Paediatrics Flashcards
(90 cards)
What is the other name for croup
acute laryngotracheobronchitis
Who is most commonly affected by croup
ages 6 months to 3 years
more common in boys
When is croup most common?
autumn/early winter
What pathogens can cause croup?
parainfluenza type 1 (most common) and type 2
adenovirus
influenza a and b
RSV
Describe the pathophysiology of croup
- virus initially infects the nasopharyngeal mucosa
- It spreads to the larynx and subglottic airways
- Inflammation of the larynx and subglottic airways leads to swelling and obsrtuction
Symptoms of croup
seal like barking cough
hoarse voice
fever
nasal congestion
stridor
Mild croup symptoms
-occasional barking cough
-no audible stridor
- no recession
-child can eat and drink normally
moderate croup symptoms
-frequent barking cough
- audible stridor at rest
- suprasternal recession
- no agitation
severe croup symptoms
-frequent barking cough
- prominent stridor
- marked sternal recession
- child agitated and distressed
- tachycardia
red flags of resp failure in croup
-drowsiness
-cyanosis
-laboured breathing
- lethargy
-tachycardia
Diagnosis of croup
usually clinical diagnosis
May x-ray to exclude foreign body
What X ray sign may be seen in croup
steeple sign (subglottic narrowing)
How is croup treated
- single dose oral dexamethasone (0.15 mg/kg) and antipyretics
- if no improvement= nebulised adrenaline
Can give O2 if required
What are 2 potential complications of croup
otitis media and superinfection leading to pneumonia
What is bronchiolitis
Viral infection of the bronchioles
Who is affected by bronchiolitis?
- under 2’s
When is bronchiolitis most common?
winter and spring
Risk factors for bronchiolitis
-prematurity
-congenital heart disease
- chronic lung disease
- tobacco exposure
- pollutants
-older siblings in nursery/school
What is the most common cause of bronchiolitis?
RSV
What type of inflammation is predominate in bronchiolitis?
neutrophilic inflammation
Symptoms of bronchiolitis
Corzyal prodrome lasting 1-3 days then development of a persistent cough plus either:
- tachypnoea or chest recession (or both)
- wheeze or crackles (or both)
May also have:
- low grade fever
- poor feeding
- apnoea
Signs of respiratory distress in bronchiolitis
- nasal flaring
- tracheal tug
- head bobbing
- grunting
- sub/intercostal recession
Bronchiolitis on examination
- dry wheezy cough
- cyanosis or pallor
- hyperinflation of the chest
- subcostal or intercostal recession
- fine end inspiratory crackles and high-pitched wheezes.
Investigations for bronchiolitis
- pulse oximetry
- nasopharyngeal aspirate for RSV culture