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Flashcards in Peds Pulm Deck (18):
1

Croup caused by what?

Who gets it?

XR finding

Parainflu! less commonly RSV or others. They are pre schoolers

Barky, harsh, seal like cough and STRIDOR

Can progress to inspiratory stridor (inhale, not exhale)

See steeple sign on XR

2

Croup admission when?

Progressive stridor or stridor with rest.

No improvement after steroids

Respiratory distress

3

Tx croup in ER?

Steroids

Racemic epic if stridor

4

Epiglottitis is high yield! What causes it?

BIG IMPORTANT THING ABOUT THEM ON PHYSICAL

HIB, usually

High Fever, poor intake and drooling. UNIONIZED

Toxic appearing

Drooling, tripping trying to breath.

COMFORT THEM BY MOM!!!! don't try to exam throat b/c can irritate more and be life threatening, wait to intubate

GIVE IV ANTIBIOTICS after airway

thumbprint sign

5

Tx of epiglottis?

IV clinda or vanco for staph. Ceftriazone or cefotaxime for HiB

6

What causes bronchiolitis?

Symptoms

RSV. Winter/spring and children less than 2

Wet cough, fever, poor feeding

7

Who gets severe RSV?

Young, asthma other stuff

Tachypnea, wheeze, crackles, rhyperresonance

Resp distress. LOOKS AND SOUNDS LIKE ASTHMA (this is too young and not reversible)

8

CXR for RSV?

Air trappin (hyperinflation) with patchy hillier infiltrates

Complication is pneumonia

9

Txfor RSV?

If you make a cure, win NOBEL PRIZE

Supportive care with O2 and fluids

STEROIDS ARE NOT EFFECTIVE

Vaccine in premies

10

When are steroids used for infection of airway in kids?

Croup.

NOT RSV

11

Parent unable to care for child at home is an indication for hospitalization

Always

12

Tx for croup?

O2, steroids, epi

13

Who gets surgery for parathyroid adenoma?

Ca++ is high and symptomatic, Creatinine clearance below 30%, osteoporosis, less than 50 years old

14

CXR in resp distress of newborn?

How is it different than transientt tachypnea of newborn?

Ground glass appearance with low lung volume
Diffuse GROUND GLASS with AIR BRONCHOGRAMS

TTN is increased volume and flattening of diaphragm
Suburst vascular markings from hilum
Fluid streaking in interlobular filssures

15

Meconium might break down surfactant, so consider administration if Meconium aspiration syndrome

Babies would have cyanosis, intercostal retractions, tachypnea

INCREASED risk of reactive airway later. GIVE ANTIBIOTICS if necessary for treating... well... poop

16

CF has pancreatic insufficiency, remember??

Tx for malabsorption?

Dietician consult

Enzymes

ADEK supplement

17

Treating pulm component of CF?

Think keep airway clean

Beta agoniststo dilate
DNase I for sputum viscoity
Hypertonic saline for flushing
Physiotherepy
Azythromycin for when lower lung function and treat psuedomonas (or fluoroquinolone)

18

What is causing stridor, wheezing and shortness of breath despite medical therapies in newborn?

Vascular ring