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Laryngeal/Tracheal infections Flashcards

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1
Q

Obstructive sleep apnea sxs

A

Snoring, gasping, apnea 30-45 s

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2
Q

Obstructive sleep apnea Dx

A

Sleep study

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3
Q

Obstructive sleep apnea Tx

A
  • Adenoidectomy w/ possible tonsillectomy

- CPAP

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4
Q

Vocal cord dysfunction sxs

A

chocking sensation, stridor

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5
Q

Vocal cord dysfunction Dx

A

Dont respond to albuterol in the office (no obstruction on spirometry)

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6
Q

Vocal cord dysfunction Tx

A

Speech therapy, reassurance

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7
Q

Asthma sxs

A

Cough (nocturnal), wheezing, chest tightness, triggers

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8
Q

Asthma risk factors

A

Viral infections
tobacco smoke
pollution
family hx

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9
Q

Asthma xtics

A
  • Inflammation
  • Hyper-responsiveness
  • Reversible obstruction
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10
Q

Asthma Dx

A
  • Hx

- Pulmonary function test (spirometry)- FEV/FVC decreased = obstructive; improves with bronchodilator

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11
Q

At what age can you perform spirometry on a child

A

5yr and over (younger and the results aren’t accurate)

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12
Q

Asthma Tx

A
  • Short acting bronchodilators
  • Inhaled corticosteroids
  • Long acting bronchodilators (w/ inhaled corticosteroid)
  • Leukotriene antagonists
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13
Q

When you need more than just rescue bronchodilator

A

Rule of twos
>2x /wk
>2x /night
>2 refills/yr

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14
Q

Effects of corticosteroids

A

Minimal: Bone density (high doses)
Normal: growth achievement
Mostly safe

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15
Q

Infant respiratory distress syndrome xtics

A

Deficiency of surfactant at birth

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16
Q

Infant respiratory distress syndrome sxs

A

Rest distress (tachypnea, nasal flaring, grunting, cyanosis) w/in minutes - hrs after birth to 2-3days

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17
Q

Infant respiratory distress syndrome Dx

A

Blood gases = hypoxic

CXR= ground glass appearance

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18
Q

Infant respiratory distress syndrome risk factors

A
  • Premie

- Diabetic mom

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19
Q

Infant respiratory distress syndrome Tx

A

O2, IV fluids (surfactant)

Glucocorticoids 24hr before birth

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20
Q

Pneumonia

A

consolidation of alveolar spaces - parenchymal infection

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21
Q

Pneumonia etiology

A

Viral (1-3mo, 3-12mo,2-5yrs), Bacterial (5-18yrs)

& atypicals

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22
Q

Pneumonia sxs

A

Fever, cough (myalgia if viral) abdominal pain-older chn/not feeding well,restless-infants

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23
Q

Afebrile pneumonia

A

Think Chlamydia

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24
Q

conjunctivitis w/ pneumonia

A

Think chlamydia

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25
Pneumonia exam findings
Tachypnea, tachycardia, fever, decreased O2 sats, Rales, Rhonchi, dull to percussion, wheezing (atypical/viral)
26
Pneumonia Dx
- CXR (not required) | - Blood culture (if toxic/admission)
27
Pneumonia Tx (outpatient)
Empirical w/ follow up infant/preschool- Amox/2nd-3rd gen Ceph/Clinda School age- Amox/Azithro/Doxy for atypical
28
Pneumonia Tx (inpatient)
Ampicillin/sulbactam 200mg/kg/24hr q6h Cefuroxime 150mg/kg/24hr q8h Ceftriaxone 50-100mg/kg/24hr q12-24h
29
When to admit
At any age if - Family can't take care of child - Comorbidities - Family can't come back for follow up
30
Vaccines against Pneumonia
- Strep pneumonia - Varicella - Measles - H influenza - Influenza
31
pertussis
Prolonged cough that can cause vomiting.
32
Pertussis mortality due to
Apnea
33
Pertussis etiology
Bordatella pertussis
34
Pertussis sxs
Paroxysmal coughing w/ inspiratory "whoop"
35
Stages of pertussis
1. Catarrhal (URI,fever; 1-2wks) 2. Paroxyxmal cough w/post tussle emesis (2-6wks) 3. Convalescent-recovering cough (10-12wks)
36
Pertussis Dx
Nasopharyngeal culture (gold std) CBC -elevated lymphocytes CXR-subsegmental atelectasis
37
Pertussis Tx
Macrolides- Azithro/Erythro
38
RSV sxs
Cough, conjunctivitis, nasal congestion (a lot of mucus) fever
39
Major complication of RSV
Bronchiolitis
40
RSV Dx
Nasopharyngeal culture
41
RSV Tx
*Prevention (wash hand, avoid infected etc)
42
RSV prophylaxis
Palivizumab (high risk
43
Bronchiolitis etilogy
RSV | Rhinovirus
44
Bronchiolitis sxs
2-3day cold, low grade fever, wheezing, tachypnea, nasal flaring
45
Bronchiolitis Dx
- Based on sxs, time of year, age | - +/- nasopharyngeal swab (ER)
46
Time of year when RSV is common
Winter (Nov-April)
47
Bronchiolitis Tx
Supportive, duration 1-2wks, suction mucus, | Hospitalized if in need of airway support/increase fluids/oxygenation
48
Cause of Cystic fibrosis
Autosomal recessive mutation in CFTR gene (Chloride channel transporter)
49
What causes death in Cystic fibrosis
Recurrent lung infections
50
Cystic fibrosis sxs
Persistent productive cough, viscous mucus secretion, hyperinflation of lungs on CXR
51
Cystic fibrosis Dx
Sweat chloride > 60meq/L
52
Bronchiectasis
Abnormal dilation of bronchi, walls damaged by inflammation
53
Sxs of Bronchiectasis
Chronic cough and sputum (think cystic fibrosis)
54
Dx bronchiectasis
Pulmonary fxn test- obstructive pattern
55
Croup etiology
Parainfluenza, RSV
56
Croup sxs
Barking seal like cough with inspiratory stridor, hoarseness, low grade fever
57
Croup Dx
Clinical (CXR-steeple sign)
58
Croup Tx
Mild: Supportive, cool mist, steam bath Moderate: steroids, Dexamethasone 0.6mg/kg or Nebulized Epi Severe: Airway support
59
Croup predominant season
Fall & winter
60
Epiglottitis etiology
Emergent | -Hemophilus influenza B
61
Epiglottitis sxs
Rapid onset of high fever, muffled hot potato voice, 3Ds (drooling, dysphagia, distress), pain in ant part of neck
62
Epiglottitis Dx
Clinical (CXR thumb sign - lateral neck)
63
Epiglottitis Rx
- Airway support - Steroids - Ceftriaxone for H influenzae
64
Tracheomalacia
abnormal collapse of trachea due to not being well developed
65
What exacerbates tracheomalacia
crying
66
Tracheomlacia sxs
Barking cough, expiratory stridor
67
Tracheomalacia Tx
self resolving, CPAP
68
Foreign body aspiration sxs
Abrupt onset of cough, insp/exp stridor(upper airway) unilateral wheezing (lower airway)
69
where so most foreign body aspirates end up
Right bronchus
70
Foreign body dx
Bronchoscopy (may or may not show up on CXR) do if have high suspicion and -ve result on CXR
71
Foreign body asp tx
Removal
72
What aspirate is most fatal
Balloon
73
most common respiratory disorder in chn
Asthma
74
most common cause of LRI in chn
RSV
75
Most common fatal autosomal dominant recessive disease
CF
76
Leading cause of death in can under 5yo worldwide
Pneumonia

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