Flashcards in Pediatric Upper Respiratory Diseases Deck (78):
What are the ssx of sinusitis?
Rhinitis with mucus that starts clear and then becomes cloudy or colored
What are the three types of sinusitis?
True or false: the mucus color is not significant
What is a persistent sinusitis?
lasts for 10 days or more
What are the characteristics of severe sinusitis?
Fever over 102.2 F that lasts for 3 days in a row
What is the progression of sinusitis?
What is the progression of recurrent URI?
Sinusoidal (occurring and recurring)
How many cold will children get in the first year of life?
When are abx indicated?
10 days without improvement
What is the formal name of croup?
What is the typical age range for croup?
between 6 months and 6 years old
What is the classical presentation of croup?
Middle of the night with *inspiratory* stridor, barky cough, and stridor
HOw long does viral croup last for?
3-7 days, with peak ssx first 1-2 nights
Which gender is more often affected with croup?
What is virus causes croup?
-Parainfluenza virus type 1
What is the bacterial cause of croup? How common is this?
How do you diagnose viral croup?
Clinical presentation and maybe a XR of the neck
What is the classic XR sign with croup? What is the sensitivity of this?
Only about 50% of cases
What is the treatment for croup? (2)
-Racemic Epi by neb
When is epi indicated fro croup?
What is the corticosteroid used for croup?
When is hospitalization indicated for croup?
If need repeated doses of epi for stridor
What is the most common cause of epiglottitis?
What are the ssx of epiglottitis?
Sudden onset of fever, respiratory distress, and total airway occlusion within hours
What is the position that patients with epiglottitis take?
When is epiglottitis most common?
1-8 years old
What is inflamed with epiglottitis?
Should you use a tongue depressor to check for epiglottisi?
Should you attempt x-ray or lab work with epiglottisi?
What should you do with a pt who is in respiratory distress from epiglottitis?
Gather anesthesiologist, ENT, and ped surgeon
What is the classic XR finding with epiglottitis?
What is the most common infectious agent that causes bacterial trachititis?
What is bacterial tracheitis?
Inflammation of the trachea, causing mucosal swelling at the level of the cricoid cartilage
What is the major consequence of bacterial tracheitis?
What are the ssx of bacterial tracheitis?
brassy cough, fever, and toxicity
How do you make the diagnosis of bacterial tracheitis?
Leukocytosis w/ L shift
What is the treatment for bacterial tracheitis?
Intubation and anti-staph abx
What age is FB aspiration most common?
What are the ssx of FB aspiration?
rapid onset of wheezing/stridor
Stridor comes from what part of the airway?
Wheezing comes from what part of the airway?
What spinal levels are at the beginning and end of the trachea?
C6 - T5
How do you diagnose FB aspiration?
CXR and history
What type of XR should be obtained for FB aspiration?
lateral and AP neck
What do expiratory films show with a FB obstruction?
Air trapping on afected side and mediastinal shift to the unaffected side
What do inspiratory films show with a FB obstruction?
Mediastinal shift back to affected side as the other lung aerates
FB in the trachea are seen best with what view of the neck?
FBs in the esophagus are best seen with what view of the neck?
What is the treatment for FB aspiration?
Large airway on lateral neck XR is suspicious for what?
Where do retropharyngeal abscesses usually occur?
Buccopharyngeal fascia and the prevertebral fascia
What happens to the lymph nodes with a retropharyngeal abscesses?
Suppurate from extension of a bacterial pharyngeal infection
What are the most common infectious agents for retropharyngeal abscesses?
What age group is most commonly affected with retropharyngeal abscesses?
Children less than 3 years
When does the prevertebral space close?
What should always be in you ddx for retropharyngeal abscesses?
What are the symptoms of retropharyngeal abscesses?
What are the signs of a retropharyngeal abscesses? (3)
Exam of the oropharynx with retropharyngeal abscesses will show what?
Posterior swelling which may be greater on one side than the other
How do you diagnose a retropharyngeal abscesses?
Clinical history, CT if unsure
What is the treatment for retropharyngeal abscesses?
Drainage and abx the cover gram positive organisms
Stridor that disappears with lying prone = ?
What is the usual cause of subglottic stenosis?
Numerous Intubations at prematurity
What is Laryngomalacia?
Immaturity of the supporting structure surrounding the larynx, and abnormal neuromuscular development
What makes Laryngomalacia worse?
What is the voice/cry like with Laryngomalacia?
What is the prognosis for Laryngomalacia?
Resolves by 12-18 months
What is the treatment for Laryngomalacia?
-Reassurance if no respiratory failure
-Surgical intervention if bad
What is tracheomalacia?
a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse especially when increased airflow is demanded.
What are the ssx of tracheomalacia?
Wheezing more often than stridor
When does the retropharyngeal space close?
3-4th year of life
What is the most common cause of stridor in the newborn period?
What is the onset time for epiglottitis?
4-12 hours (quick)
In which of the major LRTI in children does the patient appear toxic?
Which way will a coin show on a CXR if it's in the esophagus? Trachea?
Esophagus = coronal plane
Trachea = sagittal plane
If a child has trismus, drooling, and stridor, what should be in your ddx?
What is a major difference in the PE findings with a retropharyngeal abscess as compared to a peritonsillar abscess?
Peritonsillar will be off to one side