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ICM -- Pulmonology > Pediatric Lung and Airway Topics > Flashcards

Pediatric Lung and Airway Topics Flashcards

1
Q

Grunt Implies

A

Decreased compliance of chest wall

Trying to create PEEP

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2
Q

What is Stridor

A

Turbulent inspiratory airflow below/in the larynx coming across a partly closed glottis

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3
Q

What is Stertor?

A

Snoring

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4
Q

When are ronchi/crackles heard? What do they mean?

A

Inspiration.
Fine = Acute inflammation
Harsh = Fibrosis

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5
Q

When are rales/wheezes heard? What do they mean?

A

Expiratory

Obstruction

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6
Q

Physical signs of a lung/airway problem in a peds patient

A

Tachypnea, nasal flaring, intercostal retractions, accessory muscle use, pursed lips, prolonged expiratory phase, cyanosis

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7
Q

Wheeze vs. Stridor. Who is intra and who is extrathoracic?

A

Wheeze – Intrathoracic, Worse on expiration

Stridor – Extrathoracic, worse on inspiration

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8
Q

Example of fixed obstruction

A

Laryngeal or tracheal web

incomplete recanalizaton of the larynx

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9
Q

Variable extrathoracic problems in peds patients

A

Vocal Cord Dysfunction

Obstructive Sleep Apnea

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10
Q

Variable intrathoracic obstruction problems in peds patients

A

Endobronchial or tracheal tumor

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11
Q

Causes of bronchiolitis

A

RSV, hMPV,
Influenza, Parainfluenza,
Corona, Rhino, Adeno

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12
Q

When does bronchiolitis hit the midwest?

A

Nov-April

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13
Q

Who gets bronchiolitis?

A

Nearly all kids by age 2

Risk of 2ndary bacterial infection or otitis media

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14
Q

Big risks with bronchiolitis?

A

High risk for infants with poor lung development

Can cause apnea in infants

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15
Q

Treatment for bronchiolitis?

A

Supportive (Oxy., Fluids)

Prevention with Palivizumab monthly during season

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16
Q

Presentation of bronchiolitis?

A

Runny Nose, Cough, Fever, tachypnea,
Intercostal retractions
Bilateral wheezing and crackles
Diffuse infiltrates

17
Q

What is a steeple sign on an X ray telling you?

A

Epiglottal Swelling, Narrowing of Airway

18
Q

Fancy word for croup

A

laryngotracheitis

19
Q

Symptoms of Croup

A

Seal-bark cough, Hoarseness, Stridor

Subglottic larynx edema/inflam.

20
Q

Which kids get croup?

A

6%, peak at 1-2 yo

Slightly more males (1.5:1)

21
Q

When do kids get croup?

A

Late fall, early winter

22
Q

Causes of croup?

A

Parainfluenza, RSV

Influenza, Coxsackie, rhino, mPNV

23
Q

Signs of H. flu

A

Unable to control secretions, fever, unimmunized, tripod position, elevated RR, thumb sign on epiglottis x ray

24
Q

How many ribs should you see on a chest xray

A

10

25
Q

Who has the membrane

A

diptheria

26
Q

What does the trachea move toward and away from

A

Away from infection

Toward collapse

27
Q

Most common causes of CAP in an under 1 month

A

Group B
E coli
L monocytogenes
CMV, HSV

28
Q

Most common causes of CAP in an 1-3 months

A

Virus
S pneumo
S aureus
afebrile pneumonitis pathogens

29
Q

Most common causes of CAP in a 3 month-5 years

A

Virus
S pneumo
S aureus

30
Q

Most common causes of CAP in school age

A

Virus
M pneumoniae
S pneumoniae
C pneumoniae

31
Q

Tests encouraged in evaluating an outpatient peds pneumonia?

A 
Pulse Ox
Flu testing (if in season)
Mycoplasma IgM (before giving a macrolide)
32
Q

Which test aren’t encouraged, but could be fine in an outpatient peds pneumonia

A

CXR

Blood Culture if deterioration or no improvement

33
Q

4 month old. stridor of upper airways. Noisy breathing since week 2 of life. No recent illness, fevers, or coughs. What is it

A

Laryngomalacia

34
Q

What do you do for Laryngomalacia patients?

A

Surgery to remove redundant tissues

35
Q

Describe how diaphragmatic hernia patient might present

A

Newborn in resp. distress.
Grunting, tachypneic, cyanotic even w/ bag valve
Crackles on right, no sounds on left

36
Q

What does diaphragmatic hernia do to the lungs?

A

Causes lung hypoplasia, persistent pulmonary hypertension

37
Q

How is diaphragmatic hernia treated?

A

Medically managed with ventilatory support or ECMO

Surgical management when stable

ICM -- Pulmonology (9 decks)

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