation of the middle ear
- One of the most common childhood infections
Characteristics of otitis media?
Bulging erythematous tympanic membrane with impaired mobility
Epidemiology of otitis media?
- The peak incidence and prevalence of OM is during the 1st 2 yr of life
- More than 80% of children experience at least one episode of OM by the age of 3 yr
How to classify otitis media?
- Acute - less than 14 days
- Chronic - more than 14 days
Treatment of otitis media?
- Amoxicillin
- Ear wicking for chronic supurative otitis media
Local complications of otitis media?
- Hearing impairment
- mastoiditis
Intracranial complications of otitis media?
- Meningitis
- epidural abscess
- subdural abscess
- focal encephalitis
- brain abscess
- sigmoid sinus thrombosis
Importance of a patent airway in newborns?
Most newborn infants are obligate nasal breathers
1. Nasal obstruction presenting at birth may be life-threatening
2. Nasal passages contribute 50% of the total resistance
What are the causes of nasal congestion with obstruction in the 1st year of life?
- Viral or bacterial infection
- Enlarged adenoids
What is nasal flaring?
a sign of respiratory distress
- reduces the resistance to inspiratory airflow through the nose and can improve ventilation
Describe the nasal airway in children?
- Internal nasal airway doubles in size in the 1st 6months of life
- The lumen of an infant’s or child’s airway is narrow
- The area just below the vocal cords is the narrowest portion in <10year olds
Consequences of mucosal edema in a newborn?
Minor reductions in cross-sectional area due to mucosal edema or other inflammatory processes cause an exponential increase in airway resistance and a significant increase in the work of breathing
Supportive care in airway obstruction?
- Bulb syringe and saline nose drops
- Topical nasal decongestants, and antibiotics, when indicated, improve symptoms in affected infants
What is allergic rhinitis?
Inflammatory disorder of the nasal mucosa
Symptoms of allergic rhinitis?
- Nasal congestion
- rhinorrhea
- itching
Allergic rhinitis is associated with?
- conjunctivitis
- sinusitis
- otitis media
- serous otitis
- hypertrophic tonsils and adenoids
- eczema
Causes of obstruction of the pharyngeal airway?
Enlarged tonsils, adenoids, tongue, or syndromes with midface hypoplasia
- Worse during sleep than during waking.
Describe features of laryngeal, tracheal or bronchial obstruction?
Worse when awake, exacerbated by exertion
What is choanal atresia (bilateral)?
a congenital disorder in which the nasal choanae (paired openings that connect the nasal cavity with the nasopharynx) are occluded by soft tissue (membranous), bone, or a combination of both due to failed recanalization of the nasal fossae during fetal development