- paroxysmal/spasmodic cough, usually ends in prolonged, high-pitched, ? inspiration?
- Tx: ?
whooping
crowing
azithro
- brassy cough?
- can spread to vertebra aka? or epiphyses of long bones
- Dx?
- CXR?
- Tx?
TB Pott's Dz TST hilar lymphadenopathy isoniazid, rifampin
viral- commonly ?, influenza, metapneumovirus, parainfluenza, adeno
bacterial- s. pneum, h flu, chlamydia pneum (? cough), mycoplasma pneum
pneumonia
RSV
staccato
pneumonia- ? varies by age Sx: viral? bacterial? Dx: Tx: Px: ?
- CAP
- viral: wheezing, fever, cough, retractions, staccato/paroxysmal cough, muscle soreness
- bacterial: rales, dec breath sounds, retractions, ill-appearing, fever, CP, N/V, consolidation (ego phony, dullness to percuss)
- CXR- multilobar infiltrates (s. pneum, legionella); interstitial pneum (viral/mycoplasma)
- empiric a/b, antivirals, SUPPORTIVE- fluids, antipyretics, analgesics, O2 prn
- <2 PCV & Hib; adult PPV & influenza
wheezy bronchitis <24 mo., often epidemic, MC 3-6mo in Jan-Feb?
bronchiolitis
bronchiolitis
Sx: rhinitis w/ ?, tachypnea, wheezing, rales, retractions, nasal flaring, rales, retractions, nasal flaring
Dx: clinical, pulseox, CXR prn, for RSV (also?)
Tx: ?
Px: prevention in high-risk infants?
inc resp distress
EZ-RSV; pneumonia- NASAL SWAB
supportive
Synagis
- adenovirus (<2), RSV, parainfluenza, rhinovirus, coronavirus
- Sx: ? cough preceded by viral URI, nontoxic, low-grade fever, diffuse ? clear after cough
- Dx:
- Tx?
- excellent Px
bronchitis nonproductive rhonchi clinical supportive
croup - MC type? organism? Sx: ? prodrome, ?, spasmodic cough (worse at night), hoarseness, stridor, nasal flaring, retractions, tachypnea Dx: ? Tx: Px:
- laryngotracheobronchitis, parainfluenza virus**; others: RSV, influenza, A&B, adenovirus, enterovirus, rhinovirus
- barking
- clinical, steeple sign
- antipyretics, hydration, nebulized racemic epinephrine q2h, c/s w/in 1st 24hrs
- excellent, most self-lmtd, duration <5d
epiglottitis- in 2-6 yrs it’s ?
- h flu type B, s pyogenes, s pneum, s aureus (includes MRSA)
- Sx:
- Dx:
- Tx:
- Px: excellent w/ protocol- critical care, otolaryngology, anesthesia, & peds
supraglottitis
- acute severe sore throat, odynophagia, dysphagia, high fever, drooling, inspiratory stridor, & tripod position***, FATAL asphyxia
- beefy red, stiff, edematous epiglottitis; thumb sign
- airway protection, cefotaxime (claforan), ceftriaxone (rocephin), vancomycin
CF:
- most common?
- gene mutation?
- Sx:
- Dx:
- Tx:
- Px:
- lethal genetic dz
- 7q31.1
- chronic/recurrent cough, sputum prod, dyspnea, and wheezing, recurrent pneumonia, clubbing, CXR: bronchiectasis and scarring
- *sweat test >60mEq/L, 66% *gene mutation F508, spirometry obstructive, panc insuff.
- supportive
- median survival age - 35 yrs
LRI in 1-6 mo or 6mo-5yrs caused by?
RSV
pneumonia MC virus?
RSV (others- parainfluenza, influenza, adeno)
greater than 50% of infants and children w/ CXR and mod-severe pulm TB have no ? discovered by ? and ?
physical findings
contact tracing, PPD (TST)
Bronchiectasis
-chronic cough producing? during?
copious thick, tenacious purulent sputum, infxn
50% CF have ? on chromosome 7 DELETED
50% have acute or persistent ?
Dx:?
F508
respiratory Sx
sweat chloride test
sudden onset of cough, wheeze, and dyspnea?
FBA
bronchogenic cysts
-Tx- Sx? aSx?
surgical excision for both, but in aSx only if there is a 75-90% infection rate!
pneumonia from acute bronchitis Sx on auscultation?
egophony
