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Clinical Medicine 4 > Pediatric Pulmonology > Flashcards

Pediatric Pulmonology Flashcards

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1
Q

Etiology of Epiglotitis?

A

Bacterial. S Pyogenes, S Pneumonia, Staph.

H Flu way down d/t vaccines.

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2
Q

Epiglotitis is acute inflammation of which glottic region?

A

Supraglottic

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3
Q

Speed of onset in Epiglotitis?

A

RAPID onset

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4
Q

Do kids like well or toxic in Epiglotitis?

A

Toxic

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5
Q

Voice sounds like what in Epiglotitis?

A

Muffled, hot potato

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6
Q

Stridor happens early or late in Epiglotitis?

A

Late finding

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7
Q

Lateral neck xray shows what in Epiglotitis?

A

Thumbprint sign

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8
Q

Dx of Epiglotitis?

A

Clinical and direct visualization endoscopy while intubating

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9
Q

Stat treatment for Epiglotitis?

A

Intubation

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10
Q

Abx for Epiglotitis?

A

Ceftriaxone or Cefotaxime

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11
Q

Who to PPX if exposed to Epiglotitis? What to use?

A

Unvaccinated, immunocompromised, or <6mo.

Rifampin.

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12
Q

Croup aka?

A

Laryngeotracheal Bronchitis

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13
Q

Croup is inflammation of which region of the glottis?

A

Subglottic

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14
Q

Etiology of Croup?

A

Viral Parainfluenza 1,2,3

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15
Q

Age of Croup?

A

3mo-5mo, peak at 2y/o

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16
Q

Seasons for Croup?

A

Fall and Spring

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17
Q

Sx in day 1-3 in Croup?

A

Rhinorhea, low grade fever. Like common cold.

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18
Q

Sx in day 3-5 Croup?

A

Barking, seal like cough mostly between 10am-4pm.

+/- Stridor

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19
Q

Sx in day 5-7 of Croup?

A

Resolves

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20
Q

Dx for Croup?

A

Clinical. Don’t need xray d/t not being a lung issue.

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21
Q

Tx of Croup without stridor?

A

Decaron IV 0.6mg/kg PO, max 20mg and go home to rest.

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22
Q

Tx of Croup at home?

A

Cold night air, open freezer door. Humidified air.

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23
Q

Tx of Croup with stridor?

A

HOSPITAL
Decadron IV PO, Racemic Epi via nebulizer, watch 2-3h. Admit if no improvement and give continuous Racemic Epi neb. Consider PICU.

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24
Q

Broncholitis is infection of upper or lower respiratory tract?

