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Flashcards in Peds Lower Resp Tract Infection Deck (23):
1

Where does lower Resptract begin?

After the larynx

2

What is Pneumonia?

Inflammation or infection of the lung gas exchange units (terminal and respiratory bronchioles

3

What is the most common broad cause of pneumonia?

Viruses 90%
Strep Pneumo is most common cause of BACTERIAL Pneumonia

4

How can pneumonia microbes be transferred into the lungs?

Either deposition and colonization of the resp tract
OR Hematogenous (systemic spread)

5

What are the different host defenses that affect the Resp tract?

Nasopharyngeal air filtration
Laryngeal protection of the airway
Mucocilliary clearance
Normal cough reflex and strength
Normal anatomy
Unobstructed airway drainage
Normal cellular and humoral immune function

6

What diseases affect the Mucocilliary escalator?

Kartagener's syndrome

7

What is the most common clinical findings in Pneumonia?

Fever
Cough
TACHYPNEA
(most sensitive and specific sign of pneumonia in infants)

8

What is the WHO diagnosis criteria?

Tachypnea and retractions to diagnose pneumonia in children younger than 5yo.

9

What is charicteristic of Pertussis?

"Whoop" sound heard on inspiration
Post tussive emesis(vomit)
G- Pleomorphic bacilli
Transmission from cough droplets
Very contageous
6 days incubation

10

How is Pertussis Diagnosed?

80-90% lymphocytes
Leukocytosis with absolute lymphocytosis
CXR shows perihilar infiltrates, atelectaisis or emphysema
Nasopharyngeal swabs sent for PCR

11

What is Tx of pertussis?

Erythromycin
Isolate Pt for 5 days
O2, IV fluids
Hospitalize if an infant

12

What is charicteristic of Influenza?

Spread by large droplets
School age children
Community outbreak in winter
Children infectious for >10 days

13

What is Reye Syndrome?

Systemic disorder of Mitochondrial function occurring during or after viral illness
Vomiting
Agitation, delirium, decorticate posturing
Flaccidity, Apnea

14

How is influenza diagnosed?

Clinical
Nasal swab test

15

What is Tx of the FLU?

Zanamivir and Oseltamivir
Resistant to amantidine and rimantidine

16

What type of virus is RSV?

Paramyxovirus

17

How is RSV transmitted?

Droplets, paticles and fomites
survives 6 hrs on stethoscope
12 hrs on hard surfaces

18

What are the signs and symptoms of RSV?

Mild to severe
Right upper lobe atelectaisis

19

What are the 2014 AAP guidelines for Tx of Bronchiolitis?

NO: viral testing
no CXR
no albuterol or racemic EP
no Oral Steroids
no Abtx
no chest percussion

20

What is the presentation of a child with Chlamidia Trachomatis?

Repeditive Staccato cough. Conjunctivitis
Tachypnea and rales
ABSENCE of fever and wheezing
CXR not abn
WBC normal

21

What is the Tx of Chlamidia Trachomatis? Conjunctivitis?

Oral Erythromycin or azithromycin

Macrolides tetracyclines, quinolones, sulfonamides

22

What is charicteristic of mycoplasma pneumonia?

Dx made by cold aglutinin test
Definitive test is by mycoplasma titer

23

What is the Tx of mycoplasma Pneumonia?

Macrolides
Double cover with cephalosporin til definitive Dx is made.