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42 Cards in this Set

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  • Back
What is the most common cause of death in children under 5?
Acute resp infection (Pneumonia)
The top 4 causes of childhood deaths?
Pneumonia
Diarrhea
Malaria
Malnutrition
How many childhood deaths per year from pneumonia?
2 million
How much higher is infant death rate from ARI in developing world?
10 times higher
How much higher is childhood death rate from ARI in developing wourld?
18-75 times higher
What percent of childhood ARI deaths are preventable by immunization?
25%
What percent of ARI deaths are from measles?
15%
Do epidemiology rates for same infection differ based on location on earth?
Yes
10 Risk factors for ARI
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
Causes of URI
Usually viral
Group A strep
Diphtheria
Epiglottitis (from H. influenza b)
Croup (from parainfluenza and adenovirus)
What causes scarlet fever?
Group A strep
(scarlatina rash, pharyngitis, strawberry tongue)
What causes epiglottitis?
Commonly H. influenza B
What causes croup (laryngotracheobronchitis)?
Parainfluenza
Adenovirus
What causes lower respiratory infections?
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)
What infection causes pneumonia in infants < 3 mos, passed from mom?
Chlamydia trachomatis
What are the viruses that cause Lower Resp Infections?
RSV 15-20%
Parainfluenza 7-10%
Adenoviruses 2-4%
Influenza 2-4%
Human metapneumovirus
What is the severe lung problem associated with measles?
Necrotizing bronchitis/pneumonia
When is bacterial superinfection seen in viral infection?
In adults
In malnourished children
Associated with measles, flu and RSV
What lower resp infections common in HIV?
Strep pneumonia
H influenza
Pneumocystis carinii (PCP)
What are the common bacterial infections found in pneumonia?
H influenza 27%
Strep pneumo 27%
Staph 17%
Other
Same worldwide
How to get a sputum from a child?
Morning gastric washing
Possible pharyngeal aspirate after inducing coughing
Lung aspirate (needle)
Can you use a PPD after BCG?
Yes
What percentage of blood culture positive in bacterial pneumonia?
33%
What is the sensitivity of lung/pleural aspirate in dx bacterial pneumonia?
80%
Is serology helpful for diagnosing pneumonia?
No, just for studies to track
Are ELISAs helpful for dx bacteria/viruses in LRI?
Yes
What LRI virus is found in lab by immunofluourescence?
RSV -- immunofluorescence
What is the problem with the pneumococcus vaccine?
It covers 13 serotypes...must be updated as other serotypes start to dominate
Does breastfeeding reduce ARI rates?
Yup
How does WHO define severe LRI, and how treat?
Retractions, tachypnea
Inability to drink
Abx and refer to hosptial for parental abx
How does WHO define moderateLRI, and how treat?
RR >40 but no retractions: antibiotics at home
How does WHO define mild ari and how treat?
No abx, observe at home
What drugs are recommended by WHO for LRI treatment?
Bactrim (better for H. influenza)
Amoxicillin (better for Strep pneumonia)
Oral chloramphenicol
Does the WHO ARI management protocol work?
Yes, decline in deathrates
How to prevent LRI?
Eliminate malnutrition
Eliminate vitamin deficiency
(Vit A? helps in measles...may increase rates of dz in well nourished)
Breast feeding
Handwashing
Immunizations
Maternal immunizations
In developing world, what percent of kids with pneumonia are also positive for malaria?
40%
Is this xray common for virus or bacteria:

Lobar/segmental infiltrate
Bacteria
TB
Is this xray common for virus or bacteria:

Abscess
Bacterial, commonly anaerobe of FB aspiration
Is this xray common for virus or bacteria:

Pneumonia with pleural effusion
Bacterial
TB
Is this xray common for virus or bacteria:

Bronchopneumonia (thickened central airways/lymphad)
Mostly viral
Maybe mycoplasma, chlamydia, pertussis, others...)
Is this xray common for virus or bacteria:

Diffuse intersticial pneumonitis
Viruses
Chlamydial pneumonia
PCP
What two vaccine preventable diseases commonly have pneumonia as complication?
Measles
Sometimes varicella