Pediatric Pulmonology Flashcards Preview

CPR II Exam 2 > Pediatric Pulmonology > Flashcards

Flashcards in Pediatric Pulmonology Deck (31)
Loading flashcards...
1

What are the 3 components of the pediatric assessment triangle?

Appearance, breathing and circulation

2

What are the 3 components of cardiopulmonary arrest in children?

Respiratory (O2), cardiac (pump, perfusion, BP), circulatory volume (perfusion, BP); occurs when there is ineffective ventilation, circulation or both

3

What can cause wheezing/cough in a pediatric pt?

Foreign body, oropharyngeal dysphasia, tracheoesophageal dysphagia, GERD, cystic fibrosis, vocal cord dysfunction, bronchitis/RAD, pneumonia, alpha 1 anti-trypsin deficiency

4

What are asthma action plans?

Game plan for dealing with asthma exacerbations; want everyone in the green zone which means having the sx of intermittent asthma (Sx <2 days/week, night time awakenings <2 times a month, SABA use <2days/week, no interference with normal activity)

5

What is poorly controlled asthma?

If the pt is not in the green zone with intermittent asthma, then it is poorly controlled; also if pt is seemingly doing well but are having >2 exacerbations/year needing systemic steroids they are poorly controlled and need tx added to their regimen; any pt who has >2 exacerbations requiring steroids in the same year

6

What is the tx for a pt suffering an acute asthma exacerbation?*

Albuterol (+/- ipratropium), steroids, oxygen

7

What are the components that need to be evaluated in the appearance of pt when assessing their degree of respiratory distress?

Interaction with environment (bad sign if not aware of surroundings), consolability (bad sign if highly irritable, panicky or agitated), looking at things/gaze (bad sign if eyes rolling around, lack of focus), speech/cry (bad sign if unable to speak, weak/gasping cry)

8

What is a bad sign when evaluating the respiratory rate in a pt?

Hypoxia will be compensated with tachypnea as long as the body can keep up, but when fatigue sets in, RR will start to become slow and irregular

9

What are some signs of increased work of breathing?

Nasal flaring, intercostal, subcostal, suprasternal retractions, rocking respirations, stridor, diffuse/localized wheeze, rales, grunting, accessory muscle involvement, decreased breath sounds, tripod/leaning forward position

10

What should be evaluated in the circulatory status when assessing a pt's degree of respiratory distress?

Perfusion (capillary refill), cyanosis, pale/mottled/ashen skin (can be signs of hypoxemia/shock)

11

What is viral croup?

usually caused by parainfluenza virus; laryngeal/tracheal swelling, possible stridor; kids don't act super sick

12

What is the MCC of infectious airway obstruction in kids 6-36 months old?

viral croup

13

What is the MCC of epiglottitis?

H. influenza type B (but rarely seen anymore due to vaccine); kids will be febrile, leaning forward, inability to swallow own secretions

14

What is bronchiolitis?

Wheezing caused by a viral infection (RSV the most notorious*); kids <2 yo get the sickest, really hard on former premature infants

15

What pathogens are most likely to cause pneumonia in newborns?*

Group B strep, listeria, gram - rods

16

What pathogens are most likely to cause pneumonia in infants/children?*

Strep pneumonia

17

What pathogens are most likely to cause pneumonia in adolescents?*

mycoplasma

18

What are the sx of pneumonia in children?

fever, tachypnea, cough, wheeze/rales

19

What is the tx for anaphylaxis?*

Epinephrine, oxygen, steroids

20

What are the sx of anaphylaxis?

retropharyngeal/laryngeal edema, facial edema and urticarial, bronchospasm

21

How does aspiration pneumonia usually present?

Respiratory distress following a choking/gagging/coughing episode

22

What is the inheritance pattern for cystic fibrosis?*

autosomal recessive; if both parents are carriers there is a 1/4 chance of a child having the dz

23

What are the signs and sx seen with cystic fibrosis?

chronic respiratory sx/infections (sinusitis, bronchitis, pneumonia, bronchiectasis), pancreatic enzyme insufficiency and resulting trouble with nutrition/growth, malabsorption, clubbing of the fingers, sterility in males (congenital absence of the vas deferens), *meconium ileus

24

Cystic fibrosis is the MC in which population?*

Ashkenazi jews (carrier frequency 1/24)

25

What are the common pathogens causing respiratory infections in those with cystic fibrosis?

Staph aureus and H influenza in early childhood; pseudomonas by the 2nd-3rd decade

26

Why do pts with cystic fibrosis require fat soluble vitamins?*

Because they have trouble absorbing fats due to a pancreatic enzyme deficiency and therefore fat soluble vitamins as well

27

What is the importance for universal newborn screening?

The earlier metabolic, hematologic, endocrine, and genetic abnormalities are IDed the earlier they can be treated and the better the outcome will be

28

What do positive newborn screening tests require?*

confirmatory testing

29

What is the prognosis for pts with cystic fibrosis?

Median age of survival is approx 40 yo; 80% of pts should reach adulthood

30

What is the MCC of death in cystic fibrosis pts?*

respiratory failure/cor pulmonale

31

What is the criteria for the diagnosis of cystic fibrosis?

Commonly diagnosed with newborn screening is abnormal and confirmatory testing is performed; confirmatory testing can be elevated sweat Cl on 2 occasions and actual chromosomal testing