Flashcards in Pediatric upper respiratory conditions Deck (31)
what are the three types of sinusitis?
`when are antibiotics warranted?
10 days getting worse, no improvement (sinusitis)
classic presentation: laryngotracheobronchitis
retractions of chest wall
coryza - profuse nasal discharge
barking cough - INSPIRATORY
appears in the middle of the night
prior URI for a few days
during what ages is laryngotracheobronchitis infection most likely?
6 months - 6 years
what are the etiologies of laryngotracheobronchitis (viral croup)? which is the most common?
parainfluenza virus type 1 (most common)
parainfluenza virus type 2
respiratory syncytial virus
what is the steeple sign? why is it not as useful?
upon CXR, tapered subglottic airway
only 50% present
what is the best medication therapy for true (rescue) airway distress in laryngotracheobronchitis (viral croup)? why?
decrease in airway edema by vasoconstriction of airway blood vessels
what is the most common, and useful, medication for laryngotracheobronchitis (viral croup) in a non-rescue situation? what is the route?
IM or PO
classic presentation: epiglottitis
anxious patient that prefers the sitting position, with neck in hyperextension and significant drooling
what is the most common etiology of epiglottitis?
haemophilus influenza type B
what is the treatment of epiglottitis?
anesthesia and endotracheal intubation
bacterial tracheitis may follow what infection?
presentation: bacterial tracheitis
brassy cough, high fever, toxicity
what is the most common causative agent of bacterial tracheitis?
what is the major pathology associated with bacterial tracheitis?
mucosal swelling at cricoid level
thick, copious, purulent secretions
diagnosis: bacterial tracheitis?
leukocytosis with left shift
treatment: bacterial tracheitis?
what is seen on expiratory film for foreign body aspiration? inspiratory film?
expiratory - air trapping on affected side, mediastinal shift to unaffected side
inspiratory - mediastinal shift to affected side as other lung aerates
how are foreign bodies in the trachea visualized?
sagittal plane - lateral view
how are foreign bodies in the esophagus visualized?
coronal plane - AP view
what is a retropharyngeal abscess?
infection between buccopharyngeal fascia and prevertebral fascia - lymph nodes in this region most commonly suppurate from extension of a bacterial pharyngeal infection
what are the most common causes of retropharyngeal abscess?
presentation: retropharyngeal abscess
what is seen in the oropharynx for a retropharyngeal abscess?
posterior swelling which may be greater on one side than the other
what is the treatment for retropharyngeal abscess?
drainage and abx that cover gram positive organisms and anaerobes
what is the most common cause of stridor in infancy
what are the causes of laryngomalacia?
1. immaturity of the supporting structures surrounding the larynx
2. abnormal neuromuscular development
inspiratoryo stridor that is worse with crying and while in the supine position; improves in prone position
what is the treatment for laryngomalacia?
1. reassurance to parents if no respiratory insufficiency or failure to thrive
2. surgical intervention sometimes necessary with epiglottoplasty or laser excision
cause wheezing more often that stridor