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MCN 02 > CHAPTER 5:3 > Flashcards

CHAPTER 5:3 Flashcards

RESPIRATORY DISORDERS

1
Q

What is called the closure of a normal opening

A

ATRESIA

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2
Q

it is a condition in which the posterior nares are obstructed by membranous septum or bone either bilaterally or unilaterally

A

CHOANAL ATRESIA

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3
Q

Most common congenital malformation of the nose

A

CHOANAL ATRESIA

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4
Q

Occurs in 1:7,000 live births, Often associated with other congenital anomalies in 50% of cases (craniofacial syndromes and
skull based defects (encephalocele

A

CHOANAL ATRESIA

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5
Q

Types of CHOANAL ATRESIA:

A
  1. UNILATERAL (usually the right-60% of cases
  2. BILATERAL
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6
Q

Type of CHOANAL ATRESIA that may go undiagnosed until the child presents with persistent one sided nasal drainage (if the neonate develops respiratory infection) and seem to have more nasal obstruction not proportional to the degree of infection

A

UNILATERAL (usually the right-60% of cases)

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7
Q

Type of CHOANAL ATRESIA where Neonates become apneic or cyanotic at birth and require resuscitation in order to prevent asphyxia/severe hypoxia (artificial airway)

A

BILATERAL

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8
Q

It is used to look into the nose to make sure the airways are open and to assess healing after surgery

A

Fiberoptic endoscope

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9
Q

It is used to evaluate the extent of the choanal atresia once a feeding tube fails to pass through the nasal passage; it detects the composition (membranous or bony) and thickness of the atresia, the depth of the nasopharynx and any associated skull base anomalies

A

CT scan

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10
Q

Surgery may be delayed until the child is how many years old if only one nasal passage is blocked-( anatomy is sufficiently developed to facilitate easy access to the posterior choanae, and intraoperative blood transfusion is not normally required for repair at
this age)

A

2 or 3 years old

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11
Q

This approach requires less operative time and causes slightly less morbidity related to the incision, but the risk of the nasal passages closing later may be higher

A

transnasal

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12
Q

This approach provides better exposure and more accurate bone
removal.

A

transpalatal

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13
Q

A term applied to a broad classification of UPPER AIRWAY illness that result from inflammation and narrowing of the larynx (voice box), the trachea (windpipe) and the bronchi (larger branching air tubes)

A

CROUP

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14
Q

It is most common in children age 5 and younger (3mos.) — particularly those who were born prematurely. Peak = 2nd year

A

Croup

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15
Q

When does Croup usually occurs

A

in the winter or early spring

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16
Q

A child can get croup more than once. TRUE OR FALSE

A

TRUE

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17
Q

2 important changes in the upper airway in croup

A
  1. the epiglottis and larynx swells thereby occluding the airway
  2. the trachea swells against the cricoid cartilage causing restriction
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18
Q

loud, harsh, “brassy” or “barking” cough (similar to a the noise of a seal barking)

A

CROUPY COUGH

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19
Q

the result of swelling around the vocal cords (larynx) and windpipe (trachea). When the cough reflex forces air through this narrowed passage, the vocal cords vibrate with a barking noise.

A

CROUPY COUGH

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20
Q

the medical term for HOARSENESS

A

DYSPONIA

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21
Q

high-pitched or squeaking noise when breathing in created by narrowing of the airway

A

INSPIRATORY STRIDOR

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22
Q

occurs due to swelling or obstruction of the larynx

A

RESPIRATORY DISTRESS

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23
Q

What are the 4Ds as Manifestation for Acute Epiglotitis

A

Dysphonia
Dysphagia
Drooling
Distressed respiratory effort

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24
Q

Specific kind of humidity that provides relief for most children (decreases swelling of laryngeal tissue)

A

High humidity with cool mist

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25
Q

What medication causes mucosal vasoconstriction and subsequent decrease in edema

A

RACEMIC EPINEPHRINE (nebulized)

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26
Q

what medication does rapid action but sometimes symptoms “relapse” within 2 hours (assessment is
important)

A

RACEMIC EPINEPHRINE (nebulized)

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27
Q

What medication that does anti-inflammatory effects to decrease subglottic edema

A

CORTICOSTEROIDS

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28
Q

WHat medications are for:
- _____for bacterial croup
- _____for fever

A
  • ANTIBIOTICS
  • ANTIPYRETICS
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29
Q

Generally extubated until spasm and edema are no longer a problem and the child can manage secretions successfully (Usually within 24-36 hours)

A

ARTIFICIAL AIRWAY=ET intubation/tracheostomy

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30
Q

device that provides cool humidification with administration of O2 or compressed air

