Glossary of respiratory disorders, pediatrics

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

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