Pediatric Upper Respiratory Diseases Flashcards Preview

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Flashcards in Pediatric Upper Respiratory Diseases Deck (78):
1

What are the ssx of sinusitis?

Rhinitis with mucus that starts clear and then becomes cloudy or colored

2

What are the three types of sinusitis?

Persistent
Severe
Worsening

3

True or false: the mucus color is not significant

True

4

What is a persistent sinusitis?

lasts for 10 days or more

5

What are the characteristics of severe sinusitis?

Fever over 102.2 F that lasts for 3 days in a row

6

What is the progression of sinusitis?

Steadily increase

7

What is the progression of recurrent URI?

Sinusoidal (occurring and recurring)

8

How many cold will children get in the first year of life?

6-8

9

When are abx indicated?

10 days without improvement

10

What is the formal name of croup?

Laryngotracheobronchitis

11

What is the typical age range for croup?

between 6 months and 6 years old

12

What is the classical presentation of croup?

Middle of the night with *inspiratory* stridor, barky cough, and stridor

13

HOw long does viral croup last for?

3-7 days, with peak ssx first 1-2 nights

14

Which gender is more often affected with croup?

boys

15

What is virus causes croup?

-Parainfluenza virus type 1
-RSV also

16

What is the bacterial cause of croup? How common is this?

Mycoplasma pneumonia

Rare

17

How do you diagnose viral croup?

Clinical presentation and maybe a XR of the neck

18

What is the classic XR sign with croup? What is the sensitivity of this?

Steeple sign
Only about 50% of cases

19

What is the treatment for croup? (2)

-Dexamethasone
-Racemic Epi by neb

20

When is epi indicated fro croup?

Respiratory distress

21

What is the corticosteroid used for croup?

Dexamethasone

22

When is hospitalization indicated for croup?

If need repeated doses of epi for stridor

23

What is the most common cause of epiglottitis?

HiB

24

What are the ssx of epiglottitis?

Sudden onset of fever, respiratory distress, and total airway occlusion within hours

25

What is the position that patients with epiglottitis take?

Tripod

26

When is epiglottitis most common?

1-8 years old

27

What is inflamed with epiglottitis?

Epiglottis
Arytenoids
Arytenoepiglottici area
Vocal cords

28

Should you use a tongue depressor to check for epiglottisi?

No

29

Should you attempt x-ray or lab work with epiglottisi?

No

30

What should you do with a pt who is in respiratory distress from epiglottitis?

Gather anesthesiologist, ENT, and ped surgeon

31

What is the classic XR finding with epiglottitis?

Thumb sign

32

What is the most common infectious agent that causes bacterial trachititis?

Staph Aureus

33

What is bacterial tracheitis?

Inflammation of the trachea, causing mucosal swelling at the level of the cricoid cartilage

34

What is the major consequence of bacterial tracheitis?

Airway obstruction

35

What are the ssx of bacterial tracheitis?

brassy cough, fever, and toxicity

36

How do you make the diagnosis of bacterial tracheitis?

Presentation
High fever
Copious secretions
Leukocytosis w/ L shift

37

What is the treatment for bacterial tracheitis?

Intubation and anti-staph abx

38

What age is FB aspiration most common?

1-3

39

What are the ssx of FB aspiration?

rapid onset of wheezing/stridor

40

Stridor comes from what part of the airway?

Trachea

41

Wheezing comes from what part of the airway?

Bronchus

42

What spinal levels are at the beginning and end of the trachea?

C6 - T5

43

How do you diagnose FB aspiration?

CXR and history

44

What type of XR should be obtained for FB aspiration?

lateral and AP neck

45

What do expiratory films show with a FB obstruction?

Air trapping on afected side and mediastinal shift to the unaffected side

46

What do inspiratory films show with a FB obstruction?

Mediastinal shift back to affected side as the other lung aerates

47

FB in the trachea are seen best with what view of the neck?

Lateral

48

FBs in the esophagus are best seen with what view of the neck?

AP

49

What is the treatment for FB aspiration?

Endoscopy

50

Large airway on lateral neck XR is suspicious for what?

Retropharyngeal abscess

51

Where do retropharyngeal abscesses usually occur?

Buccopharyngeal fascia and the prevertebral fascia

52

What happens to the lymph nodes with a retropharyngeal abscesses?

Suppurate from extension of a bacterial pharyngeal infection

53

What are the most common infectious agents for retropharyngeal abscesses?

Staph Aureus

54

What age group is most commonly affected with retropharyngeal abscesses?

Children less than 3 years

55

When does the prevertebral space close?

3-4 years

56

What should always be in you ddx for retropharyngeal abscesses?

Peritonsillar abscess

57

What are the symptoms of retropharyngeal abscesses?

Fever
Sore throat
Dysphagia
Respiratory distress

58

What are the signs of a retropharyngeal abscesses? (3)

Toxic appearance
Torticollis
Trismus
Drooling

59

Exam of the oropharynx with retropharyngeal abscesses will show what?

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

60

How do you diagnose a retropharyngeal abscesses?

Clinical history, CT if unsure

61

What is the treatment for retropharyngeal abscesses?

Drainage and abx the cover gram positive organisms

62

Stridor that disappears with lying prone = ?

Laryngomalacia

63

What is the usual cause of subglottic stenosis?

Numerous Intubations at prematurity

64

What is Laryngomalacia?

Immaturity of the supporting structure surrounding the larynx, and abnormal neuromuscular development

65

What makes Laryngomalacia worse?

Crying
Agitation
supine position

66

What is the voice/cry like with Laryngomalacia?

Nomal

67

What is the prognosis for Laryngomalacia?

Resolves by 12-18 months

68

What is the treatment for Laryngomalacia?

-Reassurance if no respiratory failure
-Surgical intervention if bad

69

What is tracheomalacia?

a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse especially when increased airflow is demanded.

70

What are the ssx of tracheomalacia?

Wheezing more often than stridor

71

When does the retropharyngeal space close?

3-4th year of life

72

What is the most common cause of stridor in the newborn period?

Laryngotracheobronchitis

73

What is the onset time for epiglottitis?

4-12 hours (quick)

74

In which of the major LRTI in children does the patient appear toxic?

Epiglottitis

75

Which way will a coin show on a CXR if it's in the esophagus? Trachea?

Esophagus = coronal plane
Trachea = sagittal plane

76

If a child has trismus, drooling, and stridor, what should be in your ddx?

retropharyngeal abscess

77

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

78

What is the age of range for croup?

3 mo - 3 years