1. Hi, my name is Krysta Thompson and my grand rounds presentation is on
RSV and bronchiolitis.
2. First, I’m gonna discuss the pathophysiology of bronchiolitis.
a. It is a communicable disease that is transmitted by respiratory
secretions, usually by hand contact with an older child or adult with
an upper respiratory infection.
b. The most common virus causing bronchiolitis is respiratory syncytial
virus, or RSV, though there are other common viruses that can cause
it as well.
c. Whatever virus is present will cause inflammation, epithelial cell
edema in the linings of the small airways, copious mucus
production, and even some necrosis.
d. The inflammation and epithelial cell edema cause airway
obstruction in the small bronchioles and alveolar epithelial cells.
e. The epithelial necrosis causes dense plugging of the bronchial lining,
which then causes airway resistance, atelectasis, hyperinflation, and
increased mucus production.
f. Usually if the case is mild, the symptoms will last for 1-3 days
g. If the case is more severe, there can be cyanosis, retractions, nasal
flaring, and respiratory distress.
3. RSV is a highly contagious virus that can cause bronchiolitis, along with
other respiratory illnesses.
a. It enters the body through the nasopharyngeal or conjunctival
mucosa, where it spread quickly to the apical ciliated epithelial cells
in the respiratory tract.
b. The cytoxicity of the virus and the host cause the respiratory
epithelial cells to necrose.
This study source was downloaded by 100000846744270 from CourseHero.com on 05-06-2022 23:56:38 GMT -05:00
https://www.coursehero.com/file/34814855/NR602-Wk-2-Grand-Rounds-Transcriptdocx/
, c. This causes mucus plugging, which, along with cellular debris and
DNA, causes small airway obstruction.
d. There is also impaired mucus clearance, airway edema, and
decreased lung compliance because of ciliary dysfunction.
4. This disease typically affects children 2yrs old and under, with age 2-3mo
being the most common age, and is responsible for 10% of primary care
visits in the first 2yrs of life.
a. It is also the leading cause of hospitalization for infants
b. More than 80% of RSV cases are infants <1yr
c. The incubation period is about 2-8 days and the highest incidence is
usually between November and March
d. Males have a slightly higher risk of becoming infected than females
e. While RSV is usually self-limiting, it can cause some long-term
complications
5. There are quite a lot of risk factors associated with RSV
a. Infants with major chronic diseases such as:
i. Cystic Fibrosis
ii. Neuromuscular disorders
iii. Bronchopulmonary dysplasia
iv. Significant hemodynamic issues due to congenital heart disease
and
v. Immunodeficiency.
b. Infants who are less than 12 weeks old are also at higher risk, as are
c. Premature babies that were born at <35wks gestation
d. Males
e. Babies that live in overcrowded homes
f. Babies that have not been breastfed
g. Or have been exposed to tobacco smoke
h. Babies who attend daycare or have siblings at home
i. And babies who are born in the winter.
6. The most common clinical findings of RSV bronchiolitis include
a. Fever, which can be low grade up to 102
b. Wheezing
c. Cough
d. Tachypnea
e. And rhinorrhea and rhinitis
This study source was downloaded by 100000846744270 from CourseHero.com on 05-06-2022 23:56:38 GMT -05:00
https://www.coursehero.com/file/34814855/NR602-Wk-2-Grand-Rounds-Transcriptdocx/
RSV and bronchiolitis.
2. First, I’m gonna discuss the pathophysiology of bronchiolitis.
a. It is a communicable disease that is transmitted by respiratory
secretions, usually by hand contact with an older child or adult with
an upper respiratory infection.
b. The most common virus causing bronchiolitis is respiratory syncytial
virus, or RSV, though there are other common viruses that can cause
it as well.
c. Whatever virus is present will cause inflammation, epithelial cell
edema in the linings of the small airways, copious mucus
production, and even some necrosis.
d. The inflammation and epithelial cell edema cause airway
obstruction in the small bronchioles and alveolar epithelial cells.
e. The epithelial necrosis causes dense plugging of the bronchial lining,
which then causes airway resistance, atelectasis, hyperinflation, and
increased mucus production.
f. Usually if the case is mild, the symptoms will last for 1-3 days
g. If the case is more severe, there can be cyanosis, retractions, nasal
flaring, and respiratory distress.
3. RSV is a highly contagious virus that can cause bronchiolitis, along with
other respiratory illnesses.
a. It enters the body through the nasopharyngeal or conjunctival
mucosa, where it spread quickly to the apical ciliated epithelial cells
in the respiratory tract.
b. The cytoxicity of the virus and the host cause the respiratory
epithelial cells to necrose.
This study source was downloaded by 100000846744270 from CourseHero.com on 05-06-2022 23:56:38 GMT -05:00
https://www.coursehero.com/file/34814855/NR602-Wk-2-Grand-Rounds-Transcriptdocx/
, c. This causes mucus plugging, which, along with cellular debris and
DNA, causes small airway obstruction.
d. There is also impaired mucus clearance, airway edema, and
decreased lung compliance because of ciliary dysfunction.
4. This disease typically affects children 2yrs old and under, with age 2-3mo
being the most common age, and is responsible for 10% of primary care
visits in the first 2yrs of life.
a. It is also the leading cause of hospitalization for infants
b. More than 80% of RSV cases are infants <1yr
c. The incubation period is about 2-8 days and the highest incidence is
usually between November and March
d. Males have a slightly higher risk of becoming infected than females
e. While RSV is usually self-limiting, it can cause some long-term
complications
5. There are quite a lot of risk factors associated with RSV
a. Infants with major chronic diseases such as:
i. Cystic Fibrosis
ii. Neuromuscular disorders
iii. Bronchopulmonary dysplasia
iv. Significant hemodynamic issues due to congenital heart disease
and
v. Immunodeficiency.
b. Infants who are less than 12 weeks old are also at higher risk, as are
c. Premature babies that were born at <35wks gestation
d. Males
e. Babies that live in overcrowded homes
f. Babies that have not been breastfed
g. Or have been exposed to tobacco smoke
h. Babies who attend daycare or have siblings at home
i. And babies who are born in the winter.
6. The most common clinical findings of RSV bronchiolitis include
a. Fever, which can be low grade up to 102
b. Wheezing
c. Cough
d. Tachypnea
e. And rhinorrhea and rhinitis
This study source was downloaded by 100000846744270 from CourseHero.com on 05-06-2022 23:56:38 GMT -05:00
https://www.coursehero.com/file/34814855/NR602-Wk-2-Grand-Rounds-Transcriptdocx/
