Lecture 10/29-Resp Flashcards
(105 cards)
1
Q
main organisms that causes croup
A
Parainfluenza virus
also RSV
2
Q
main cause of epiglottitis
A
H. influenza
3
Q
what sound is caused by an upper airway obstruction
A
stridor
4
Q
what sound is due to fluid or atelectasis in small airways
A
crackles/ rales
5
Q
what sound means fluid in big airways (low note)
A
Rhonchi
6
Q
little alveoli are popping open
A
crackles
7
Q
what are signs of work of breathing
A
grunting
retractions
seen more infants due to lack of fixed chest
8
Q
mainstay for test for respiratory dz?
A
chest x-ray
9
Q
used to see if there is a structure obstruction the trachea. Also good for trachealesophageal fistula (TEF), GER, vascular rings.
A
barium swallow
10
Q
what helps to look for malacias, foreign bodies.
A
Laryngoscopy and bronchoscopy
11
Q
test to look for RSV, influenza, parainfluenza.
A
Viral swab (panel)
12
Q
what are 2 infections of the upper airway
A
Croup
Epiglottis
13
Q
Structural problems with upper airway obstruction
A
Laryngomalacia subglottic stenosis (from intubation)
14
Q
Functional problems with the upper airway
A
Vocal cord paralysis
15
Q
some risk factors of upper airway problems
A
Difficult delivery ductal ligation (PDA) intubation foreign body infection
16
Q
when in the year is croup common?
A
fall and early winter
17
Q
what age group is croup common in
A
6 mo- 3 year
18
Q
what presents with a prodrome URI followed by a barking cough and possibly a low grade fever
A
Croup
19
Q
what will the xray with croup show?
A
subglottic narrowing and normal epiglottis
20
Q
what testing do you do for croup?
A
Viral swab for respiratory virus
21
Q
what sign do you see on x-ray with croup?
A
Steeple sign from laryngeal edema
subglottic narrowing
22
Q
tx for croup
A
Supportive “go outside in cold air” vasoconstriction
Nebulizers (racemic epi neb)
dexamethasone
23
Q
if a kid shows up in the ER with croup, what must they have achieved to be able to go home?
A
Not stridor at rest within 3 hours
not recurrent nebs needed (if so- hospitalize)
24
Q
what viruses are in a viral panel?
A
Influenza A an B RSV human metapneumovirus parainfluenza 1,2,3 Adenovirus Strep pneumo
25
what is the invasion of bacteria into the mucosa of a patient with viral croup. Will have purulent secretions with high fever and severe obstruction.
Croup- Bacterial tracheitis
26
how do you tx croup- bacterial tracheitis
Hospitlization
Suctioning, hydration
IV ABX for staph aureus
probably intubated
27
Inspiratory stridor with sudden onset and drooling. Will be tripoding and flaring nares
Epiglottis
28
Tx for epiglotitis
emergency- need to intubate
29
what causes epiglotitis if someone is immunized (usually)
Group A Strep and Staph Aureus
30
What will the x-rays look like on epiglottitis?
Thumb sign on lateral x-ray (shows thickened tissue of epiglottitis)
31
Underdeveloped cartilaginous structures
| Most common cause of stridor in infants
Laryngomalacia
32
when will a child usually outgrow laryngomalacia?
improves with age, resolves by 2 years of age
33
when is laryngomalacia worse?
Supine
| Activity (feedings)
34
how do you diagnose laryngomalacia?
laryngoscopy and bronchoscopy
35
vessels coming off the heart are compressing the upper tracheal
vascular ring or sling
36
Congenital or from intubation
Mild to severe with serious obstruction of airway
Stridor after extubation
Suspect in Pt with recurrent croup
Subglottic stenosis
37
Tx for subglottitic stenosis?
Surgical correction- plasty
38
if there is a progressive wheeze what should you suspect?
CF
| bronciolitis obliterans
39
What can be a lower or upper airway disorder?
tracheomalacia or vascular ring
40
how do you treat a severe tracheomalacia?
Tracheostomy
41
what are some txs for lower resp tract infections
beta adrenergic nebs
| CPT
42
most common organisms for bronchiolitis?
RSV
43
Cough, coryza, rhinorrhea… over 3-7 days to noisy raspy breathing and audible wheeze
Bronchiolitis
44
what is the leading cause of hospitalization of infants?
bronchiolitis
45
when does RSV peak?
late winter from November to March
46
How do you dx RSV?
viral swab
47
what may the CXR show with bronchiolitis?
may be normal or show
peribronchial cuffing
increased intestitial markings
hyperinflation
48
what is the monoclonal antibody given every month to help prevent at risk infants?
Synagis (palivizumab)
49
symptoms in infants are fever, prominent runny nose, and congestion, coupled with wheezing. Duration of 1-2 weeks
RSV
50
are viral or bacterial pneumonias more common in children?
Viral
51
What is the most common bacterial pneumonia
Strep pneumo
52
what are atypicals that cause pneumonia?
