Pathology: Pediatric Diseases

Question 1

Pediatric pneumonia: symptoms of viral pneumonia

Answer 1

Runny nose, nasal congestion, cough, fever

Question 2

Pediatric pneumonia: RSV, most commonly occurs in

Answer 2

Winter months (mid-December - march)

Question 3

Pediatric pneumonia: RSV CXR

Answer 3

Hyperinflated lungs
Patchy infiltrates
Atelectasis

Question 4

Pediatric pneumonia: RSV confirming diagnosis

Answer 4

Rapid immunofluorescent detection in nasal washings

Question 5

Pediatric pneumonia: aerosolized treatment for RSV

Answer 5

Ribovirin through SPAG

Question 6

Most common cause of bronchiolitis in children

Answer 6

RSV

Question 7

Pediatric pneumonia: how does mortality rate differ in bacterial pna vs viral pna

Answer 7

Higher than viral

Question 8

Pediatric pneumonia: bacterial pna risk factors

Answer 8

Immunocompromised
Aspiration from GERD
Malnutrition
School attendance

Question 9

Pediatric pneumonia: causative agents in bacterial pna for neonatal and pediatric

Answer 9

Neonate: group B strep, Ecoli
Pediatric: staph, H flu

Question 10

Pediatric pneumonia: treatment/management

Answer 10

Oxygen therapy
Nutrition
Fluid
Bronchodilators

Question 11

Diffusehypoxic lung injury resulting in pulmonary edema and progressive alveolar collapse

Answer 11

ARDS

Question 12

ARDS: time of onset of respiratory symptoms

Answer 12

Within 1 week of known clinical insult

Question 13

ARDS: CXR

Answer 13

Bilateral opacities

Question 14

ARDS: degree of hypoxemia (PEEP >5)

Answer 14

P/F ratio: moderate 100-200

Question 15

Refractory hypoxemia, pulmonary edema, loss of surfactant function, decreased LC, LV, FRC are all manifestations of

Answer 15

ARDS

Question 16

ARDS: ventilatory support approaches for treatment

Answer 16

Low VT,PIP
PEEP
Secondary vent strategies
Permissive hypercapnia
Lung recruitment

Question 17

ARDS: pharmacological therapies

Answer 17

Pulmonary vasodilators (prost)
SABA
Steroids

Question 18

ARDS: when are antibiotics indicated

Answer 18

Bacterial infection

Question 19

Inherited, genetic, recessive disorder involving the respiratory, digestive, and reproductive systems

Answer 19

Cystic fibrosis

Question 20

CF: caused by

Answer 20

CFTR

Question 21

CF: diagnostic tests

Answer 21

Sweat chloride >60 (30-59 > 6mos intermediate, repeat)
CFTR mutation

Question 22

CF: early symptoms

Answer 22

Dry, hacking cough
Large amount of secretions

Question 23

CF: CXR

Answer 23

Atelectasis, hyperinflation, flattening of diaphragm, increase A-P

Question 24

CF: components of tx/management

Answer 24

SABA/anticholinergics
Mucolytic agent: DNase, hypertonic saline
CPT/aw clearance
High protein diet, enzyme replacement therapy

Question 25

Reversible airway obstruction

Answer 25

Asthma

Question 26

Asthma: common triggers

Answer 26

Allergies Stress Exercise Cold exposure Infection Inhaled irritants

Question 27

Asthma: signs/symptoms in early stages

Answer 27

Dyspnea, cough, secretions, expiratory wheezing

Question 28

Asthma: CXR during acute episode

Answer 28

Hyperinflation, infiltrates

Question 29

Asthma: control medications

Answer 29

LABA (-almetrol) Inhaled corticosteroids (-one) Leukotriene modifiers (montelukast) Immunomodulators (Zumba)

Question 30

Asthma: rescue meds

Answer 30

SABA: levalbuterol, albuterol Anticholinergic: ipratropium Systemic steroids

Question 31

Asthma: emergency room care

Answer 31

First, oxygen therapy Continuous albuterol or 3 tx/hr Inhaled anticholinergic Systemic corticosteroids steroids

Question 32

Status asthmaticus

Answer 32

Acute episode that does not respond to usual bronchodilator treatment

Question 33

Asthma: additional treatments

Answer 33

Continuous bronchodilator Subq epi IV steroids Mag Helios Inhaled anesthetics

Question 34

Asthma: when is mechanical ventilation indicated

Answer 34

Rising CO2 Increasing MV Decreasing consciousness

Question 35

Asthma: what to attempt before intubation

Answer 35

NIPPV

Question 36

Asthma: what is essential in monitoring and measuring?

Answer 36

Peak flow

Question 37

Asthma: components of comprehensive management program

Answer 37

Patient and parent education Identification and avoidance/mgmt of triggers Peak flow monitoring Recognizing symptoms Asthma action plan

Question 38

Moderate persistent asthma

Answer 38

Symptoms: everyday Activities: moderate limitation Lung function: FEV1 60-80%, FEV1/FVC ratio 75-80% SABA use: everyday Awakenings: 2nights/week (NOT nightly)

Question 39

Asthma: yellow zone peak flow range

Answer 39

50-80%

Question 40

Asthma: yellow zone status

Answer 40

Increase in symptoms

Question 41

Asthma: yellow zone action

Answer 41

Preventative inhaler Add rescue Increase tx with oral steroids Call doctor

Question 42

Croup: etiology

Answer 42

Parainfluenza (viral)

Question 43

Croup: URI

Answer 43

Present

Question 44

Croup: incidence

Answer 44

Fall or winter

Question 45

Croup: onset

Answer 45

Gradual

Question 46

Croup: fever

Answer 46

Low-grade

Question 47

Croup: admission criteria

Answer 47

Strider at rest

Question 48

Croup: lateral neck

Answer 48

Subglottic edema, hourglass, steeple, or pencil sign

Question 49

Croup: tx/drugs

Answer 49

Oxygen Cool aerosol Race mic Steroids

Question 50

Epiglottitis: etiology

Answer 50

Hemophilus influenza

Question 51

Epiglottitis: URI

Answer 51

Absent

Question 52

Epiglottitis: age

Answer 52

2-6 years

Question 53

Epiglottitis: signs and symptoms

Answer 53

Sudden onset High fever Drooling/retractions

Question 54

Epiglottitis: lateral neck

Answer 54

Supraglottic edema Thumb sign Obliterated vallecula

Question 55

Epiglottitis: tx/drugs

Answer 55

Intubate (in or) Antibiotics Oxygen/CPAP