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42 Cards in this Set
- Front
- Back
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What is the most common cause of death in children under 5?
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Acute resp infection (Pneumonia)
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The top 4 causes of childhood deaths?
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Pneumonia
Diarrhea Malaria Malnutrition |
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How many childhood deaths per year from pneumonia?
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2 million
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How much higher is infant death rate from ARI in developing world?
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10 times higher
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How much higher is childhood death rate from ARI in developing wourld?
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18-75 times higher
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What percent of childhood ARI deaths are preventable by immunization?
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25%
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What percent of ARI deaths are from measles?
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15%
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Do epidemiology rates for same infection differ based on location on earth?
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Yes
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10 Risk factors for ARI
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Young age
Premature/low birth weight Malnutrition Lack of Breast feeding Environment (smoke) Exposure (crowding/many sibs) Low Socioeconomic status Inadequate access to medical care Prev hx pneumonia/wheezing HIV |
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Causes of URI
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Usually viral
Group A strep Diphtheria Epiglottitis (from H. influenza b) Croup (from parainfluenza and adenovirus) |
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What causes scarlet fever?
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Group A strep
(scarlatina rash, pharyngitis, strawberry tongue) |
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What causes epiglottitis?
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Commonly H. influenza B
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What causes croup (laryngotracheobronchitis)?
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Parainfluenza
Adenovirus |
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What causes lower respiratory infections?
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Strep pneumonia
H influenza B Staph aureus Mycoplasma pneumonia Chlamydia trachomatis Pertussis Diphtheria TB Virus -- Respiratory Syncytial virus, parainfluenza virus, adenovirus, influenza, human metapneumovirus Measles HIV/AIDS Parastiic (geohelminths, malaria, filaria, cysts) |
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What infection causes pneumonia in infants < 3 mos, passed from mom?
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Chlamydia trachomatis
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What are the viruses that cause Lower Resp Infections?
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RSV 15-20%
Parainfluenza 7-10% Adenoviruses 2-4% Influenza 2-4% Human metapneumovirus |
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What is the severe lung problem associated with measles?
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Necrotizing bronchitis/pneumonia
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When is bacterial superinfection seen in viral infection?
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In adults
In malnourished children Associated with measles, flu and RSV |
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What lower resp infections common in HIV?
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Strep pneumonia
H influenza Pneumocystis carinii (PCP) |
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What are the common bacterial infections found in pneumonia?
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H influenza 27%
Strep pneumo 27% Staph 17% Other Same worldwide |
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How to get a sputum from a child?
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Morning gastric washing
Possible pharyngeal aspirate after inducing coughing Lung aspirate (needle) |
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Can you use a PPD after BCG?
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Yes
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What percentage of blood culture positive in bacterial pneumonia?
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33%
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What is the sensitivity of lung/pleural aspirate in dx bacterial pneumonia?
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80%
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Is serology helpful for diagnosing pneumonia?
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No, just for studies to track
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Are ELISAs helpful for dx bacteria/viruses in LRI?
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Yes
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What LRI virus is found in lab by immunofluourescence?
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RSV -- immunofluorescence
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What is the problem with the pneumococcus vaccine?
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It covers 13 serotypes...must be updated as other serotypes start to dominate
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Does breastfeeding reduce ARI rates?
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Yup
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How does WHO define severe LRI, and how treat?
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Retractions, tachypnea
Inability to drink Abx and refer to hosptial for parental abx |
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How does WHO define moderateLRI, and how treat?
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RR >40 but no retractions: antibiotics at home
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How does WHO define mild ari and how treat?
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No abx, observe at home
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What drugs are recommended by WHO for LRI treatment?
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Bactrim (better for H. influenza)
Amoxicillin (better for Strep pneumonia) Oral chloramphenicol |
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Does the WHO ARI management protocol work?
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Yes, decline in deathrates
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How to prevent LRI?
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Eliminate malnutrition
Eliminate vitamin deficiency (Vit A? helps in measles...may increase rates of dz in well nourished) Breast feeding Handwashing Immunizations Maternal immunizations |
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In developing world, what percent of kids with pneumonia are also positive for malaria?
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40%
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Is this xray common for virus or bacteria:
Lobar/segmental infiltrate |
Bacteria
TB |
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Is this xray common for virus or bacteria:
Abscess |
Bacterial, commonly anaerobe of FB aspiration
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Is this xray common for virus or bacteria:
Pneumonia with pleural effusion |
Bacterial
TB |
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Is this xray common for virus or bacteria:
Bronchopneumonia (thickened central airways/lymphad) |
Mostly viral
Maybe mycoplasma, chlamydia, pertussis, others...) |
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Is this xray common for virus or bacteria:
Diffuse intersticial pneumonitis |
Viruses
Chlamydial pneumonia PCP |
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What two vaccine preventable diseases commonly have pneumonia as complication?
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Measles
Sometimes varicella |
