Peds

Question 1

Infant RDS (hyaline membrane disease) Epi

Answer 1

• Usually premature

- RF: mothers w/ DM, multifetal preg, C-section, fam hx

Question 2

Infant RDS (hyaline membrane disease) Pathophys

Answer 2

• Surfactant def –> collapsed alveoli

Question 3

Infant RDS (hyaline membrane disease) Sx

Answer 3

• Within minutes of birth: grunting, tachypnea, accessory muscle use, dusky, diminished breath sounds, falling BP

Question 4

Infant RDS (hyaline membrane disease) Dx

Answer 4

• Clinical dx

- CXR: ground glass appearance

Question 5

Infant RDS (hyaline membrane disease) Tx

Answer 5

• Frequent monitoring
• Warm humid O2
• Give surfactant

Question 6

Infant RDS (hyaline membrane disease) Prevention

Answer 6

• Prevention: shot of beta methasone 48 hrs prior to delivery (23-34 wks)

Question 7

Acute Bronchiolitis Epi

Answer 7

• Most common lower resp inf <2 y/o

Question 8

Acute Bronchiolitis Etiology + Pathophys

Answer 8

• Usually acute viral (most common = RSV)

- Inflam of bronchioles

Question 9

Acute Bronchiolitis Sx

Answer 9

• Rhinorrhea
• Cough
• Tachypnea
• Tachy
• Increased resp effort

Question 10

Acute Bronchiolitis Dx

Answer 10

• H&P

- If <2 m/o eval for sepsis

Question 11

Acute Bronchiolitis Tx

Answer 11

• Hydration
• O2
• Antivirals

Question 12

Acute Bronchiolitis Prognosis

Answer 12

• Most fully recover

- Some continue to wheeze thru age 5+

Question 13

RSV Epi

Answer 13

• Leading cause of infant death from viral inf
• Most have by age 2
• Esp. Oct-March

Question 14

RSV Pathophys

Answer 14

• Airborne (large droplets)

- High risk of nosocomial inf

Question 15

RSV Sx

Answer 15

• Adults: minor URI

- Peds: common cold sx, in distress, complications: AOM, bact pneumonia

Question 16

RSV Dx

Answer 16

• Clinical

- RSV rapid antigen (to identify that it is in community)

Question 17

RSV Tx

Answer 17

• None

Question 18

RSV Prevention

Answer 18

• Hand washing
• Cohort care (providers treating pts)
• Synagis (giving antibodies for passive immunity–$$$)

Question 19

Pediatric Asthma Epi

Answer 19

• Genetics
• Age
• Environment
• RF: M, AA, lower SES

Question 20

Pediatric Asthma Pathophys

Answer 20

• Chronic inflam resulting in episodic airflow obstruction

Question 21

Pediatric Asthma Sx

Answer 21

• Dry cough
• Expiratory wheezing
• SOB
• Chest tightness
• Sx worse at night
• Accessory muscle use

Question 22

Pediatric Asthma Dx

Answer 22

• Recurrent wheezing (early childhood, viral trigger)

- Chronic (persists into adulthood, usually allergic trigger)

Question 23

Pediatric Asthma Tx

Answer 23

• Monitoring
• Pt education
• Control factors that contribute to asthma
• Meds

Question 24

Croup Epi

Answer 24

• 3 months - 5 y/o

- Late fall and winter

Question 25

Croup Etiology + Pathophys

Answer 25

- Parainfluenza**, flu, RSV, adenovirus | - Airway resistance

Question 26

Croup Sx

Answer 26

- 1-3 days of URI sx --> sudden onset upper airway obstruction - Barky cough - Hoarse - Inspiratory stridor - Worse at night - Aggravated by crying

Question 27

Croup Dx

Answer 27

- Xray: steeple sign | - Can be acute (viral URI) or spasmodic (allergic, resolves quickly)

Question 28

Croup Tx

Answer 28

- At home: cool mist, steamy shower, freezer door, go outside - In ED: nebulized epi, steroids

Question 29

Croup Prognosis

Answer 29

- Usually 3-4 day course

Question 30

Epiglottitis Etiology

Answer 30

- H. flu (now not as common w/ vaccine), strep

Question 31

Epiglottitis Sx

Answer 31

- Fine one minute, sick the next - High fever - Sore throat - Dyspnea - Rapidly progressive resp obstruction - Drooling - Tripod position

Question 32

Epiglottitis Dx

Answer 32

- Cherry red swollen epiglottis | - Xray: thumbprint sign

Question 33

Epiglottitis Tx

Answer 33

- Send to ED - Establish airway - O2 - Culture --> abx

Question 34

Pertussis Epi

Answer 34

- Vaccine | - Reportable

Question 35

Pertussis Sx

Answer 35

Stages: - Catarrhal: congestion, rhinorrhea - Paroxysmal: inexorable paroxysms - Convalescent: resolution

Question 36

Pertussis Dx

Answer 36

- Absence of fever, malaise, sore throat - Culture - Leukocytosis

Question 37

Pertussis Tx

Answer 37

- Humidify air | - Antimicrobial (erythro or azithro) to prevent spread

Question 38

Pertussis Prognosis

Answer 38

- 6 wk course | - Complications: pneumonia, secondary inf, seizures, apnea