A

CROUPETTE

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31
Q

Lower respiratory illness that occurs when an infecting agent causes inflammation and
obstruction of the bronchioles

A

BRONCHIOLITIS

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32
Q

What gender is more affected with bronchiolitis

A

boys

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33
Q

diagnostic test in determining the presence of RSV through enzyme linked immunosorbent assay (ELISA)/immunoflourescent antibody ( IFA)

A

Nasal or nasopharyngeal culture

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34
Q

diagnostic test that -shows hyperaeration and consolidation (similar to that of pneumonia); shows collapse of alveoli/atelectasis

A

Chest X-ray

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35
Q

Interferes with MMR and varicella vaccines (live virus vaccines)-deferred for 9 months after Respigam infusion

A

RSV-IGIV (RESPIGAM)

36
Q

Volume of drug may not be well tolerated by infants (not given to children with congenital heart defects)

A

RSV-IGIV (RESPIGAM)

37
Q

▪ Does not interfere with MMR, and varicella vaccine
▪ Pain and mild transient erythema at the site

A

PALIVIZUMAB (SYNAGIS)

38
Q

A chronic multisystem disorder characterized by exocrine gland dysfunction, inherited as an autosomal recessive trait

A

CYSTIC FIBROSIS

39
Q

The reason why the mucus produced by the exocrine glands is abnormally thick, causing obstruction of the small passageways of the affected organ

A

exocrine gland dysfunction

40
Q

its characteristics include:
* both parents are unaffected but carry trait
* occurs in 1 of 4 children

A

autosomal recessive inheritance

41
Q
  • US=30,000 affected; worldwide=70,000
  • Occurs in 1:3000 live births in US
  • Most common among Caucasians (whose ancestors came from northern Europe)
A

CYSTIC FIBROSIS

42
Q
  • About 1,000 new cases with this case are diagnosed each year.
  • More than 70% of patients are diagnosed by age two.
  • More than 40% of the its patient population is age 18 or older.
  • In 2005, the predicted median age of survival was almost 37 years.
A

CYSTIC FIBROSIS

43
Q

3 most common manifestations of CYSTIC FIBROSIS

A
  1. progressive chronic lung disease
  2. pancreatic enzyme deficiency-acinar cells primarily affected
  3. sweat gland dysfunction-electrolyte composition is greatly affected
44
Q

these occurs as the airways become increasingly obstructed

A

emphysema and atelectasis

45
Q

what causes contraction of the muscle fibers in pulmonary arteries leading to pulmonary hypertension (cor pulmonale)

A

chronic hypoxemia

46
Q

what is produced by unabsorbed food fractions excreted in the stool

A

steatorrhea

47
Q

4F’s of Cystic Fibrosis

A

❖ Frothy (bulky and large quantity)
❖ Foul-smelling
❖ Fat-containing (greasy)
❖ Float

48
Q

What causes large bulky stools and lack of supportive fats

A

rectal prolapse

49
Q

Alternative Names for SWEAT CHLORIDE TEST

A

Sweat Test; Sweat Chloride; Iontophoretic Sweat Test; Pilocarpine
Iontophoresis

50
Q

what is the normal sweat chloride concentration

A

less than 40 mEq/L

51
Q

the standard diagnostic test for CF

A

SWEAT CHLORIDE TEST

52
Q

This test is used to evaluate fat absorption as an indication of how the liver, gallbladder, pancreas, and intestines work. Normal fat absorption requires bile from the gallbladder (or liver if the gallbladder has been removed), enzymes from the pancreas, and normal intestines.

A

FECAL FAT TEST/ QUANTITATIVE STOOL FAT DETERMINATION

53
Q

what is the chloride concentration that results in a (+) test result

A

greater than 60 mEq/L

54
Q

a test of 24 hour stool collection (or sometimes 72 hours or days)

A

FECAL FAT TEST/ QUANTITATIVE STOOL FAT DETERMINATION

55
Q

These tests are most often done in young children suspected of having cystic fibrosis.

A

TRYPSIN AND CHYMOTRYPSIN IN STOOL

56
Q

This test is used as a screening tool for cystic fibrosis but it does not diagnose it. Other testing is needed to confirm a diagnosis of cystic fibrosis.

A

TRYPSIN AND CHYMOTRYPSIN IN STOOL

57
Q

These are proteolytic enzymes released from the pancreas during normal digestion.

A

Trypsin and chymotrypsin

58
Q

It is a hormone produced by the small intestine when partially digested food has moved into the intestine from the stomach.

