Peds LRTIs Flashcards Preview

Respiratory > Peds LRTIs > Flashcards

Flashcards in Peds LRTIs Deck (68):
1

Where does the LRT begin?

Sublaryngeal

2

What are the major LRTIs?

Bronchiolitis
Larnygotracheobronchisits
Tracheitis
Bronchitis
Pneumonia

3

What is the definition of pneumonia?

Infection of the lung parenchyma, specifically the gas exchange unit

4

What percent of all pediatric deaths result from pneumonia?

18%

5

What accounts for most LRTIs in children?

Viruses (90%)

6

What is the main bacterial cause of LRTIs?

Strep pneumoniae

7

What is the pathophysiology of pneumonia? (2)

Deposition of and subsequent replication of viral or bacterial agents in the respiratory tract mucosa or the lung can be seeded hematogenous spread

8

How do viral infections predispose to the development of pneumonia?

Impair host defenses, leading to secondary bacterial pneumonia

9

Recurrent pneumonias should be suspicious for what?

Immune disease or change in physiology

10

What are the 3 major signs of pneumonia?

Fever
Cough
Tachypnea

11

What is the most sensitive and specific sign of pediatric pneumonia? How sensitive/specific?

Tachypnea--really, really sensitive, but not so specific

12

What are the lung findings of pneumonia?

-Rales and rhonchi
Decreased breath sounds

13

What is the best non-verbal finding of pneumonia? Why?

Refusal to eat d/t breathing problems

14

How is it kids can have pneumonia, but have normal sounds?

Hearing sounds from the other side

15

What are the two best signs of pneumonia in kids younger than 5 yo?

Tachypnea
Retractions

16

Post tussive emesis = ?

Bordetella pertussis

17

True or false: humans are the only known host of Bordetella pertussis

True

18

What is the gram stain and morphology of Bordetella pertussis?

Gram negative pleomorphic bacilli

19

What is the incubation period of Bordetella pertussis?

6 days

20

What are the three stages of Bordetella pertussis?

1. Catarrhal phase (non-specific ssx)
2. paroxysmal phase (coughing)
3. Convalescent phase (decreasing coughing)

21

How do you diagnose Bordetella pertussis?

Clinical picture
Leukocytosis with absolute lymphocytosis

22

What are the CXR findings of Bordetella pertussis?

Perihilar infiltrates
Atelectasis
Emphysema

23

How do you confirm Bordetella pertussis?

Nasopharyngeal swab for PCR

24

When should you hospitalize pts with Bordetella pertussis?

-If less than 6 mo
-IVF or oxygen needed

25

What is the treatment for Bordetella pertussis?

Erythromycin 40 mg/kg q 6 hours for 14 days

26

How long should you isolate patients for with Bordetella pertussis?

5 days

27

What are the ssx of influenza?

-High fever
-Myalgias
-Non-productive cough
-HA

28

What is the viral family of influenza?

RNA orthomyxovirus

29

What age group is most affected with the flu?

School ages children

30

How long are children infectious for after ssx appear? What about immunocompromised children?

10 days

weeks to months if immunocompromised

31

Is the flu abrupt or gradual onset?

Abrupt

32

How often do febrile seizures occur in children hospitalized for the flu?

20%

33

What is the most common complication of the flu?

Strep pneumoniae

34

What is Reye syndrome?

Systemic disorder of mitochondrial function that occurs during of after a viral illness

35

What are the two viruses that can set off Reyes syndrome?

Flu
varicella

36

What is the treatment for Reyes syndrome?

Supportive

37

What are the metabolic changes with Reyes syndrome?

Hypoglycemia
Hyperammonemia
LFTs increased

38

How do you diagnose the flu?

Rapid nasal swab

39

How do you treat the flu?

Supportive

40

True or false: you should vaccinate ALL children with underlying chronic disease for the flue

True

41

What age is appropriate for the flu?

6 months and older

42

What are the ssx of bronchiloitis (RSV)?

Rhinorrhea
Sneezing
Sudden worsening of a cough

43

What viral family is RSV?

Paramyxoviridae

44

What are the two proteins on RSV virus and what are their functions?

G protein -attachment
F- fusion protein

45

What is RSV?

Bronchiolitis

46

By what age are virtually all children have an infection with RSV?

2 years

47

How long can RSV survive on fomites?

12 hours

48

What are the signs of RSV?

Tachypnea rhinorrhea
Low grade fever
OM

49

What is the pathognomonic finding of a CXR with RSV?

Segmental atelectasis
Air trapping

50

What is the treatment for RSV?

Maintain nasal airway
Supportive

51

What is the only thing you should do with RSV?

Supportive


(no CXR, albuterol, viral swabs etc)

52

Cough, tachypnea, bilateral conjunctivitis, without fever under 4 months of age = ?

Chlamydia trachomatis

53

What percent of children born to mothers with chlamydia infections will get pneumonia?

30-50%

54

What is the usual presentation of chlamydia trachomatis (age, ssx)?

1-3 months old
Cough, tachypnea, NO fever

55

What are the CXR findings with chlamydia trachomatis?

Hyperinflation, but no significant findings

56

What are the CBC findings with chlamydia trachomatis?

WNL but with peripheral eosinophilia

57

**What is the treatment for chlamydia trachomatis?**

**Oral Erythromycin**

58

High fever, cough, lethargy, tachypnea, low oxygen sat, L shift CBC, = ?

Strep Pneumoniae

59

What does the CXR show with strep pneumonia in kids?

Lobar or segmental consolidation

"round" pneumonia

60

What does the CBC should with pneumonia?

Leukocytosis with a L shift

61

What is the treatment for strep pneumonia in children?

Ampicillin

62

When are IV abx indicated for strep pneumonia?

If severe

63

What are the ssx of mycoplasma pneumonia? What age?

Mild LRTI ssx
Usually school age

64

How common is mycoplasma pneumonia in children less than 3-4 yo?

Rare

65

How do you diagnose mycoplasma pneumoniae?

Cold agglutinins test
Mycoplasma titers

66

What is the most common symptom with mycoplasma pneumonia?

Intractable nonproductive cough

67

What is the abx of choice for mycoplasma pneumonia? Why?

Macrolides
lack a cell wall

68

Why treat mycoplasma pneumonia with a macrolide and cephalosporin?

Macrolide for mycoplasma
Cephalosporin for strep pneumonia