Therapeutic management: Edema of the upper airway (DO NOT USE TONGUE BLADE TO INITIATE GAG REFLEX). Prepare to intubate
Describe acute laryngitis
More common in older children and adolescents
Usually caused by a virus
Chief complaint is horseness
Generally self-limiting and without long term sequalae
Describe Acute Laryngotracheobronchitis (LTB) and it's clinical manifestations
The most common croup syndrome
Generally affects children <5yrs
Organisms responsible include RSV, parainfluenza virus, mycoplasma pneumonia, and influenza A & B
Clinically manifested by inspiratory stridor, suprasternal retractions, barking or seal-like cough, increasing respiratory distress and hypoxia, can progress to respiratory acidosis, respiratory failure, and death
What is the therapeutic management for LTB?
Maintain hydration (PO or IV)
Nebulizer treatments: racemic epinephrine,
What is acute spasmodic laryngitis?
Also called spasmotic croup or midnight croup
Praoxysmal attacks of laryngeal obstruction
Occurs chiefly at night
inflammation: mild or absent
Most often affects children ages 1-3yrs old
treatment includes humidity such as placing in shower or cool night drives
What is bacterial tracheitis and how it therapeutically managed?
Infection of the mucosa of the upper trachea
Distinct entity with features of croup and epiglottitis
Clinical manifestations simulation to LTB
May be a complication of LTB
Thick, purulent secretions result in respiratory distress
Therapeutic management: humidified oxygen, antipyretics, antibiotics, may require intubation
What is cystic fibrosis?
Hereditary autosomal recessive trait- if both parents carry, there is 1 in 4 chance
Basic defect related to abnormal secretions of exocrine glands (mucus producing)
Lead to obstruction of secretory ducts of pancreas, liver, reproductive organs
Thick mucus obstructs respiratory passages leading to air trapping and overinflation
What are the s/s of cystic fibrosis?
Pancreatic enzyme deficiency
Atelectesis, lung abscess, pneumonitis
FTT, weight loss
How is cystic fibrosis diagnosed?
s/s in the newborn include meconium ileus
Salty taste, hard nonproductive cough,bronchial infections, barrel chest, clubbing, malnutrition (ftt and bruising)
Newborn screening for CF
Stool analysis may show increased fat and decreased albumin with an absence of trypsin
sweat-chloride test induces sweat and measures sodium chloride. >60 meq/L on 2 tests is diagnostically positive
How is cystic fibrosis treated and managed?
newborn: meconium ileus treated user hyperosmolar enemas or surgery