Pediatrics Respiratory HY
Jog memory: steeple sign? Thumb sign? subglottic narrowing?
-croup- parainf, listen to seal bark cough -epiglotitis- cherry red epiglottis thumb sign -tracheitis- trachea irreg margins on xray, croup that has gotten further down
whats the mc cause of croup HY?
-laryngotracheitis =most common -spasmodic croup -bacterial tracheitis -laryngotracheobronchitis -laryngotracheobronchopneumonitis
HYHY etiology of croup -whats the most common?
Further down into bronchi, alveoli, have to start thinking bact and not just viral
HY what is a stridor? (is it lower or upper airway obstrxn?)
HY upper airway obstrxn
?- During inspiration, the epiglottitis (arrows) collapses onto the glottis and obstructs the airway. The obstruction is relieved with expiration.
Laryngoscopic findings in laryngomalacia ***hallmark of laryngomalacia is inspiratory stridor side notes: most cases of lmalacia are congenital, and reflux makes it worse
HYHY test mc bug for tracheitis is ??
STAPH and strep pyogenes
is it okay to examine epiglotittis in the office?
Should never examine epiglottitis in the office. Cuz on xray u find thumb sign, if u press down on it with wooden thumb receptor the RESP SYSTEM WILL COLLAPSE DT IRRITAITION
whats the mc clinical presentation of croup? what kind of cough u hear?
acute laryngotracheitis0 obst of upper airway in larynx, infraglottis, and trachea, "barking" cough
LY summary of tx for croup
airway maintnce is key mist treatment racemic epinephrine (in severely ill with croup) corticosteroids
hallmark of tracheomalacia is ?
an EXPIRATORY wheeze During expiration, the trachea collapses on itself, obstructing the carina and distal airways.
when do you see the steeple sign on cxr?
area right above vc's (subglottic area) u see the narrowing- think croup- think parainflnza
? and its variants are the infectious causes of stridor. encompasses a group of illnesses affecting larynx, trachea, & bronchi
croup HY coup is an infectious cause of stridor, it's the big umbrella- variety of illnesses can be put under croup
on xray ull find thumb sign, h influnxa, unimnzd 3rd world, do NOT put tongue depressor, send to ER >> what is this?
epiglottitis
a differential to consider in an uniumunized kid from 3rd world
epiglottitis has hx of no immnztn against hflu, come in drooling, and sitting leaning forward (cuz epiglottis covering airway and sitting like that helps) BL epiglottitis: drool, toxic apprng, anxious, sitting forward w chest forward, cherry red epiglottis, thumb sign
both tracheomalacia and asthma exhibit insp/exprtry wheezing, but;
expiratory but give inhaler asthma will improve, and asthma much worse at night/winter season whereas tmalacia is always bad Asthma- weeze is in lower lungs, whereas in tmalacia its central
epiglottitis is dt ? and croup is dt ?
hinflnza parainflnza
laryngomalacia worse with inspiration/expiration? same q for tracheomalacia?
laryngmlcia worse with insprtn, trchmlacia worse with expiration
whats the mc cause of stridor in infants? HYHY whats a hallmark exam finding on PE of this disorder?
laryngomalacia -collapse of supraglottic strucs during inspiration: - -HYHY hallmark test exam- breath in, cartilages above vc are softened so on insprtn they'll collapse and will get the stridor
?- high-pitched sound of turbulent airflow in upper airway indicates airway obstruction where does it originate?
stridor- can originate fr any part of upper airway
