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62 Cards in this Set
- Front
- Back
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What is the normal respiratory rate of a child less than 2mo
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<60
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what is the normal RR of a child 2mo-1yo
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<50
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What is the normal RR for a child 1-5yo
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<40
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What is the normal RR for a child 6-8yo
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<30
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What is the def of ACUTE NASOPHARYNGITIS
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self limited viral URI with symptoms for 4-10 days
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what is the incubation period for acute nasopharyngitis? how long to s/s last? when is the peak viral excretion?
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incubation 1-4 days
symptoms 4-10days peak viral excr @ symptomatic phase |
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what are the most common seasons for acute nasopharyngitis/common cold
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fall, late january, late april
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what are possible complications of acute nasopharyngitis/common cold?
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2ndary bacterial infxn
OM pneumonia |
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what is the clinical presentation of the common cold
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LIMITED TO THE NASOPHARYNX
nasal dischg, edematous & erythematous turbinates pharynx erythematous cervical lymphadenopathy fever: more in infants rapid onset with generalized malaise choriza, rhinorrhea (clear-yellow), cough, sneezing, sore throat, watery eyes |
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what is the differential dx of acute nasopharyngitis/common cold
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allergic rhinitis - pale boggy allergic shiners
sinusitis - >10days, facial pressure prodrome of a childhood illness |
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what do crackles represent
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airway opening - fluid in the airways
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what do wheezes represent
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air trapping + obstruction
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what are rhonchi and stridor a/w?
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on the wheeze continuum.
stridor is upper airway obstruction |
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what is the definition of bronchiolitis
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acute viral infection of the small bronchi with lower airway obstruction
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what are the causes of bronchiolitis?
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50% are RSV
others: Parainfluenza Influenza Adenovirus Rhinovirus |
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What is the clinical presentation of bronchiolitis
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prodrome 1-3 days of URI s/s
c/o rhinorrhea, cough, congestion signs: tachypnea, flaring, retracting, cough, mild fever, variable wheezing often moves from upper --> lower respiratory ilness (forced exp, flaring, retracting) |
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how do you dx bronchiolitis
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CXR will show cuffing, hyperinflation, and atelectasis
SpO2 decreased RSV test ABG if severe NP viral culture |
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what is the management plan for bronchiolitis
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Fluid & supportive trt
Bronchodilators Steroids maybe O2 --> admit NO antibiotics |
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definition of LARYNGOTRACHEOBRONCHITIS
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aka CROUP
inflammation of the larynx, trachea, bronchi |
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what age is croup prevalent
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1-3yo (but any age)
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what season is croup common
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late fall/early winter
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what is the cause of croup?
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infection, often viral
Parainfluenza Influenza Adenovirus Coxsackie RSV Mycoplasma influenzae |
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What is the clinical presentation of Croup
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prodrome of initial URI
Symptoms peak at 3-5 days barking cough that leads to hoarseness tachypnea stridor and retractions are possible but the lungs are clear! |
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How is Croup diagnosed
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mostly clinical (barking cough, hoarseness, and clear lungs)
can do a CXR = steeple sign a CBC will show an increase |
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What is the management of Croup
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keep child CALM
cool mist increase fluids steroids and neb epinephrine are controversial NO antibiotics 10% will need hospitalization |
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what are the criteria for hospitalizing kids with croup
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- marked stridor
- hypoxia - cyanosis - retractions at rest |
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what is the definition of bronchitis
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acute inflammation of the upper respiratory epithelium, including the trachea and bronchi
there is NO involvement of the alveoli |
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what are the causes of bronchitis
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primarily VIRAL
- influenza - parainfluenza - RSV - rhinovirus - echovirus can be Bacterial - mycoplasma - strep pneumonia - Haemophilus influenza - diptheria - chlamydia |
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what is the clinical presentation of bronchitis
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preceded by URI
Coarse breath sounds, rhonchi Cough: dry, hacky, nonproductive malaise and rhinitis retrosternal pain and tracheal tenderness |
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how is bronchitis diagnosed?
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history
NO labs can do a CXR - will often be normal |
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what season is croup common
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late fall/early winter
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what is the cause of croup?
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infection, often viral
Parainfluenza Influenza Adenovirus Coxsackie RSV Mycoplasma influenzae |
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What is the clinical presentation of Croup
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prodrome of initial URI
Symptoms peak at 3-5 days barking cough that leads to hoarseness tachypnea stridor and retractions are possible but the lungs are clear! |
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How is Croup diagnosed
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mostly clinical (barking cough, hoarseness, and clear lungs)
can do a CXR = steeple sign a CBC will show an increase |
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What is the management of Croup
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keep child CALM
cool mist increase fluids steroids and neb epinephrine are controversial NO antibiotics 10% will need hospitalization |
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what are the criteria for hospitalizing kids with croup
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- marked stridor
- hypoxia - cyanosis - retractions at rest |
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what is the definition of bronchitis
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acute inflammation of the upper respiratory epithelium, including the trachea and bronchi
there is NO involvement of the alveoli |
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what are the causes of bronchitis
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primarily VIRAL
- influenza - parainfluenza - RSV - rhinovirus - echovirus can be Bacterial - mycoplasma - strep pneumonia - Haemophilus influenza - diptheria - chlamydia |
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what is the clinical presentation of bronchitis
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preceded by URI
Coarse breath sounds, rhonchi Cough: dry, hacky, nonproductive malaise and rhinitis retrosternal pain and tracheal tenderness |
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how is bronchitis diagnosed?
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history
NO labs can do a CXR - will often be normal |
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what is the mgt of bronchitis?
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bronchodilators
inhaled corticosteroids and antibiotics (only if bacterial) |
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define pertussis
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aka whooping cough
prolonged respiratory symptoms leading to paroxysms of coughing with a WHOOP |
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what is the etiology of whooping cough/pertussis?
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acute bacterial infection - Bordatella pertussis
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@what age is pertussis most common?
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less than 1yo
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what are the stages of pertussis/ whooping cough
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1. catarrhal
2. paroxysmal 3. convalescent with an incubation period of 5-21 days |
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is pertussis contagious?
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YES!
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what is the first stage of pertussis
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catarrhal
- lasts 1-2 wks - most infectious - mild cough, coryza, increased lacrimation, low grade fever |
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what is the second stage of pertussis?
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paroxysmal
- lasts 4-6wks - paroxysms of coughing with WHOOP (inspirational) - often vomitting with cough |
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what is the 3rd stage of pertussis?
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convalescent
- lasts 2-3 wks - gradual decrease of whooping |
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how is pertussis diagnosed?
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NP culture
CBC will show lymphcytosis CXR |
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what isthe mgt of pertussis/whooping cough
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refer
erythromycin often hospitalize supportive treat contacts |
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what are the causes of pneumonia in neonates?
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E. coli
Klebsiela Chlamydia |
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what are the causes of pneumonia in 2mo-4-5yo
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RSV
Parainfluenza Influenza A & B Adenovirus Rhinovirus |
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what are the causes of pneumonia in 5+yo
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mycoplasma!!
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what is the clinical presentation of viral pneumonia
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URI s/s
low fever cough gradual onset of resp distress coarse rhonchi general malaise breath sounds: rales, wheezing |
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what is the clinical presentation of bacterial pneumonia
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acute onset
toxic appearance pleural pain abdominal pain decreased breath sounds, no rales dull to percussion |
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what is the difference btw viral and bacterial pneumonia presentation
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bacterial is ACUTE onset, they tend to look worse overall
higher temp with bacterial bacterial will have decreased breath sounds, but no rales viral will present with rales and wheezing and coarse rhonchi with bacterial they may have pleural and abdominal pain. |
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what is the differential for pneumonia (what mimics pneumonia)?
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GER w. aspiration
TEF asthmatic atelectasis pulmonary hemosidarosis |
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how is pneumonia diagnosed
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CXR will show:
- viral - scattered infiltrates and hyperinflation - bacterial - patchy infiltrates and lobar consolidation CBC will show more significant changes with bacterial PNA |
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compare chlamydial vs. mycoplasmal pneumonia
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???
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what is the mgt of viral pneumonia
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if uncomplicated, it is just supportive: hydration, humidity, bronchodilators if needed, closely monitor
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what is the management of bacterial pneumonia
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suspect STREP AND H. INFLUENZA
treat with AZITHROMYCIN or BIAXIN |
