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Flashcards in Peds Pulm Deck (25)
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1

 

 

What are the Lungs Conditions associated with?

1) Bronchiolitis, Pulm Edema, PNA, Asthma

2) Asthma Bronchiolitis, Foreign Body

3) cystic fibrosis

4) croup, laryngomalacia, subglottic stenosis, allergic rxn, vocal cord dysfunction

1)Crackles (rales)

2) Wheezes

3) Rhonchi

4) Stridor

2

 

What Viral Disease is this?

•Nasal congestion/URI sx

•usually afebrile

•Inspiratory stridor

Hoarseness

•Cough: barking; “seal-like

#1: Parainfluenza Virus Type 1, RSV and adenoviruses

 

 

Viral Croup (laryngotracheobronchitis)

3

 

 

How can we measure Imminent Respiratory Failure?

•Mild= ≤ 2

•Moderate=3-7

•Severe= ≥ 8

 

 

 

Westley Croup Score

4

 

How can we Diagnose and Treat Viral Croup?

 

•Diagnosis: Clinical: retractions & X-Ray show “steeple sign”

 

•Mild: Supportive therapy, Cool mist

•Moderate (score > 3): Corticosteroids:Dexamethasone IM/IV (0.6 mg/kg), Budesonide as a single dose (2mg)- not routine, Nebulized racemic epinephrine 

•Severe: Airway supportCorticosteroid IV, nebulized epi 

5

 

What is this disease and that is its MC cause?

•Sudden onset high fevers, inspiratory retractions, Rapid onset- stridor, muffled voice, dyspnea

•3 D’s: dysphagia, drooling & distress

Tri-pod posturing (“sniffing dog position”)

 

 

Epiglottitis

Haemophilus influenza type b (H. flu)

6

 

 

How can you reduce the incidence of Epilottitis, and what can uou Never do on a patient with Epiglottitis?

 

 

HIB vaccination

 

DO NOT USE A TONGUE BLADE!

7

 

 

What Antibiotics can you use empirically for Epiglottitis?

 

 

cephalosporin

+

Vancomycin (If MRSA)

8

 

What disease is this?

 

Lower respiratory tract infection that affects the small airways (bronchioles) in pt’s < 2

Common cause of hospital admissions <2 yo

Peak 2- 6mos of age…almost all children exposed by age 3

RSV #1, Rhinovirus

 

 

Bronchiolitis

9

 

What disease presents with wheezing & crackles on exam, presents with Lower Respiratory Tract sxs for 5 days, and is treated with 02, hydration, and Nasal Suction?

 

 

Bronchiolitis

10

 

What is the most important cause of lower respiratory tract infection (LRTI) in children < 1 yr and the No. 1 cause of Bronchiolitis?

 

 

Respiratory Syncytial Virus (RSV)

11

 

 

What viral infection presents with:

Diffuse wheezing & tachypnea following URI sx

•CXR: hyperinflation, peribronchial thickening

•low grade fever

crackles, prolonged expiration, wheezing, retractions

•congestion, lots of mucus

 

 

Respiratory Syncytial Virus (RSV)

12

 

 

How can you Diagnose and Treat RSV infections?

 

 

Diag: Clinical Sxs + Rapid Assay

Tx: Ribavirin (if immunecompromised), Palivizumab (prophylaxis Only)

13

 

What disease is the most common cause of respiratory distress in preterm infant?

Deficiency of surfactant production + surfactant inactivation by protein leak into airspaces = Pulmonary Edema 

 

 

Infant Respiratory Distress Syndrome (RDS)
“Hyaline Membrane Disease”

14

 

 

What syndrome is treated with 02, CPAP, Intubation, Steroids, and Surfactant replacement?

 

 

Infant Respiratory Distress Syndrome (RDS)
“Hyaline Membrane Disease”

15

 

What is the No. 1 cause of PNA in children

1-3 months

3-12 months

2-5 years

5-18 years

 

1-3 months = S. pneumo

3-12 months = S. pneumo

2-5 years = S. pneumo

5-18 years = Atypicals (Clamydia, Mycoplamsa)

16

 

 

If Grunting and Crackles are found on the physical examination for PNA, what does that mean? 

 

 

Grunting= imminent respiratory failure

Lungs: crackles (rales), rhonchi, decreased air mvmt

17

 

 

air space disease or consolidation in a lobar distribution = ________ pneumonia

interstitial or peribronchial infiltrates = ______pneumonia (or infection)

 

 

Bacterial

 

Viral

18

 

 

What disease is treated with 

Tx for S. pneumo: Amoxicillin 90 mg/kg per day divided BID x 10 days

If atypical is suspected, use macrolide (Azithromycin 10 mg/kg day one, then 5 mg/kg days 2-5.)

Admit if < 3-6 mo old or hypoxemic

 

 

Pneumonia

19

 

 

What bacteria causes Whooping Cough and how is it spread?

 

 

Bordartella Pertussis

Spread via Respiratory droplets

20

 

What disease is this?

•Diagnosis: (Gold standard) PCR (polymerase chain reaction) & culture of nasal secretions

CBC= leukocytosis 

 

•Treatment: TMP-SMX

• Prophylaxis: immunization

•Hospitalize if: Decreased O2  saturation, decreased feeding

Respiratory distress, cyanosis, apnea

 

 

Pertussis

21

 

What is the most common life-shortening genetic disease in white individuals AND is Autosomal Recessive?

 

 

Cystic Fibrosis

22

 

What disease is this?

Hallmark: High salt in sweat with recurrent sinus infections.

Most common 2nd infections due to H.flu & S. aureus in young kids

Pseudomonas in older kids

 

 

Cystic Fibrosis

23

 

 

How is Cystic Fibrosis diagnosed and treated?

 

Dx: Newborn screen, Sweat test & evaluation by CF specialist

 

Tx/management: airway clearance therapieschest physiotherapy, regular exercise

24

 

 

If Cystic Fibrosis pts are at an increased risk for developing hyponatremic dehydration, offer them _____ snacks.

 

 

 

 

Salty snacks

25