Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBBS 3: Pediatrics > URTI and Upper Respiratory Problems > Flashcards

URTI and Upper Respiratory Problems Flashcards

1
Q

Common respiratory tract infections?

A
  1. Rhinosinusitis
    e.g. Rhinoviruses, coronaviruses, HMPV
  2. Acute Pharyngitis
    - 30% of URTI (viruses and GABHS)
  3. AOM
    e.g. S. pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis
  4. Retropharyngeal, Lateral pharyngeal (parapharyngeal) abscesses
  5. Tonsilitis, adenoiditis
  6. Acute inflammatory Upper airway obstruction
    e.g. Croup, epiglottitis, laryngitis, Bacterial tracheltis
    Note: Children <2yr in child-care centers have more URTI and LRTI than do age-matched children not in child care.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is otitis media?

A

Inflammation of the middle ear
- One of the most common childhood infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Characteristics of otitis media?

A

Bulging erythematous tympanic membrane with impaired mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How to classify otitis media?

A
  1. Acute (less than 14 days)
  2. Chronic (more than 14 days)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment of otitis media?

A
  1. Amoxicillin
  2. Ear wicking for chronic supurative otitis media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications of otitis media?

A
  1. Local - Hearing impairment, mastoiditis
  2. Intracranial - Meningitis, epidural abscess, subdural abscess, focal encephalitis, brain abscess, sigmoid sinus thrombosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Importance of a patent airway in newborns?

A

Most newborn infants are obligate nasal breathers
1. Nasal obstruction presenting at birth may be life-threatening
2. Nasal passages contribute 50% of the total resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the causes of nasal congestion with obstruction in the 1st year of life?

A
  1. Viral or bacterial infection
  2. Enlarged adenoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is nasal flaring?

A

a sign of respiratory distress
- reduces the resistance to inspiratory airflow through the nose and can improve ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the nasal airway in children?

A
  • Internal nasal airway doubles in size in the 1st 6months of life
  • The lumen of an infant’s or child’s airway is narrow
  • Airway resistance is inversely proportional to the 4th power of the radius
  • The area just below the vocal cords is the narrowest portion in <10year olds
  • Minor reductions in cross-sectional area due to mucosal edema or other inflammatory processes cause an exponential increase in airway resistance and a significant increase in the work of breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Supportive care in airway obstruction?

A
  1. Bulb syringe and saline nose drops
  2. Topical nasal decongestants, and antibiotics, when indicated, improve symptoms in affected infants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of obstruction of the pharyngeal airway?

A

Enlarged tonsils, adenoids, tongue, or syndromes with midface hypoplasia
- Worse during sleep than during waking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe features of laryngeal, tracheal or bronchial obstruction?

A

Worse when awake, exacerbated by exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is choanal atresia (bilateral)?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms of choanal atresia?

A

Respiratory distress and cyanosis, worse with feeding - relieved by crying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diagnosis of choanal atresia?

A
  1. Inability to pass a catheter through each nostril 3-4cm into the nasopharynx.
  2. Direct visualization with fiberoptic rhinoscopy.
  3. CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of choanal atresia?

A

Oral airway. Drilling. Stents are left in place for weeks after the repair to prevent closure or stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Inflammation of tonsils and adenoids?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Symptoms of inflammation of tonsils and adenoids?

A
  1. Chronic mouth breathing
  2. Nasal obstruction
  3. Hyponasal speech
  4. Hyposmia and decreased appetite
  5. Poor school performance
    (Rarely: symptoms of right-sided heart failure)
  6. Nighttime symptoms consist of loud snoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of tonsils and adenoids?

A

Tonsillectomy and adenoidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who usually gets foreign body obstruction of upper airway? Why?

A

Risk greatest in 6 months-4 years old
History of:
1. Children running with food
2. Small toy/objects in mouth
3. Poor household “childproofing”
4. Older siblings feeding younger children age-inappropriate food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs of foreign body obstruction of upper airway?

A

Acute onset of cyanosis, drooling, cough and stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sign of foreign body obstruction of lower airway?

A
  1. Abrupt onset of cough, wheezing or respiratory distress
    - Signs may decrease of disappear with time
  2. May cause bronchiectasis if untreated
    Note: Suspect LRI obstruction in chronic or recurrent “pneumonias”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is heard on auscultation of a patient with foreign body obstruction of lower airway?

A
  1. Asymmetric breath sounds or
  2. Localized wheezing or
  3. Localized rales/crepitations
25
Q

Where are objects commonly lodged?

A

in the right main bronchus because of its straight course.

26
Q

What is foreign body aspiration?

A
27
Q

Management of FB aspiration?

A
  1. Removal by rigid bronchoscopy
    Followed by:
  2. Adrenaline nebulizations
  3. physiotherapy
28
Q

Bacterial causes of airway obstruction?

A
  1. Diphtheria
  2. Bacterial tracheitis
  3. Epiglottitis
  4. Mycoplasma pneumoniae (atypical)
29
Q

Viral causes of airway obstruction?

