Flashcards in Peds Pulm Deck (18):
Croup caused by what?
Who gets it?
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
Croup admission when?
Progressive stridor or stridor with rest.
No improvement after steroids
Tx croup in ER?
Racemic epic if stridor
Epiglottitis is high yield! What causes it?
BIG IMPORTANT THING ABOUT THEM ON PHYSICAL
High Fever, poor intake and drooling. UNIONIZED
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
Tx of epiglottis?
IV clinda or vanco for staph. Ceftriazone or cefotaxime for HiB
What causes bronchiolitis?
RSV. Winter/spring and children less than 2
Wet cough, fever, poor feeding
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)
CXR for RSV?
Air trappin (hyperinflation) with patchy hillier infiltrates
Complication is pneumonia
If you make a cure, win NOBEL PRIZE
Supportive care with O2 and fluids
STEROIDS ARE NOT EFFECTIVE
Vaccine in premies
When are steroids used for infection of airway in kids?
Parent unable to care for child at home is an indication for hospitalization
Tx for croup?
O2, steroids, epi
Who gets surgery for parathyroid adenoma?
Ca++ is high and symptomatic, Creatinine clearance below 30%, osteoporosis, less than 50 years old
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
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
CF has pancreatic insufficiency, remember??
Tx for malabsorption?
Treating pulm component of CF?
Think keep airway clean
Beta agoniststo dilate
DNase I for sputum viscoity
Hypertonic saline for flushing
Azythromycin for when lower lung function and treat psuedomonas (or fluoroquinolone)