Acute events
Asthma
RSV
Cystic fibrosis
Name that sign of respiratory distress
Other Respiratory Illnesses
100
What is the biggest risk factor after a tonsillectomy?
Bleeding
May see subtle signs like frequent swallowing first
100
What are the risk factors for asthma?
Family history
Environmental exposures (dust, pollution)
Allergies
100
What is RSV?
a very common, highly contagious respiratory virus that can infect people of all ages. In infants and young children, it is an important cause of bronchiolitis and pneumonia.
100
What is Cystic Fibrosis?
is an inherited, autosomal recessive disorder caused by mutations in the CFTR gene. The CFTR protein helps regulate the movement of chloride and water across cell membranes.
When CFTR doesn't work properly, secretions become abnormally thick and sticky.
100
This sound is commonly seen in RSV.
Mostly when breathing in (inspiration), though it can sometimes be biphasic.
Upper airway (throat, voice box/larynx, or windpipe/trachea).
100
What is Pertussis?
also called whooping cough, is a highly contagious bacterial respiratory infection caused by Bordetella pertussis.
200
What is epiglotitis?
a rapid, potentially life-threatening inflammation and swelling of the epiglottis and surrounding tissues that can cause sudden upper-airway obstruction.
200
What symptoms are often seen in asthma?
Difficulty breathing, short but
persistent cough, chest tightness,
wheezing, presence of retractions
200
How do we prevent RSV?
Historically, Palivizumab/synagis injections were used for a really long time to prevent RSV. Used mostly in premature infants. They would need a dose every 28 days
We have now moved more to RSV antibodies
https://www.cdc.gov/rsv/vaccines/protect-infants.html
200
What do the thick secretions affect in the body?
The thick secretions primarily affect the:
- Lungs → thick mucus, airway obstruction, chronic cough, recurrent infections
- Pancreas → blocked pancreatic ducts → decreased digestive enzymes → malabsorption and poor growth
- GI system → constipation, intestinal obstruction, bulky/fatty stools
- Sweat glands → excessive salt loss → high chloride in sweat
- Reproductive system → male infertility is common because of congenital absence of the vas deferens
200
Sound commonly seen in asthma
Wheezing
A high-pitched, tight, whistling, or musical sound
Often found in: Asthma, bronchiolitis, or viral respiratory infections like RSV
200
How is Pertussis diagnosed?
PCR (Polymerase chain reaction test)
300
What are manifestations of epiglottis?
high fever
swallowing
drooling
stridor
Tripod posture/head tilted forward (helps them breathe easier)
MEDICAL EMERGENCY
Do not see often due to the HIB vaccine
300
What is an asthma action plan?
300
What is the difference between a vaccination and a monoclonal antibody?
Vaccine vs. monoclonal antibody
Vaccine: Stimulates the person's immune system to make antibodies.
Example: maternal RSV vaccine
*Given to mother, she makes antibodies and passes them onto the infant
Monoclonal antibody: Provides antibodies directly, provides protection quickly
Example: nirsevimab
300
How is CF diagnosed?
Newborn screen
Sweat chloride test (Key diagnostic test)
- Measures the amount of chloride (salt) in sweat.
- CF causes abnormally high chloride because of defective CFTR function.
Sweat chlorideInterpretation
<30 mmol/L CF unlikely
30–59 mmol/L Intermediate → further evaluation needed
≥60 mmol/L. Consistent with CF when clinical/genetic criteria are also met
300
A short, low-pitched noise made at the end of exhalation.
GRUNTING
Where the issue is: Deep in the lower lungs (alveoli/air sacs).
Common causes: Severe lower respiratory distress, pneumonia, or infant lung disease
300
What are the 3 stages of pertussis?
Catarrhal stage
Mild cough, low grade fever, highly contagious
Paroxysmal stage
Repeated, forceful coughing fits (paroxysms)
Child may have difficulty catching their breath
Inspiratory “whoop” may occur after coughing
Post-tussive vomiting is common
Convalescent stage
Cough gradually decreases
Can persist for weeks to months
400
What are symptoms of a foreign body?
Sudden onset of stridor/cough
These children are usually healthy one minute and then suddenly coughing
400
How do we diagnose asthma in children?
PFT
400
What are symptoms seen with RSV?
- Runny nose and congestion
- Cough
- Fever
- Wheezing
- Tachypnea
- Increased work of breathing
- Bronchiolitis
- Pneumonia
- Apnea, particularly in young infants
400
What are some complications often seen in CF?
Recurrent respiratory infections
Pancreatitis
Bronchiectasis
400
This may be seen in a baby with respiratory distress, described the widening of the nostrils during breathing, especially during inspiration, because the child is working harder to move air into the lungs.
Nasal flaring
400
What is the difference between bronchitis and bronchiolitis?
Bronchitis: primarily the larger bronchi
Bronchiolitis: inflammation of the small bronchioles, most commonly in infants and young children, often caused by RSV.
Both are viral
500
Name some signs of Respiratory Distress
Head bobbing
Retractions
Grunting
Nasal flaring
Cyanosis
500
What is a peak flow meter?
500
How do we treat RSV?
Viral so mainly just supportive
- Oxygen if needed
- Nasal suctioning
- Hydration/fluids
- Monitoring respiratory status
- Feeding support
500
What are some common medications you may see in patients with CF?
Pancreatic enzymes
Bronchodilators
Inhaled antibiotics
elexacaftor/tezacaftor/ivacaftor (Trikafta)
*Treat the underlying CF defect, the CFTR protein, not just symptoms
Not every patient will qualify for this medication, will need genetic testing first
500
What is this:
Abnormal inward pulling or “sucking in” of the skin between or around the ribs during inspiration. They occur when a child is working harder than normal to breathe because of increased respiratory effort.
Retractions
500
What are symptoms typically seen with bronchitis and bronchiolitis?
Bronchitis → think:
OLDER child + persistent cough + mucus/rhonchi
Bronchiolitis → think:
INFANT + URI → wheezing/crackles + tachypnea + retractions + feeding difficulty
600
What are some of the most dangerous hazards for small children in terms of foreign body aspiration?
Button batteries
Giving honey can be helpful
Magnets can be deadly if swallowed more than 1
Water beads
600
Why are spacers helpful when administering inhalers to children?
It helps to assure that they get all the medication
Makes it easier to administer
600
What can we do for small babies with RSV to help with feeding?
Suction the nose ahead of time
600
What is the expected lifespan for someone with CF?
50 ish
600
What is this:
an abnormal movement in which an infant's head moves forward and backward or up and down with each breathbecause the infant is using the neck muscles to help breathe.
Head bobbing
600
What are the different types of croup and their causes?
Viral: Most common form; bark cough, inspiratory stridor, gradual onset, may have low grade fever
Spasmodic: Sudden night-time onset, barky cough, stridor