Pediatric Lung and Airway Topics Flashcards Preview

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

Flashcards in Pediatric Lung and Airway Topics Deck (37):
1

Grunt Implies

Decreased compliance of chest wall
Trying to create PEEP

2

What is Stridor

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

3

What is Stertor?

Snoring

4

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

Inspiration.
Fine = Acute inflammation
Harsh = Fibrosis

5

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

Expiratory
Obstruction

6

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

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

7

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

Wheeze -- Intrathoracic, Worse on expiration
Stridor -- Extrathoracic, worse on inspiration

8

Example of fixed obstruction

Laryngeal or tracheal web
(incomplete recanalizaton of the larynx)

9

Variable extrathoracic problems in peds patients

Vocal Cord Dysfunction
Obstructive Sleep Apnea

10

Variable intrathoracic obstruction problems in peds patients

Endobronchial or tracheal tumor

11

Causes of bronchiolitis

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

12

When does bronchiolitis hit the midwest?

Nov-April

13

Who gets bronchiolitis?

Nearly all kids by age 2
Risk of 2ndary bacterial infection or otitis media

14

Big risks with bronchiolitis?

High risk for infants with poor lung development
Can cause apnea in infants

15

Treatment for bronchiolitis?

Supportive (Oxy., Fluids)
Prevention with Palivizumab monthly during season

16

Presentation of bronchiolitis?

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

17

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

Epiglottal Swelling, Narrowing of Airway

18

Fancy word for croup

laryngotracheitis

19

Symptoms of Croup

Seal-bark cough, Hoarseness, Stridor
Subglottic larynx edema/inflam.

20

Which kids get croup?

6%, peak at 1-2 yo
Slightly more males (1.5:1)

21

When do kids get croup?

Late fall, early winter

22

Causes of croup?

Parainfluenza, RSV
Influenza, Coxsackie, rhino, mPNV

23

Signs of H. flu

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

24

How many ribs should you see on a chest xray

10

25

Who has the membrane

diptheria

26

What does the trachea move toward and away from

Away from infection
Toward collapse

27

Most common causes of CAP in an under 1 month

Group B
E coli
L monocytogenes
CMV, HSV

28

Most common causes of CAP in an 1-3 months

Virus
S pneumo
S aureus
afebrile pneumonitis pathogens

29

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

Virus
S pneumo
S aureus

30

Most common causes of CAP in school age

Virus
M pneumoniae
S pneumoniae
C pneumoniae

31

Tests encouraged in evaluating an outpatient peds pneumonia?

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

32

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

CXR
Blood Culture if deterioration or no improvement

33

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

Laryngomalacia

34

What do you do for Laryngomalacia patients?

Surgery to remove redundant tissues

35

Describe how diaphragmatic hernia patient might present

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

36

What does diaphragmatic hernia do to the lungs?

Causes lung hypoplasia, persistent pulmonary hypertension

37

How is diaphragmatic hernia treated?

Medically managed with ventilatory support or ECMO
Surgical management when stable