Mycoplasma pneumonia
| chlamydial pneumonia
53
URI prodrome + wheezing and stridor +/-fever
| Myalgia, malaise, headache
Viral pneumonia
54
what causes viral pneumonia?
RSV
parainfluenza
influenza A and B
Human metapneumovirus
55
what will you see on CXR with viral pneumonia?
Perihilar streaking
| increased interstitial markings or patchy bronchopneumonia
56
what virus can cause necrotizing pneumonia?
Adenovirus
57
what will there be an elevation of (cell wise) with viral pneumonia?
lymphocytes
58
Tx for viral pneumonia?
Supportive
| hospital at risk patients (asthma, RSV, CHD)
59
Present with Fever, chills, cough, dyspnea. Rales or decreased breath sounds
bacterial pnuemonia
60
what cells will be elevated for bacterial pneumonia?
neutrophils
61
tx for bacterial pneumonia?
Amoxicillin
augmentin
erythromycin
cerfuroxime
62
when does bacterial pneumonia occur (season)?
anytime of year
63
when are viral pneumonias more common (season)
fall and winter
64
More common causes of pneumonia in ages 1-5?
RSV in infants
Parainfluenza viruses
influenza viruses
adenoviruses
65
Most common causes of pneumonia >5 years?
Mycoplasma pneumoniae
| streptococcus penumoniae
66
most common cause of bacteria for pneumonia in kids >5?
mycoplasma pneumoniae
67
how do you tx mycoplasma pneumoniae?
Erythromycin
68
in teenagers what is almost always the cause of pneumonia?
Mycoplasma penumoniae
69
what 2 immuniztions have helped prevent penumonia in children?
Prevnar (PCV13)
| Hib
70
What organism causes pertussis?
Bordetella pertusis
71
peak age for pertussis?
<4 months of age
72
When is pertussis immunized?
2, 4, 6, 12-15 moths and 4-6 years
73
when does pertussis peak?
July-October (via cough)
74
3 stages of pertussis?
Catarrhal
Paroxysmal
Convalescent
75
what stage is a URI 1-2 weeks for pertussis?
Catarrhal
76
what is the stage of pertussis that is a dry cough 1-2 weeks?
Convalescent
77
what is the stage of pertussis with Staccato cough with inspiratory whoop and post tussive vomiting 2-4 weeks
paroxysmal
78
how do you dx pertussis?
NP swab
79
tx for pertussis?
Erythromycin /azithromycin
80
who else should you tx if someone is infected with pertussis?
family members
81
Adolescents present with prolonged bronchitis, persistent non-productive cough – often begins as a URI.
Don’t whoop but may have paroxysms
Cough can last weeks to months
Pertussis
82
chronic progressive disease that can present with protein and fat malabsorption (failure to thrive, hypoalbuminemia, steatorrhea), liver disease (cholestatic jaundice), or chronic respiratory infection
Cystic fibrosis
83
dx of CF
sweat test (elevated sweat chloride >60 mEq/L)
84
what will you find on PE of a CF patient?
digital clubbing
chronic sinusitis
nasal polyposis
85
tx for CF
manage infections
pancreatic enzyme replacement
ADEK vitamins
86
what may an infant present with that suggest CF?
meconium ileus
87
non functioning pulmonary tissue that does not communicate with tracheobronchial tree. Blood supply from anomalous blood supply
Pulmonary Sequestration
88
decreased in alveolar number and airways
Pulmonary hypoplasia
89
what can cause pulmonary hypoplasia?
diagphramtic hernia
| achondroplasia
90
Congenital cystic lung dz. have large airspaces.
CCAM (Congenital Cystic Adenomatoid Malformation)
91
tx for CCAM and pulmonary sequestration
remove the defective part of the lung
92
elevation of part or all of diaphragm
| diaphragm muscle is weak and stretched up
Enventration
93
depression of sternum/ anterior chest wall
Pectus Excavatum
94
protrusion of sternum/ anterior chest wall – more common in males,
Pectus Carinatum
95
what alveolar cells form the structure of an alveolar wall
Type I cells
96
What alveolar cells secrete surfactant?
Type II cells
97
Due to a surfactant deficiency
Respiratory Distress Syndrome (RDS)
98
what is another term for RDS?
bronchopulmonary dysplasia
99
what are infants with RDS at risk for?
pulmonary HTN
| reactive airway dz
100
chronic lung dz is considered when an infant needs oxygen when?
at 28 days
101
What is an ALTE?
Apparent LIfe Threatening Events in infancy
102
what are some ALTEs?
```
apnea
color change
decreased muscle tone
emesis
choking
gagging
```
103
when doe most deaths with SIDS occur?
2-4 months and between midnight and 8 am in winter
104
What is SIDS?
Sudden Death of infant < 1yr old that remains unexplained
105
what is the risks for SIDS?
```
male
low birth weight
smoking
teen mom
drug addicted mom
```