A

Lower resp tract

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25
Who gets Broncholitis?
<2 y/o
26
Increased risk factors in Broncholitis?
Premies, asthma, immunocompromised
27
Etiology of Broncholitis?
RSV 50%. Parainfluenza and Adenovirus the rest.
28
If Broncholitis is bacterial which one?
Mycoplasma
29
When does Broncholitis occur?
Late fall, throughout winter
30
How Broncholitis transmitted?
Respiratory droplets into mucosa of the victim
31
Broncholitis lasts for how many days?
10-12
32
Sx in Day 1-2 of bronchiolitis?
URI, congested, low grade fever
33
Sx in day 2-4 of Broncholitis?
WHEEZING, tachypnea, belly breathing, prolonged expiration, retractions, nasal flaring, circumoral cyanosis, >2sec cap refill, pallor, and mottling
34
Dx of Broncholitis is <3mo or with risk factors?
Nasal wash for PCR and RSV
35
What will CXR show in Broncholitis?
Perihilar markings
36
When to hospitalize in Broncholitis?
- SaO2 below 91% and need oxygen - Apenic episodes - <12 week premie - <12 week normal birth buy days 1-3 sick - Underlying risk factors - Parent can't care at home
37
Tx of Broncholitis is mainly?
Supportive
38
Give high flow O2 when in Broncholitis?
If sat <92%. Keep >94%.
39
Meds for Broncholitis?
Bronchodilators and PO Steroids (Decadron, Prednisone). NO ABX unless pneumonia superinfection.
40
ICS recommended in Broncholitis?
NO
41
What to do is resp failure in Broncholitis?
Intubate
42
Eti of Pertussis?
Bortadella Pertussis, G- coccobacillus
43
Where does Pertussis bacteria colonize?
Ciliated epithelium
44
How Pertussis transmitted
Via droplets
45
What age does vaccine wane in Pertussis?
12 y/o
46
3 stages of Pertussis?
1. Catarrhal 2. Paroxysman 3. Convalescent
47
Pertussis most infectious during which stage?
Catarrhal
48
How long does Catarrhal stage last in Pertussis?
1-2 weeks
49
Sx of Catarrhal stage in Pertussis?
Common cold
50
How long does Paroxysman stage last in Pertussis?
1-6wk, up to 10 weeks
51
Sx of Paroxysmal stage of Pertussis?
Bursts of rapid coughing with long inhalf effort at end. High-pitched "whooping" sound
52
Cough lasts for how long in Pertussis?
2-3 weeks
53
Convalescent stage lasts for how long in Pertussis?
Months
54
Dx for Pertussis?
Highly clinical dx. Can do nasopharyndeal swab but takes days to weeks for results.
55
Abx for Pertussis?
Zithromax or Erythromycin. Supportive care.
56
80% of Foreign Body Aspirations occur under what age?
<3 y/o
57
Peanuts account for what percent of Foreign Body Aspirations?
50%
58
What are often fatal Foreign Body Aspiration?
Ballons
59
Where do FBs lodge in kids?
Right or Left proximal mainstem bronchus
60
Where do fatal FBs lodge?
Larynx
61
Where do FBs lodge in adults?
Right mainstem
62
Life threatning S/Sx in FBA?
Resp distress, cyanosis, altered mental status
63
Non-life threatening S/Sx in FBA?
Wheezing, cough, decreased air entry
64
Dx for FBA?
H+P, xray, then rigid broncoscopy
65
Tx for FBA?
Rigid broncoscopy. Steroids if inflammation occurs after removal.
66
Etiology of Cystic FIbrosis?
Genetic error of chloride channel CFTR
67
Where do viscous secretions build up in Cystic FIbrosis?
Lungs, pancreas, liver, intestine, repro tract
68
Meconium Ileus in newborn with Cystic FIbrosis?
Pathognomonic!!!
69
Cough and lungs in Cystic FIbrosis?
Persistent productive cough, hyperinflation of lungs
70
Which bacteria in lungs of kids with Cystic FIbrosis?
S Aureus and H Flu
71
Which bacteria in lungs in adults with Cystic FIbrosis?
P Aeruginosa
72
Primary test for Cystic FIbrosis?
Sweat test
73
Dx for Cystic FIbrosis must have S/Sx in how many organ systems?
At least 1+
74
Tx for Cystic FIbrosis?
CFTR modulators, abx (Azithromycin for PPX and antiinflammatoruy), nebilized abx, bronchodilators
75
Respiratory Distress Syndrome occurs in who?
93% of premature babies under 28 weeks gestated
76
Respiratory Distress Syndrome due to?
Decreased surfactant
77
S/Sx of Respiratory Distress Syndrome?
Tachypnea, retractions, nasal flaring, grunting on espiration, cyanosis, decreased breath sounds, pallor, decreased peripheral pulses, peripheral edema, poor urine output
78
What does CXR show in Respiratory Distress Syndrome?
Ground glass appearance, low lung volume, pneumothorax
79
ABG in Respiratory Distress Syndrome shows what?
Hypoxia
80
Hyponatremia in Respiratory Distress Syndrome due to....?
Water retention
81
Tx of Respiratory Distress Syndrome if preggers and at risk of delivery <34 weeks?
Atenatal steroids
82
Tx of preterm <30 newborn with Respiratory Distress Syndrome?
Exogenous Surfactant, down the ETT with PEEP
83
PEEP corrects what in Respiratory Distress Syndrome?
Atelectasis, improves arterial oxygenation
84
PEEP drawbacks in Respiratory Distress Syndrome?
Pressure trauma, oxygen toxicity, BPD

Clinical Medicine 4 (10 decks)

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