Pulmonary Flashcards
(24 cards)
Asthma Predictive Index Criteria
Major: parent with asthma; Dx with eczema; Evidence of allergies
Minor: Evidence of food allergies; 4% or greater blood eosinophilia; wheezing apart from colds
Needs one major or two minor
Dx of CF?
Greater than 60 mEq/L on chloride sweat test
Spasmodic croup
At night and short lived, higher incidence of asthma, atopic hx common
Bronchiectasis
Irreversible bronchial dilation
Chronic cough with thick purulent sputum
Linear atelectasis on CXR
End result of other disease processes including CF, pertussis, ABPS, strep pneumo, TB
Vascular ring is often associated with
Double aortic arch
THEN right sided aortic arch
What should you test for in a child with right sided aortic arch?
DiGeorge syndrome (22.q11)
Schwachman-Diamond syndrome
Exocrine pancreatic insufficiency PLUS cytopenias
Aka looks like CF but with weird CBC and no lung findings
Usually can outgrow needing enzymes
Fatty replacement of pancreas on imaging
Restrictive lung disease changes in PFTs?
Decreased total lung capacity
Decreased vital capacity and residual volume
Obstructive lung disease changes on PFTs?
Decreased FEV1
Apnea of prematurity
<34 was
Treat with caffeine (decreases CO2 threshold in respiratory center)
if continues, use CPAP
Most common symptoms of increased PaCO2
Headache
CO2 is an intracranial vasodilator
Definition of BPD
For infants <32 wks: Require supplemental oxygen at 36 wks corrected
For infants >32 weeks, test at 29-55days,
if no O2 - mild BPD
If <30% O2 - moderate BPD
If >30% O2 - severe BPD
Definition of ARDS
syndrome of lung inflammation with increased vascular permeability and is characterized by acute onset, bilateral infiltrates on chest radiography, absence of left atrial hypertension, and a Pao2/Fio2 of less than 200 mm Hg
Mortality rates vary depending on the underlying disease process
Most commonly occurs after sepsis, trauma, aspiration, pneumonia, near drowning, or multi organ failure
Pneumothoraces are common
Kartagener syndrome
Primary ciliary dyskinesia
Recurrent otitis media
+ sinusitis/ “bronchitis”
+ dextrocardia
CT can show moderate degrees of hyperinflation, peribronchial thickening, atelectasis and bronchiectasis
“Tram track lines”
Bronchopulmonary sequestration
Lung tissue that has a systemic arterial supply, not pulmonary and lacks bronchial communications
More common in the lower lobe (left)
Pulmonary hypoplasia
reduction in the number of bronchioles and alveoli
Congenital pulmonary airway malformation
dysplastic lung tissue
Congenital lobar emphysema
idiopathic hyperinflation of 1 or more lobes
If worsening while incubated, what should you think of?
DOPE displacement of the tube obstruction of the tube pneumothorax equipment failure
Most common side effect of foreign body aspiration
Infection! Pneumonia and atelectasis
Bronchoscopy is gold standard for both diagnosis and management
Chylothorax risk and fluid characteristics
Often results from injury to thoracic duct during cardiac surgery
Chyle has a characteristic milky white appearance, high concentrations of triglycerides, and electrolyte composition similar to plasma, and a predominance of lymphocytes
Difficult to treat - use diet, medial, and surgical management
Most common complication of pneumonia
Effusion can occur in up to 40%
Then empyema can happen in up to 50% of these
Classic phenotype of primary ciliary dyskinesia
Hx of neonatal respiratory distress (more than 80%)
Daily nasal congestion and wet cough, starting in neonatal period
Chronic otitis media and sinus disease starting in early childhood
Triad of Kartagener syndrome
Chronic sinusitis
Bronchiectasis
Situs inversus totalis
