Pediatric respiratory issues and disorders Flashcards Preview

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Flashcards in Pediatric respiratory issues and disorders Deck (41):
1

Egophany

E->A during auscultation indicated PNA

2

what age can you start PFTs

at age 8 if cooperative

3

obstructive lung disease characteristics

characterized by reduced airflow rates; lung volumes within normal range or larger
Typical of a child having trouble exhaling air (air trapping) which results in decreased rated and FEV1 (asthma, bronchiolitis, cystic fibrosis)

4

restrictive lung disease characteristics

characterized by reduced volumes and expiratory flow rates. Typical of a child that has trouble inhaling air, thus affecting the volume (PNA)

5

Bronchiolitis definition

A disease of the lower respiratory tract that causes inflammation leading to obstruction of the small respiratory airways. noted in children

6

s/sx of bronchiolitis

URI symptoms lasting for several days, moderate fever of 102F, gradual development of respiratory distress (nasal flaring, grunting, cyanosis, prolonged expiration)
Tachypnea (60-80 bpm)
non productive cough
paroxysmal wheezing
progressive stridor
restlessness; changes in mental status
cyanosis
palpable liver and spleen (pushed down due to hyperinflation)

7

chest xray presentation for bronchiolitis

hyper inflated lungs, may have scattered areas of consolidation

8

Management of bronchiolitis

infants with mild distress can be treated as outpatients with supportive care
Prevention of high risk infants with (palivizumab) SYNAGIS IM monthly

9

Intermittent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

80% predicted and normal between exacerbations

10

Mild persistent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

>2 days/ week
Nighttime awakenings 3-4/month
rescue inhaler use >2 days/week but not daily
interference with normal activity- minot limitation
Lung function is FEV1>80% of predicted

11

Moderate persistent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

symptoms are daily, nighttime awakening are more than once per week but not nightly
rescue inhaler use is daily
some limitation and interference with normal activity
FEV1 60%-80% predicted

12

Severe persistent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

Symptoms throughout the day, nightly awakenings, rescue inhaler use several times per day, extremely limited interference with normal activity, and lung function less than 60% of predicted

13

treatment in intermittent asthma

step 1- SABA + PRN for all age groups

14

Treatment in mild persistent asthma

Step 2- Low dose ICS. Alternative: Cromolyn or monteukast

15

Treatment for 0-4 yo with moderate or severe asthma

Refer beyond mild persistent
Step 3- medium dose ICS option and consider short course of oral systemic corticosteroids

16

treatment for moderate persistent asthma fort he 5-11 yo

step 3: Medium dose ICS option and consider short course of oral systemic corticosteroids

17

treatment for the severe persistent asthma in the 5 -11yo

Step 3: Medium dose OR
step 5 ICS option and consider short course or oral systemic corticosteroids

18

How long to see patient back after initiating or changing asthma medications? How long before you can try to decrease ICS?

Bring back in 2 weeks for follow-up. Wait for 3 months of controlled before decreasing the ICH, then recheck in 2 weeks

19

FEV1/FVC values for intermittent, mild persistent, moderate persistent, severe persistent

intermittent: >85%
mild persistent: FEV1/FVC: >80%
Moderate persistent: FEV1/FVC: 75%-80%
Severe persistent: FEV1/ FVC:

20

FEV1 values for intermittent, mild persistent, moderate persistent, severe persistent

Intermittent: >80%
mild persistent: >80%
Moderate persistent: 60-80%
Severe persistent:

21

What age do you not consider lung function for asthma

0-4 years

22

Most common agent of PNA in newborns

Group B strep, chlamydia, E.coli

23

most common agent of PNA in infants and young children

RSN and H. Influenzae, strep pneumoniae (community aquired)

24

most common agent of PNA in preschool through young adulthood

Strep pneumoniae, mycoplasma, chlamydia

25

how much % of PNA is viral?

70%-80%

26

Radiograph for H. Influenzae

Lobar consolidation

27

Radiograph for S. Pneumonaie

lobar consolidation

28

Radiograph for Klebsiella

lobar consolidation

29

CXR for pneumocystis

diffuse interstitial, alveolar, apical or upper lobe infiltrates

30

radiograph for E.Coli

Patchy infiltrates, pleural effusion

31

Radiograph for staphylococcus

Patchy infiltrates

32

Radiograph for Pseudomonas

Patchy infiltrates

33

TX for CAP S. Pneomoniae

PCN

34

TX for CAP M. Catarrhalis (walking PNA)

macrocodes such as azithromycin (zithromax)

35

TX for CAP H. Influenze

Amoxicillin or cephalosporin

36

TX for viral PNA

supportive measures: hydration and antipyretics
ANX if secondary infection
Humidified o2 and chest physiotherapy
Bronchodilators

37

Cystic fibrosis definition

a autosomal recessive disorder that causes a defect in epithelial chloride transport resting in dehydrated, thick secretions leading to chronic multi system disorder affecting the respiratory tract, GI, hepatobiliary and reproductive tracts

38

s/sx of cystic fibrosis

viscid meconium or ileus in newborns, recurrent URI,
large, liquid bulky, foul stool (steatorrhea)
salt-tasting skin
chronic cough
rhinorrhea
hepatosplenomegaly
fat-soluble vitamin deficiencies
FTT
Delayed pubery
infertility

39

labs for cystic fibrosis

pilocarpine sweat test, PFTs with obstructive patter, hyponatremic hypochloremic dehydration (alkalosis)
Chest radiograph: cystic lesions, atelectasis

40

s/sx of croup

clear lungs, barking cough, low grade fever, recent uri, dyspnea

41

steeples sign (narrowing of the trachea) on radiograph is indicative of

croup