A
  1. Parainfluenza viruses (types 1, 2, and 3)
    -75% of cases
  2. Influenza A and B
  3. Adenovirus
  4. Respiratory syncytial virus (RSV)
  5. Measles.
30
Q

What is croup?

A
31
Q

Clinical signs of croup?

A

Stridor, barking cough, mild fever, hoarseness, worse at night, URI

32
Q

What age do children get croup?

A

6 mo – 3 yr

33
Q

Causes of croup?

A

Parainfluenza (other viruses)

34
Q

Management of croup?

A
  1. Adrenaline nebulization ± brief steroid use
    - Oral or inhaled corticosteroids may be administered to decrease the severity of symptoms and potentially avoid hospital admission
  2. Intubation is necessary when disease is severe. 3. In children with atypical, prolonged, or recurrent symptoms refractory to medical therapy, bronchoscopy may be helpful for further evaluation.
35
Q

What is epiglottitis?

A
36
Q

Clinical signs of epiglotittis?

A

Abrupt onset, toxic, anxious, high fever, drooling, dysphagia rare cough

37
Q

Age group that usually gets epiglottitis?

A

3 - 7 years

38
Q

Causes of epiglotittis?

A

H influenza B

39
Q

Diagnosis and management of epiglottitis?

A

Direct visualization by experienced clinician, intubation, i.v antibiotics, ICU

40
Q

Retropharyngeal abscess?

A
41
Q

Clinical signs of retropharyngeal abscess?

A

Acute pharyngitis, high fever, toxic, dysphagia, hyperextension of head, drooling

42
Q

Causes of retropharyngeal abscess?

A

Group A strep, staph aureus, Anaerobes

43
Q

Diagnosis of retropharyngeal abscess?

A

Visualization, lateral neck x-ray, i.v antibiotic, surgery

44
Q

Clinical signs of retropharyngeal abscess?

A

Sudden onset of fever, stiff neck, dysphagia, and occasionally stridor
- Follows a recent pharyngitis or upper respiratory tract infection

45
Q

Bacterial tracheitis?

A
46
Q

Clinical signs of of bacterial tracheitis?

A

Croup-like illness, high fever, toxic

47
Q

What age group ususally gets bacterial tracheitis?

A

< 6 years

48
Q

Causes of bacterial tracheitits?

A

S. aureus

49
Q

Diagnosis of bacterial tracheitis?

A

Visualization, lateral neck x-ray, nebulized adrenaline, i.v antibiotics

50
Q

Exudatice tracheitis?

A

Affected children are usually older (6-10years)
More ill than those with standard croup
Causes: Staphylococcus aureus,Hib, pneumococcus

51
Q

Differential diagnosis of URT obstruction?

A

Bacterial tracheitis
Diphtheritic croup
Measles Croup
Foreign body
Retropharyngeal or peritonsillar abscess
Extrinsic compression (laryngeal web, vascular ring)
Intraluminal obstruction (laryngeal papilloma, subglottic hemangioma
Angioedema (anaphylaxis)

52
Q

Laryngeal papillomas?

A

Most common respiratory tract neoplasms in children
Occurs in 4.3/100,000
They are warts—benign tumors—caused by the human papillomavirus (HPV)
50% of recurrent respiratory papillomatosis (RRP) occur in children <5yr
67% RRP have mothers with condylomata during pregnancy or parturition
The risk for transmission is ∼1/500 vaginal births in mothers with active condylomata

53
Q

Clinical presentation of laryngeal papillomas?

A

Chronic hoarseness in infants
Most occur in the larynx (31% nose, pharynx, trachea, bronchi, and lungs)
Progressive hoarseness and communication difficulties
Respiratory distress develops
Obstructive sleep apnea

54
Q

Treatment of laryngeal papillomas?

A

Treatment of RRP is endoscopic surgical removal

55
Q

Examples of Congenital Causes Airway Obstruction?

A

Laryngomalacia
Congenital Subglottic stenosis
Vocal cord paralysis
Congenital laryngeal webs and atresia
Congenital subglottic haemangioma

56
Q

Laryngomalacia?

A

The most common congenital laryngeal anomaly
The most common cause of stridor in infants and children
60% of congenital laryngeal anomalies with stridor are due to laryngomalacia
Stridor is exacerbated by any exertion: crying, agitation, or feeding
Stridor results from the collapse of supraglottic structures inwards during inspiration
Symptoms usually appear within the first 2wk of life and increase in severity for up to 6mo
Gradual improvement can begin at any time

57
Q

Treatment of laryngomalacia?

A

Expectant observation - suitable for most infants
Most symptoms resolve spontaneously
Endoscopic supraglottoplasty for few patient with severe obstruction

58
Q

Differential diagnosis of stridor in an infant?

A

Laryngomalacia
Laryngeal cyst, haemangioma or web
Laryngeal stenosis
Vocal cord paralysis
Vascular ring
Gastro-oesophageal reflux
Hypocalcaemic (laryngeal tetany)
Respiratory papillomatosis
Subglottic stenosis

MBBS 3: Pediatrics (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions