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43 Cards in this Set
- Front
- Back
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what respiratory disorder in children is often precipitated by a viral URI?
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otitis media
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what congenital disorder increase otitis media infxn risk in children?
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1. down's syndrome
2. cleft palate 3. prevents eustachian tube drainage and increases the risk of infxn |
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what are si/sx of otitis media?
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1. ear pressure
2. decreased hearing 3. fever 4. erythema 5. decreased mobility of tympanic membrane 6. TM bulging 7. a meniscus of fluid behind the TM (effusion) |
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what should you suspect with erythema dn decreased mobility of the TM in a child?
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1. otitis media
2. caused by: strep pneumo, H. flu or moraxella or RSV |
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what are common causes of otitis media?
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1. strep pnemo
2. H. influenzae 3. Moraxella 4. viral infxn (RSV) |
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what is tx for otitis media?
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1. amoxicillin (1st line)
2. amoxicillin/clavulanate (augmentin; 2nd line) |
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what is tx for chronic effusions c/ otitis media?
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1. surgical tube placement
2. may be required for chronic effusions 3. to prevent developmental delay secondary to hearing loss |
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what is commonly seen in children with peak incidence at 6 mo (or <2yr) with >50% d/t RSV?
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Bronchiolitis!
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what is the m/c peak incidence for bronchiolitis in children?
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1. peak at 6 mon
2. common age <2yr |
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what is m/c cause of bronchiolitis in children?
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1. >50% d/t RSV
2. parainfluenzae 3. adenovirus |
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what are si/sx of bronchiolitis in children?
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1. mild rhinorrhea
2. fever progressing to cough 3. wheezing c/ crackles 4. tachypnea 5. nasal flaring 6. decreased appetite |
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how do you dx bronchiolitis in children?
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1. by culture
2. or antigen detection of nasopharyngeal secretions |
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what is tx for bronchiolitis in children?
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1. bronchodilators
2. oxygen as needed |
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what are m/c causes of croup?
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(laryngotracheobronchitis)
1. parainfluenza 2. influenza 3. RSV 4. Mycoplasma |
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what are si/sx of croup?
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(laryngotracheobronchitis)
1. presents in fall and winter 2. 3 mon-3 yr olds 3. barking cough 4. inspiratory stridor 5. sx worse at night 6. hoarse voice 7. precede by URI 8. neck x-ray= "steeple sign" |
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what presents with neck x-ray "steeple sign" in 3 mon-3 yr olds c/ barking cough and inspiratory stridor?
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1. croup (laryngotracheobronchitis)
2. parainfluenza, RSV, mycoplasma |
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what is tx for croup?
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(laryngotracheobronchitis)
1. oxygen 2. cool mist 3. racemic epinephrine (Epi) and steroids if severe 4. ribavirin may be used for immunocompromised |
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what should you think of in a child c/ fulminant inspiratory stridor, drooling, dysphagia and leaning forward?
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1. Epiglottitis!!
2. H. flu (type B) 3. med emergency!! |
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what is m/c cause of epiglottitis?
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H. influenzae type B
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what are si/sx of epiglottitis?
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1. fulminant inspiratory stridor
2. drooling 3. sitting leaning forward 4. dysphagia 5. "hot potato" voice 6. "thumb print" sign on lateral neck film 7. cherry-red epiglottitis on endoscopy |
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what presents with "thumb print sign" on lateral neck film"
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1. epiglottitis
2. H. flu 3. med emergency |
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how do you tx epiglottitis?
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1. examine pt in OR
2. intubate as needed 3. ceftriaxone |
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what presents with inspriatory stridor, high fever, and toxic appearing?
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1. bacterial tracheitis
2. staph and strept spp. |
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what is m/c cause of bacterial tracheitis?
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1. staphylococcus and
2. streptococcus spp. |
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what are si/sx of bacterial tracheitis?
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1. inspiratory stridor
2. high fever 3. toxic appearing 4. leukocytosis |
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what is tx for bacterial tracheitis?
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1. nafcillin or
2. ceftriaxone |
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what presents c/ inspiratory stridor, wheezes, decreased breath sounds, dysphagia and unresolved pneumonia in a child?
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1. foreign-body aspiration
2. usually presents after age 6 mon |
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what are si/sx of foreign-body aspiration?
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1. usually after age 6 mon (need to grasp object to inhale it)
2. inspiratory stridor (chronic) 3. wheeze 4. decreased breath sounds 5. dysphagia 6. unresolved pneumonia 7. hyperinflation on CXR of affected side |
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what is seen on CXR of foreign-body aspiration?
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1. hyperinflation on affected side
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what is tx for foreign-body aspiration?
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1. endoscopic or
2. surgical removal |
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what are m/c causes of pneumonia in newborns?
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1. streptococcus agalactiae (group B strep)
2. gram negative rods 3. chlamydia trachomatis |
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what are m/c causes of pneumonia in infants?
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1. S. pneumo
2. H. flu 3. Chlamydia 4. Staph aureus 5. Listeria monocytogenes 6. viral |
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what are m/c causes of pneumonia in preschoolers?
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1. RSV
2. other viruses 3. Mycoplasma |
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what are m/c causes of pneumonia in adolescents?
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1. S. pneumo
2. Mycoplasma 3. Chlamydia |
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what are si/sx of pneumonia?
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1. cough (productive in older children)
2. fevers 3. nausea/vomiting/diarrhea 4. tachypnea 5. grunting 6. retractions 7. crackles |
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what is the first stage of pertussis?
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1. Catarrhal stage
2. 1-2 wks of cough, rhinorrhea, wheezing |
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what is the second stage of pertussis?
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1. paroxysmal stage
2. 2-4 wk of paroxysmal cough c/ "whoops" |
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what is the third stage of pertussis?
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1. convalescent stage
2. 1-2 wks of persistent chronic cough |
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what pneumonia organism causes classic "staccato cough" and conjuctivitis c/ afebrile pts?
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Chlamydia!!
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what pneumonia organism causes wet cough, often with audible wheezes?
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RSV
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what pneumonia organism may be a/c skin lesions?
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Staphylococcus
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what is the dx for pneumonia?
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1. rapid antigen detection or
2. culture of secretions 3. CXR showing infiltrates |
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what is tx for pneumonia?
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1. infants get hospitalized
2. bronchodilators and o2 for RSV 3. erythromycin for atypical dz (Chlamydia, Mycoplasma) 4. cefuroxime for bacteria |
