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Pulmonary Flashcards

(55 cards)

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0
Q

What are the 2 cells in lungs?

A

Type 1: 90%

Type 2: 10% - makes surfactant

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1
Q

Respiratory distress vs respiratory failure?

A

distress: RR goes up but NOT compensating
failure: COMPENSATING d/t no good O2 and ventilation –> acidotic

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2
Q

Transient tachypnea of new born (TTN)?

A

delayed fluid clearance

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3
Q

TTN - PE?

A

tachypnea

nasal flaring

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4
Q

TTN - prognosis?

A

resolves w/in 3 days

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5
Q

TTN - dx?

A

nasal cannula/CPAP

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6
Q

TTN - labs?

A

CXR: hazy bilaterally w/ streaking in perihilar area

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7
Q

TTN - tx?

A

abx based on PE and hx until culture is negative

maintain glucose

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8
Q

Respiratory distress syndrome (RDS)?

A

premature babies females

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9
Q

Increase risk w/ RDS?

A

diabetic moms

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10
Q

RDS - patho?

A

no good surfactant –> V/Q mismatch –> hypoexmia (acidosis) –> pulmonary vasoconstriction and leaking of protein –> hyaline membrane dz

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11
Q

RDS - PE?

A

GRUNTING
cyanosis
hypoxemia
nasal flaring

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12
Q

RDS - dx?

A

CXR: ground glass appearance

premature

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13
Q

RDS - tx?

A 
antenatal corticosteroids 
vent support to prevent barotrauma 
prevent complications
give surfactant 
nitric oxide: decrease pulmonary HTN
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14
Q

RDS - prognosis?

A

bad news bears: 40%

survivors end up with bronchopulmonary dysplasia

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15
Q

What is meconium aspiration syndrome (MAS)?

A

dark green vomit
normally passes through via GI but ends up in lungs –> damages lungs
> 38wks of gestation

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16
Q

Why is meconium bad?

A

deactivates surfactant

aspiration of bile acids –> chemical pneumonia

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17
Q

MAS -PE?

A

metabolic acidosis

yellow clubbing fingers, umbilical cord

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18
Q

MAS- labs?

A

CXR: opacities w/ surrounding hyperinflation

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19
Q

MAS - complications?

A

pneumonia
acidosis
pneumothorax

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20
Q

MAS - delivery room managment?

A

stick a vacuum down the nose and see if there is anything that sucks up

  • yes: continue to suck
  • no: DON’T SUCK
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21
Q

MAS - tx?

A 
surfactant therapy (b/c the bile deactivated surfactant proteins) w/in 6hrs of brith for 2-3 doses 
be on look out for pneumothorax, +/-chest tube
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22
Q

What dz can cx wheeze?

Study These Flashcards
A

asthma
bronchiolitis
CF

23
Q

What bug is bronchiolitis?

Study These Flashcards
A

RSV

esp during fall/winter season

24
What is bronciolitis?
lower resp tract in <2 yo | acute inflammation of the bronchioles that causes increased MUCUS PRODUCTION AND BRONCHOSPASM
25
Bronchiolitis - RF?
premature - low surfactant LBW heart dz immunodeficient
26
Bronchiolitis -dx?
rales/rhonic wheezes after/with viral resp infxn during RSV fall/winter seasons
27
Bronchiolitis - labs?
CXR: cuffing and atelectasis | +/- nasopharyngeal swab
28
Bronchiolitis vs asthma?
presents the same way but bronchiolitis may not have an effect w/ bronchodilator (if there is an effect - continue) O2 if premature, cardio probs, <12 wks old DO NOT USE: corticosteroids antivirals abx
29
When to admit bronchiolitis?
multiple RF | severe: <90%, retractions
30
Bronchiolitis - prevention?
avoid RSV by hand washing, hygiene breast feed vaccine may be considered (palivizumab/synagis) IF premature, chronic lung dz of prematurity, congenital heart dz
31
CF - risk?
inherited | caucasian
32
Cystic fibrosis - pathophysio?
defect of membrane pumps that lead to increased salty secretion from sweat glands also affects the lungs b/c it builds up mucus that is obstructive AND destructive
33
What membrane pump is broken in CF?
CFTR
34
What organ systems start to fail w/ CF?
``` lungs GI Gu Metabolic Pulm ```
35
CF - PE?
lungs: WHEEZE/CRACKLES, recurrent URI GI: steatorrhea and diarrhea; HEPATOSPLENOMEGALY GU: sterility Metabolic alkalosis NASAL POLYPS sciolosis/kyphosis d/t lack of Ca development in bones
36
CF -dx?
Cl test
37
CF - labs?
``` hypohloremic metabolic alkalosis increased serum glucose sputum cultures high LFT CXR: -pulmonary nodules d/t abscesses ```
38
CF - tx?
pancreatic enzymes (to help with the hepatosplenomegaly) mucolytics bronchodilators chest physiotherapy for the mucus
39
Baby has poor growth w/ multiple hospitalization for pneumonia?
check CF
40
Baby has nasal poly?
CF
41
Baby has pseudomonas pneumonia?
CF
42
Baby has rectal prolapse?
screen for CF
43
Pneumonia cx?
VIRAL >>>> bacterial
44
Pneumonia vital signs?
fever | tachypnea
45
Pneumonia- PE?
crackles wheezes decreased breath sounds
46
Bacterial pneumonia - CXR?
focal infiltrate loss of lung vol loss of heart sillhouette air bronchograms
47
Bacterial pneumonia -neonates bugs?
group B listeria monocytogenes gram neg - E. coli, Klebsiella pneumoniae
48
Bacterial pneumonia - neonates tx?
admit gentamicin febrile? ADMIT
49
Bacterial pneumonia - 1mo ~5yrs bugs?
``` S pneumoniae H influ - if unimmunized chlamydia strep pyogenes staph aures ```
50
Bacterial pneumonia - 1mo ~5yrs bugs -tx?
admit if <4-6mo | outpt therapy: HD amox or augmentin
51
Bacterial pneumonia >5yrs -bugs?
myocplasma | strep pneumoniae
52
Bacterial pneumonia >5yrs- tx?
admit if toxic | outpt therapy: macrolide
53
When to use cough supressents?
only if older than 6yo | ONLY TO HELP SLEEP
54
How to tx cough?
``` humidified air limit exposure to smoke hydration warm water + brown sugar/honey NO HONEY in <1yo ```

Pediatrics (12 decks)

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