lower airway

Question 1

child unattended sudden SOB

Answer 1

Foreign body

Question 2

intrathoracic vs extrathoracic..helps me decide who to call

Answer 2

• extra: inspiratory stridor..call ENT

- intra: inside bronchioles. Expiratory wheeze = call pulmonologist.

Question 3

foreign body dx

Answer 3

2 view xray
in trachea:
neg”coin sign” AP and + AP lateral

if + coin sign AP its not in trachea

Question 4

foreign body tx

Answer 4

• call specialist removal (bronchoscopy, endoscopy, laryngoscope etc)
• abx

Question 5

asthma obstructive lung dz?

Answer 5

yes

reversible bronchodilators

Question 6

three A

Answer 6

allergies
atopy / ezcema
asthma

Question 7

asthma dx

Answer 7

PFT

FEV1/ FVC reduced but reversible

Question 8

asthma education parents

Answer 8

• avoid triggers
• rid of pets
• carpets
• pillows
• upholstery
• KEY smoking cessation

Question 9

bronchiolitis patho

Answer 9

RSV

Question 10

bronchiolitis tx

Answer 10

supportive (IVF, O2)
if in ER bad sats…
r/o PNA with xray
possibly beta agonist

Question 11

bronchiolitis pt

Answer 11

young <2yr
dyspnea, wheezing
WINTER MONTHS
(no asthma dx)

Question 12

bronchiolitis f/u…

Answer 12

can progress to acute resp failure and ARDS yet still not much we can do

Question 13

CF inheritance

Answer 13

autosomal recessive

TFTR gene

Question 14

CF dx

Answer 14

prenatal screen 
sweat chloride (over 40 infant, over 60 anyone older)

Question 15

CF sx

Answer 15

meconium ileus
recurrent pulm infxn
failure to thrive
salty

Question 16

CF tx

Answer 16

lung: chest physiotherapy, fight pseudomonas and s aureus
pancreas: give pancreatic enzymes, fat DEAK vitamins

Question 17

CF men are infertile?

Answer 17

yes due to absence of the sperm canal vas deferens