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Congenital, Infectious and Inflammatory Diseases of the upper airway

Terms in this set (14)

- Respiratory compensation
- Cardiovascular compensation
- Apnea, hypopnea
- Mouth breathing, snoring
- Mucosal injury (dryness, mechanical injury)
- Reflux
- Sleep cycle disruption
- Attention deficit, hyperactivity, irritability
- Headaches
- Parasomnias (bedwetting, sleepwalking, bruxism, bed thrashing, restless legs)
Short-term consequences of upper airway obstruction & OSA
- Failure-to-thrive and obesity
- Chronic lung disease (pulmonary hypertension, asthma, for pulmonale)
- Cardiovascular (hypertension, stroke, pro-atherogenic, arrythmias, ischemic heart disease, cardiac failure)
- Maxillofacial
- Metabolic (hyperlipidemia, hypertension, abnormal glucose intolerance, behavioral)
- Neurologic (seizures, intellectual, memory, dementia
- Quality of life (daytime sleepiness, accidents, depression, partner in distress)
Long-term consequences of upper airway obstruction & OSA
At least 1
- Snoring
- Paradoxical breathing
- Daytime impairment (sleepiness, behavioral, learning)
At least 1
- PSG with AHI 1/h and more
- Obstructive hypoventilation with snoring, paradoxical movement or flattening of nasal pressure transducer signal
ICSD-3 criteria for pediatric OSA
- Chronic respiratory disease
- Failure to thrive
- Polyps
- Alkalosis, metabolic
- Neonatal intestinal obstruction
- Clubbing of fingers
- Rectal prolapse
- Electrolyte in sweat
- Aspermia/absent vas deferens
- Sputum - S.aureas/P.aeruginosa
Symptoms for cystic fibrosis
- Oculomotor nerve
- Trochlear nerve
- Obthalamic branch of trigeminal nerve
- Maxillary branch of trigeminal nerve
- Internal carotid artery
- Abducent nerve
- Trochlear nerve
Contents of the cavernous sinus
- Fever
- Ptosis
- Proptosis
- Chemosis
- Cranial nerve palsies
- Lethargy
- Headache
- Periorbital swelling
- Papilledema
- Venous engorgement
- Decreased visual acuity
- Sluggish or dilated pupil
- Periorbital sensory loss
- Decreased corneal reflex
- Nuchal rigidity
- Diplopia
- Seizures
- Hemiparesis
Cavernous sinus thrombosis symptoms
- PTA, parapharyngeal abscess, retropharyngeal abscess
- Lymph node suppuration
Suppurative streptococcal tonsillitis (GABHS) complications
- Scarlet fever- endotoxin, strawberry tongue, yellow membraneous film, desquamatation of papillae
- Acute rheumatic fever - 1-4 weeks after: cross-reactive antibodies to heart muscle (endo, myo or pericarditis)
- Poststreptococcal glomerulonephritis - 1-2 weeks after: circulating antibodies and immune complexes damaging glomerulus
- PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcus)
--Antineuronal antibodies cross-react with regions in basal ganglia
--Behavioral and motor disturbances
Non-suppurative streptococcal tonsillitis (GABHS) complications
Micro - Haemophilus inf type B
Age - 2-6 yo
Onset - Rapid (hours)
Cough - Absent
Dysphagia - Severe
Stridor - Inspiratory
Temp. - Elevated
Posture - Sitting forward
Drooling - Marked
Voice - Muffled
X-ray - Thumbprint sign
Epiglottitis:
- Micro
- Age
- Onset
- Cough
- Dysphagia
- Stridor
- Temperature
- Posture
- Drooling
- Voice
- X-ray
Epiglottitis
Micro - Haemophilus inf type B
Age - 2-6 yo
Onset - Rapid (hours)
Cough - Absent
Dysphagia - Severe
Stridor - Inspiratory
Temp. - Elevated
Posture - Sitting forward
Drooling - Marked
Voice - Muffled
X-ray - Thumbprint sign
Micro - Parainfluenza
Age - <3 years
Onset - Slow (days)
Cough - Barking cough
Dysphagia - none
Stridor - Biphasic
Temp. - Elevated
Posture - Lying back
Drooling - None
Voice - Hoarse
X-ray - Steeple sign
Croup
- Micro
- Age
- Onset
- Cough
- Dysphagia
- Stridor
- Temperature
- Posture
- Drooling
- Voice
- X-ray
Croup
Micro - Parainfluenza
Age - <3 years
Onset - Slow (days)
Cough - Barking couch
Dysphagia - none
Stridor - Biphasic
Temp. - Elevated
Posture - Lying back
Drooling - None
Voice - Hoarse
X-ray - Steeple sign
Micro - Staph aureus, Strep
Age - Wide
Onset - Slow (days)
Cough - Brassy
Dysphagia - None
Stridor - Variable
Temp. - Elevated
Posture - Lying back
Drooling - None
Voice - Hoarse
X-Ray - Narrow tracheal lumen
Bacterial Tracheitis
- Micro
- Age
- Onset
- Cough
- Dysphagia
- Stridor
- Temperature
- Posture
- Drooling
- Voice
- X-ray
Bacterial Tracheitis
Micro - Staph aureus, Strep
Age - Wide
Onset - Slow (days)
Cough - Brassy
Dysphagia - None
Stridor - Variable
Temp. - Elevated
Posture - Lying back
Drooling - None
Voice - Hoarse
X-Ray - Narrow tracheal lumen
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