Week 2.2 - Respiratory Conditions Flashcards
Children are more likely to have lower airway inflammation be described as bronchiolitis and not bronchitis. Why is this?
It is more likely to affect their bronchioles –> Different terminology
What are the most common viruses that effect children?
Respiratory Syncytial Virus
Also, nonpolioviruses, adenoviruses, parainfluenza, human metapneumoviruses, coronaviruses, influenza
What are some modifiable risk factors for respiratory infection in children?
Not breastfed, daycare attendance, smoking in house, malnutrition, anemia
What are not non-modifiable risk factors for respiratory infection in children?
Preterm, chronic lung disease, congenital heart disease, cystic fibrosis, chronic illness, immunocompromised, allergies, asthma.
Why might warm humidity help with bronchiolitis/RSV?
Moisten secretions and promote their movement
What are croup syndromes? What do they look like?
Affect upper Respiratory tract - pharynx, epiglottis, larynx, trachea, tonsils, middle ear (otitis media)
Characterizes by sudden onset of harsh, barking cough. Often inspiratory stridor with hoarseness and sore throat.
Causes mild to severe respiratory distress.
What kind of croup is characterized by sudden onset? How does the onset present?
Acute Epiglottitis
–> Sore throat, inspiratory frog-like stridor
What causes acute laryngo-tracheobronchitis?
Viral in origin
What causes acute spasmodic croup?
Could be viral or anxiety related
What causes acute epiglottitis?
H. Influenzae type B
–> Most serious of croup disorders due to high risk of airway obstruction
What causes acute tracheitis?
Staphylococcus
Acute laryngotrancheobronchitis is the most common croup syndrome. What usually causes it and what is it characterized by? What age group does it affect?
Usually viral in origin
–> Characterized by gradual onset of low-grade fever, barky brassy seal-like cough that is worse at night, inspiratory stridor, hoarseness
Usually affects children under five.
What age group is most commonly affected by acute epiglottitis?
Age 2-8 years
What are the 4Ds of acute epiglottitis?
Drooling, dysphonia, dysphagia, distress (agitation)
Why should we try to minimize crying in a child with croup?
Causes increased edema in airway, not worth the risk of extra assessments
What medications might be used for croup?
–> Dexamethasone
–> Antipyretics
–> Epinephrine
–> Inhalations (antibiotics for epiglottis)
How can we treat foreign body aspiration? How is it diagnosed?
Back blows, abdominal thrusts initially - removal might be done by endoscopy
Diagnosed with Xray
What is the most common cause bronchioilitis?
Respiratory Syncytial Virus
Mucosal inflammation/edema, accompanied by bronchioles becoming constricted during expiration occurs during which illness process? What does this lead to?
Bronchiolitis
–> Air trapping + hyperinflation
–> Atelectasis with complete obstruction
Impaired gas exchange results in metabolic acidosis and mild respiratory alkalosis
What is the most common cause of bronchiolitis?
RSV
Chest overexpansion, rhinorrhea, and crackles are common in which airway issue in children?
Bronchiolitis
–> Alterations in behaviour and LOC is sign of cyanosis
What does the course of RSV look like?
Peaks at day 3-5 and lingers for 2-4 weeks.
What is most important of treatment for bronchiolitis?
Oxygen and hydration
–> We want to increase efficacy and decrease resp effort to prevent exhaustion
Influenza is most severe in which age group?
Infants
A child presents with dry throat, dry cough, is flushed and fevered with chills, has photophobia, myalgia and a lack of energy. What does this resemble?
Influenza
How long does influenza last?
4-5 days.
What bacteria causes pertussis or whooping cough?
Bordetella pertussis
Pertussis is highly contagious and has a high risk to young infants. It has a high morbidity and risk of mortality. How is it prevented?
Vaccination
–> Lifelong immunity after infection
What is the usual etiology of pneumonia in children?
Viral - RSV/influenza most common
May also be bacterial or aspiration
What is the normal respiratory rate for a three year old?
20-30 rpm
What is the normal respiratory rate for a school aged child?
3-6: 20-25
6-12: 14-22
What is the normal respiratory rate for a youth (12+)
12-18 rpm
What are the goals of care in a child with a respiratory tract infection?
To decrease respiratory effort, prevent exhaustion, and/or increase efficacy
What is the most serious croup disorder? What causes it?
Acute epiglottitis due to high risk of airway obstruction
–> caused by haemophilus influenzae
What is Otitis media?
Fluid in middle ear alongside acute illness and symptoms of middle ear infection
What causes mononucleosis? What symptoms are associated with it?
Caused by Epstein-Barr Virus
–> Fever, exudative pharyngitis, lymphadenopathy, hepatosplenomegaly, and increased atypical lymphocytes.
Which structures can be affected by croup syndromes?
Larynx, trachea, bronchi, epiglottis, pharynx (upper airway)
What age group is usually effected by acute larygotracheobronchitis?
Children under 5
What age is usually affected by acute spasmodic laryngitis?
1-3 years of age.
What is the most common kind of croup?
Laryngotracheobronchitis
Do children develop immunity to RSV?
No, re-infections are common
What are the long-term effects of bronchiolitis?
Infection in the first year of life Increases the risk of childhood asthma
What age group is typically effected by bronchiolitis?
Children ages 2-12 months, rare after 2 years
What is tamiflu?
Antiviral that can be given in early infection of influenza to prevent severe infection.
When is RSV season?
November-April
What is choanal astresia?
A kind of congenital respiratory anomaly wherein a bony or membranous septum develops between the nose and pharynx, blocking airflow through nose.
What is a congenital diaphragmatic hernia?
A defect in the diaphragm that allows abdominal organs to be displaced into the thoracic cavity.
–> More common on the left side, where diaphragm closes last.
What bacteria often causes respiratory infections in children?
Group A B-hemolytic strep
Staph
C. trachomatis, H. Influenza
Mycoplasmas, pneumococci
How does acute epiglottitis present?
With abrupt onset and inspiratory stridor
–> Sore throat, retractions, fever, frightened look, tripoding
4Ds - drooling, dysphagia, dysphonia, distress
What are the first two interventions for a child with a compromised airway?
Reposition
Clear airway
