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12 Cards in this Set
- Front
- Back
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What is the most sensitive finding for pneumonia in an infant and how do you identify it?
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Tacypnea; by retractions
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What are retractions and why are they noticeable?
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inspiratory retractions of the more compliant parts of the chest, can be sub- or inter-costal, above the thoracic inlet(supraclavicular and suprasternal); easily seen because of children's lower mass and greater chest wall compliance;
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How are retractions noticed in a physical exam?
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those w/suprasternal retractions can have downward movement of the trachea felt on palpation; nasal flaring; most obvious are SCM ans scalene muscle contractions
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What would a baby have nasal flaring on physical exam?
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they're in respiratory distress and nasal flaring widens nasal aperture and reduces flow resistance
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What is the most common condition that predisposes children to get pneumonia and why?
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Viral URI because it destroys resp epithelium that is a cellular barrier, thus changing the normal resp tract flora and impairing the mucociliary system, also inhibiting phagocytosis; all of this leads to suppression of the child's mechanisms to remove foreign flora
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What is bronchiolitis?
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usually affects children younger than age 2; 50-70% usually caused by RSV
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How is congenital pneumonia contracted?
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through aspiration, when the fetus aspirates infected amniotic fluid when gasping for air after an asphyxial event; through the genital tract before or after labor hematogenous from infected maternal blood
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When can respiratory distress from congenital pneumonia start?
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at birth or several hours after
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What does the chest xray for congenital pneumonia look like?
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hyaline membrane disease, fluid filled lungs, rarely a lobar infiltrate is seen
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What are signs and labs that would indicate congenital pneumonia?
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shock, poor perfusion, ANC<2000, elevated CRP
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How would you treat congenital pneumonia?
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take a blood culture and start empiric abx amp/gent until etiology is learned
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What are the most likely pathogens for congenital pneumonia?
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E.coli, Listeria, GBS, herpes, Candida
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