A

Secretin

59
Q

It normally causes the pancreas to release a fluid with a high concentration of bicarbonate

A

Secretin

60
Q

what instrument shows hyperinflation

A

CHEST X-RAY

61
Q

This test measures the ability of the pancreas to respond to secretin

A

SECRETIN STIMULATION TEST/ PANCREATIC FUNCTION TEST

62
Q

Alternative names for PULMONARY FUNCTION TEST

A

PFTs; Spirometry; Spirogram; Lung function tests

63
Q

what test determine the extent of lung involvement- atelectasis and emphysema are present (increased airway resistance)

A

PULMONARY FUNCTION TEST

64
Q

insertion of a hollow needle through abdominal wall into the uterus to obtain cells from amniotic fluid around the baby. The fluid is then tested to see if both of the baby’s CFTR genes are normal.

A

amniocentesis

65
Q

It uses ultrasound to guide a thin tube through the vagina and cervix into the uterus and remove a tiny piece of the placenta to biopsy. The cells of the placenta are then tested to see if the baby has CF.

A

Chorionic villus biopsy

66
Q

1) _____-loosens and liquefies pulmonary secretions
2) _____-opens large and small airway
3) _____-decreases viscosity of mucus (rh-Dnase)

A
  • Mucolytics
  • Bronchodilators
  • Dornase alfa (Pulmozyme)
67
Q

high frequency chest wall oscillation to loosen secretions

A

Devices Thairapy rest device

68
Q

– a small handheld plastic pipe with a stainless steel on the inside that facilitate removal of mucus.

A

Flutter Mucus device

69
Q

What is taken every meals and snacks =assist in digestion of nutrients and decreasing fat and bulk

A

Pancreatic enzyme supplements (Cotayza-S, Pancrease, Viokase)

70
Q

CYSTIC FIBROSIS’ last resort

A

Lung transplant

71
Q

It is the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history

A

Sudden Infant Death Syndrome

72
Q

In 1998, it was the third leading cause of death in infants

A

Sudden Infant Death Syndrome

73
Q

Peak age to Sudden Infant Death Syndrome

A

most likely to occur at 2-4 months, but 90% occurs by 6 months of age

74
Q

4 Types of croup

A

Acute Spasmodic Laryngitis
Laryngo-tracheo Bronchitis
Bacterial Tracheitis
Acute Epiglotitis

75
Q

Type of croup:

Part affected: Glottic
Severity: Least serious

A

Acute Spasmodic Laryngitis

76
Q

Type of croup:

Part affected: Subglottic
Severity: most common; most serious viral croup; progresses if untreated

A

Laryngo-tracheo Bronchitis

77
Q

Type of croup:

Part affected: upper trachea
Severity: guarded; close observation required

A

Bacterial Tracheitis

78
Q

Type of croup:

Part affected: supraglottic
Severity: most life threatening

A

Acute Epiglotitis

79
Q

Type of croup:

**Causative Agent: ** Viral with allergic/ psychosomatic component
Onset: sudden; typically occurs at night; tends to recur

A

Acute Spasmodic
Laryngitis

80
Q

Type of croup:

**Causative Agent: **Viral: parainfluenza, influenza A & B, RSV, Mycoplasma pneumonia
**Onset: **gradual; starts as URI, progresses to symptoms of respiratory distress

A

Laryngo-tracheo
Bronchitis

81
Q

Type of croup:

**Causative Agent: **Bacterial: usually staphylococcus aureus
**Onset: **progressive from URI

A

Bacterial Tracheitis

82
Q

Type of croup:

**Causative Agent: **Bacterial: usually HIB
Onset: rapidly progressive (hours)

A

Acute Epiglotitis

83
Q

Type of croup:

**Manifestation: ** Afebrile Mild respiratory distress
**Treatment: ** Humidity
Severe: Racemic epinephrine
Mild: home but must seek medical help if (+)s/s of respiratory distress

A

Acute Spasmodic Laryngitis

84
Q

Type of croup:

**Manifestation: ** Low grade fever Non toxic appearance
**Treatment: ** Humidity Racemic epinephrine

A

Laryngo-tracheo
Bronchitis

85
Q

Type of croup:

**Manifestation: ** High fever
Thick purulent tracheal secretions URI appears as viral croupy cough but no response to LTB therapy
**Treatment: ** antibiotics

A

Bacterial
Tracheitis

86
Q

Type of croup:

**Manifestation: ** High fever
Toxic appearance
4Ds:
Dysphonia
Dysphagia
Drooling
Distressed respiratory effort
**Treatment: ** Antibiotics Airway protection

A

Acute Epiglotitis

MCN 02 (6 decks)

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