Croup, Epiglotitis, Laryngitis, & Hoarsness Flashcards
(26 cards)
What typically causes Viral Croup?
- Parainfluenza (most common cause)
- other viruses; RSV, influenza, rubeola virus, adenovirus, mycoplasma pneumonia
How does the parainfluenza virus in viral croup effect kids Vs. Adults?
Kids=> causes inspiratory stridor, worst at night.
Adults=> laryngitis
What are the signs and Symptoms of Viral Croup?
- afebrile or low grade fever
- inspiratory stridor
- barking cough**
- gets worse at night
What is the defining characteristic in a radiographic image of viral coup?
AP neck XR = has a “steeple sign”***
What is the treatment for viral coup?
- cool moist air helps
- oxygen
- racemic epinephrine via nebulizer
- Dexamethasone (glucocorticoid)
What are the signs and symptoms of Epiglottis?
- High Fever
- toxic appearance
- drooling
- dysphagia
- muffled voice
- “tripod”position
- soft stridor–> inspiratory retractions
- “Thumbprint”
** can very suddenly lead to complete airway obstruction
What would a lateral neck x-ray look like for epiglottis?
“Thumbprint” sign
What is the etiology of Epiglottitis?
- Hemophilus influenza; Type B
What is the Tx of Epiglottitis?
DO NOT WAIT TO TX– can be very dangerous!!
- Immediate endotracheal intubation
- may need tracheostomy
after airway=> stable
- blood-work
- IVs abx (ceftriaxone) –> can be switched to oral abx
What is a complication of epiglottitis?
- MC in adults now than kids b/c vaccine
What are some Ddx of Hoarseness?
- laryngitis
- Laryngopharyngeal reflux
- squamous cell carinoma
- laryngeal papillomatosis
- prebyphonia (getting old)
- vocal cord nodule, polyp, cyst, paralysis
Laryngitis is…?
inflammatory process involving the larynx; infections & noninfections
What are the causes of infectious Laryngitis? (most often times acute)
- Viral (rhinovirus, influenza virus, parainfluenza virus, adenovirus,coxsackie, RSV
2, Barcterial- Branhamella Catarrhalis, H influenza, Group A Stre, C Diptheriae
What are the causes of noninfectious Laryngitis?
- cancer
- overuse
- reflux
Presentation of Laryngitis?
- hoarness
- reduced vocal pitch/aphonia
- Viral Respiratory infections w rhinorrhea, casal congestion cough etc
What does Acute Viral laryngitis look like through a laryngoscopy?
How about chronic?
- Acute-> diffuse laryngeal erythema/edema
- -> Vascular engorgement of vocal tubes
- ->irregular vocal fold edges. - Chronic–> often= mucosal nodules & ulcerations visible (similar to laryngeal cancer)
TX/ RX of Laryngitis
- Time
- avoid use of vocal cords (do not whisper= hyper-functioning of larynx)
- avoid throat clearing
- inhale humidified air
- Hydration
** Tobacco delays resolution (surprise surprise!)
What RX does data not support in the TX of laryngitis?
Antihistamines & Corticosteroids.
Abx- also not helpful in health patients.
Larynogopharyngeal Reflux ( sings/symptoms)
- frequent throat clearing
- dry cough
- hoarseness
- globus sensation
- no heartburn in >60% patients
- edema inferior to true vocal fold edge– w thick mucos
What is Leukoplakia?
White coating, benign (keratosis)
Can be precancerous/malignancy
What specific strains are implicated in the cause of Laryngeal Papillomatosis? (3)
HPV 6,11, & 16
How can you prevent Laryngeal Papillomatosis?
HPV vaccine.
What is the TX for Laryngeal Papillomatosis?
- spontaneous remissions do occur.
- HPV (quadrivalent) vaccine–> used as a prophylactic
- prevent airway obstruction
- direct surgical resection
- tracheostomy (occasionally)
What is Glottic Stenosis?
Narrowing of larynx at the glottis level (posterior most common) from webbing, fibrosis, or scarring.
