Respiratory Medicine - Bronchiolitis Flashcards Preview

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Flashcards in Respiratory Medicine - Bronchiolitis Deck (7)
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1
Q

What is Bronchiolitis?

A
  1. Bronchiolitis is a condition characterised by acute bronchiolar inflammation.
  2. Respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases.
  3. NICE released guidelines on bronchiolitis in 2015
2
Q

Epidemiology of Bronciolitis?

A
  1. Most common cause of a serious lower respiratory tract infection in < 1yr olds (90% are 1-9 months,
  2. With a peak incidence of 3-6 months).
  3. Maternal IgG provides protection to newborns against RSV
    higher incidence in winter
3
Q

Causes of Bronciolitis

A
  1. Respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases
  2. Other causes: mycoplasma, adenoviruses
  3. May be secondary bacterial infection
    more serious if bronchopulmonary dysplasia (e.g. Premature), congenital heart disease or cystic fibrosis
4
Q

Clinical signs of Bronchiolitis?

A
  1. Coryzal symptoms (including mild fever) precede:
  2. Dry cough
  3. Increasing breathlessness
  4. Wheezing, fine inspiratory crackles (not always present)
  5. Feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission
5
Q

What are the NICE recommendations for immediate referral (usually by 999 ambulance)?

A
  1. Apnoea (observed or reported)
  2. Child looks seriously unwell to a healthcare professional
  3. Severe respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minute
  4. Central cyanosis
  5. Persistent oxygen saturation of less than 92% when breathing air.
6
Q

NICE recommend that clinicians ‘consider’ referring to hospital if any of the following apply?

A
  1. A respiratory rate of over 60 breaths/minute
  2. Difficulty with breastfeeding or inadequate oral fluid intake (50-75% of usual volume ‘taking account of risk factors and using clinical judgement’)
  3. Clinical dehydration.
7
Q

Investigation and Management?

A
  1. Immunofluorescence of nasopharyngeal secretions may show RSV
  2. Humidified oxygen is given via a head box