LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Neumología Pediátrica. Anexos ❚ 121 4. Know the changes in blood gases and pulmonary function measurements during the resolution of status asthmaticus 5. Know the factors that impact on the prognosis for wheezing in early infancy (i.e., risk factors for developing persistent asthma) D. Bronchiolitis 1. Epidemiology a. Know that the majority of infants are infected with respiratory syncytial virus in the first year after birth b. Know that young age, premature birth, and a history of apnea of prematurity are risk factors for the development of apnea with viral bronchiolitis c. Know that certain ethnic groups are at increased risk for the development of permanent sequelae of adenoviral bronchiolitis d. Know that natural immunity to respiratory syncytial virus is imperfect and that reinfection is common e. Know that respiratory syncytial virus is transmitted by direct inoculation of virus onto the nasal or ocular mucous membrane rather than by exposure to airborne virus f. Know the factors associated with an increased risk of bronchiolitis g. Know the indications for respiratory syncytial virus immunoprophylaxis 2. Etiology/genetics a. Know that respiratory syncytial virus is the most common cause of bronchiolitis in infancy b. Know that human metapneumovirus is a pathogen that causes bronchiolitis 3. Pathophysiology a. Pathology 1. Recognize the pathologic findings associated with infectious bronchiolitis 2. Know the functional characteristics of the lung and chest wall that predispose the infant with bronchiolitis to increased morbidity b. Physical mechanisms and consequences 1. Know that hypoxemia associated with bronchiolitis usually represents disruption of the normal matching of ventilation and perfusion 4. Diagnosis and clinical manifestations a. History b. Physical examination 1. Recognize the physical findings typical of bronchiolitis c. Imaging 1. Recognize radiologic findings typical of acute bronchiolitis d. Pulmonary function tests e. Other investigations 1. Know that carbon dioxide retention is usually a late finding in patients with viral bronchiolitis 2. Know that bacterial superinfection in the first three or four days of infection is uncommon in infants with respiratory syncytial virus bronchiolitis 3. Know the diagnostic tests for the identification of the organism causing viral bronchiolitis f. Diagnostic criteria