Pediatric upper respiratory conditions Flashcards Preview

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Flashcards in Pediatric upper respiratory conditions Deck (31)
1

what are the three types of sinusitis?

persistent
severe
worsening

2

`when are antibiotics warranted?

10 days getting worse, no improvement (sinusitis)

3

classic presentation: laryngotracheobronchitis

retractions of chest wall
nostril flaring
coryza - profuse nasal discharge
barking cough - INSPIRATORY
appears in the middle of the night
prior URI for a few days
variable fever
sore throat

4

during what ages is laryngotracheobronchitis infection most likely?

6 months - 6 years

5

what are the etiologies of laryngotracheobronchitis (viral croup)? which is the most common?

parainfluenza virus type 1 (most common)
parainfluenza virus type 2
influenza A
adenoviruses
respiratory syncytial virus
enteroviruses
mycoplasma pneumo
measles
HSV
corynebacterium diphtheria

6

what is the steeple sign? why is it not as useful?

upon CXR, tapered subglottic airway

only 50% present

7

what is the best medication therapy for true (rescue) airway distress in laryngotracheobronchitis (viral croup)? why?

racemic EPI

decrease in airway edema by vasoconstriction of airway blood vessels

8

what is the most common, and useful, medication for laryngotracheobronchitis (viral croup) in a non-rescue situation? what is the route?

dexamethasone

IM or PO

9

classic presentation: epiglottitis

anxious patient that prefers the sitting position, with neck in hyperextension and significant drooling

10

what is the most common etiology of epiglottitis?

haemophilus influenza type B

11

what is the treatment of epiglottitis?

anesthesia and endotracheal intubation
IV access
CBC, culture
abx

12

bacterial tracheitis may follow what infection?

viral croup

13

presentation: bacterial tracheitis

brassy cough, high fever, toxicity

14

what is the most common causative agent of bacterial tracheitis?

staph aureus

15

what is the major pathology associated with bacterial tracheitis?

mucosal swelling at cricoid level
thick, copious, purulent secretions

16

diagnosis: bacterial tracheitis?

respiratory distress
high fever
copious secretions
leukocytosis with left shift

17

treatment: bacterial tracheitis?

intubation
antistaphylococcal abx

18

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

19

how are foreign bodies in the trachea visualized?

sagittal plane - lateral view

20

how are foreign bodies in the esophagus visualized?

coronal plane - AP view

21

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

22

what are the most common causes of retropharyngeal abscess?

strep pyogenes
oral anaerobes
staph aureus

23

presentation: retropharyngeal abscess

fever
sore throat
neck pain
pregressive dysphagia
respiratory distress
torticollis
trismus
drooling
stridor

24

what is seen in the oropharynx for a retropharyngeal abscess?

posterior swelling which may be greater on one side than the other

25

what is the treatment for retropharyngeal abscess?

drainage and abx that cover gram positive organisms and anaerobes

26

what is the most common cause of stridor in infancy

laryngomalacia

27

what are the causes of laryngomalacia?

1. immaturity of the supporting structures surrounding the larynx
2. abnormal neuromuscular development

28

presentation: laryngomalacia

inspiratoryo stridor that is worse with crying and while in the supine position; improves in prone position

29

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

30

presentation: tracheomalacia

cause wheezing more often that stridor

31

tracheomalacia may be associated with what condition?

TE fistula