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14 Cards in this Set
- Front
- Back
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What is acquired angioedema-inflammatory reaction? Etiology/Epidemiology?
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reaction of vascular dilation and increased permeability
--Usually from a buildup of bradykinin -- caused by ACE inhibitors, bee stings, transfusions seen in patients with no specific incidence on history, likely taking hypertension medication |
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What is the treatment for angioedema - inflammatory reaction?
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supply O2
epi steroids antihistamines (H1 and H2) (not necessarily IgE mediated) |
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What is the Etiology of hereditary angioedema - inflammatory reatction? Pathogenesis? Tx?
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Type 1 - AD deficiency of C1 esterase inhibitor
Type 2 - nonfunctional C1 esterase inhibitor characterized by recurrent mucocutaneous edema around face, mouth and throat Tx - danazol, treat acute attacks with c1 esterase replacement |
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20 mo, healthy, woke up fine, but during the day developed fever, SOB, lethargy, difficulty swallowing, and slobbering.
Nostrils flared, scared appearing. DDx? Dx? |
DDx: Infection:
croup, pneumonia, abscess blocking airway Asthma Foreign body Allergic reaction Dx: Acute epiglottis |
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20 mo, healthy, woke up fine, but during the day developed fever, SOB, lethargy, difficulty swallowing, and slobbering.
Nostrils flared, scared appearing. What to do? What NOT to do? |
Do: Head/neck xray
Take to OR, give anesthesia, Inubate or do scope |
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Etiology and Presentation of Acute Epiglotitis
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used to be almost exclusively H flu
now think Group A hemolytic STEP usually sudden and rapid, with high fever, drooling, respiratory distress, dysphagia, tripod body position |
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Management of acute epiglotitis
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do NOT manipulate child
xray on parents lap if you have to This is a medical emergency, so trach if you have to step 1 - establish airway step 2 - blood culture Step 3 - start ceftriaxone, steroids, and do other labs - keep intubated for few days |
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How do you differentiate Acute Epiglotits vs. Croup
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age - younger in acute epiglotitis toxicity
rapidity - faster in acute epiglotitis cough - present in Croup |
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18 mo, choked eating MandM's and drinking soda 6 days ago.
xrays were done, and child was sent home. however, child is still coughing, and wheezing. DDx? Dx? Epidemiology |
foreign body obstruction
do not back-blow or finger sweep male, toddlers, most common |
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Offending agents for foreign body obstructions
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vegetables
penuts safety pins plastics (radiolucent) Suspicion is key in Dx |
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Why more common in children?
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posterior dentition not developed
incomplete protective swallowing mechanisms symptoms may disappear, but are likely to return |
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Importance of location in foreign body obstruction
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larynx - hoarsness, stridor (items usually flat, thin)
trachea - audible slap/thud. lots of wheezing bronchial - expiratory wheeze (Xrays can be inconclusive... if you suspect - then look!) |
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23 mo, history of neck swelling and drooling over last 24 hours.
patient has had URI sickness, feverish, stick neck, tilted neck, sore throat for 2 days. anorexia irritable child, mass in right neck, rotates head to left, cant open mouth, lots of mucus, bulge in the back of the throat. DDX? Dx? |
retropharyngeal abscess
caused by infection from lymphatic chains run through this space |
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Epidemiology, complications, pathology, and treatmnet of retropharyngeal abscess
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6 months to 6 years
becomes fibrotic and atrophies after the age of 6 can cause airway obstruction, and can ruptures and spread. mostly G+/anarobes group A BH Strep staph aureus bacteroides if small, give fluids and AB's, observe if large - incise and drain w// AB's |
