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Master the boards: Pediatrics > Pulmonology > Flashcards

Pulmonology Flashcards

(64 cards)

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1
Q

What is Transient Tachypnea of the Newborn associated with?

A

C-section delivery leads to excess fluid in the lungs and hypoxia

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2
Q

What happens if Transient Tachypnea of the Newborn lasts >4hours?

A

it is considered Sepsis: must be evaluated with blood and urine analysis

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3
Q

When do you performa Lumbar Puncture (LP) with CSF analysis and Cx?

A

newborn displaying neurological signs: irritability, lethargy, temperature irregularity, feeding problems

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4
Q

What is Meconium Aspiration Syndrome (MAS)?

A

Post-term infant is born through meconium-stained fluid obstructing the airway and causing respiratory distress

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5
Q

What are the 3 leading causes of Meconium Aspiration Syndrome (MAS)?

A

Physiologic Maturational event

Acute Hypoxic event

Chronic Intrauterine hypoxia

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6
Q

How is Meconium Aspiration Syndrome (MAS) Diagnosed?

A

Meconium-stained infant, respiratory distress and CXR showing patchy infiltrates, coarse streaking of both lung fields on flattening of the diaphragms

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7
Q

What is seen on CXR in Meconium Aspiration Syndrome (MAS)?

A

Patchy infiltrates
Coarse Streaking of Both lung fields
Flattening of the Diaphragm

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8
Q

How do you manage Meconium Aspiration Syndrome (MAS)?

A

Airway management and ventilatory support with O2

Inhaled Nitric Oxide

If patient worsens: surfactant therapy to break up meconium in the alveoli

Last line: Extra-COrporeal Membrane Oxygenation (ECMO)

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9
Q

If a patient with MAS does not improve with Airway management, O2 and Inhaled nitric oxide what can you give?

A

Surfactant therapy to break up meconium in the alveoli

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10
Q

If all other treatment fails what is the last line for MAS?

A

Extra-corporeal Membrane Oxygenation (ECMO)

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11
Q

What is Croup?

A

Infectious upper airway condition characterized by severe inflammation

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12
Q

What is the most common cause of Croup?

A

Parainfluenza Virus Type 1 and 2

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13
Q

What is the 2nd most common cause of Croup?

A

Respiratory Synctial Virus (RSV)

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14
Q

How does Croup typically present?

A

Barking cough, Coryza and inspiratory stridor

increased difficulty breathing when lying down with possible peripheral cyanosis and accessory muscle use

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15
Q

How is croup diagnosed?

A

Clinical diagnosis: aided by CXR if symptoms are mild

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16
Q

What is seen on CXR in Croup?

A

“steeple sign”: narrowing of the air column in the trachea

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17
Q

How is Croup Treated?

A

Steroids and Nebulized Epinephrine

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18
Q

How does Hypoxia differ in Croup and Epiglotitis?

A

Croup has hypoxia on presentation, Epiglottitis has intermittent hypoxia

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19
Q

What age group is foreign body aspiration most common in?

A

Ages 1-3

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20
Q

How does foreign body aspiration present?

A

sudden onset respiratory distress without a preceding illness

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21
Q

What is the most common location for an aspirated object to lodge into?

A

Right Mainstem Bronchus

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22
Q

What are the most common symptoms of Foreign Body aspiration?

A

Choking and sudden onset respiratory distress

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23
Q

What is seen on physical exam in foreign body aspiration?

A

Monophonic wheezing with diminished air movement on the affected side

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24
Q

What is the best initial diagnostic test for suspected foreign body aspiration?

A

CXR: however about 2/3 of objects are radiolucent and not seen on CXR

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25
What is the most accurate and most appropriate treatment for Suspected Foreign body aspiration?
Immediate Rigid Bronchoscopy
26
What is Epiglottitis?
Severe, life-threatening swelling of the epiglottis and Arytenoids
27
How does Epiglottitis commonly present?
Child with a history of Vaccination delinquency with; hoarseness, fever, drooling in the tripod position and refusal to lie flat
28
What is seen on physical exam in Epiglottitis?
Extremely hot cherry-red epiglottis
29
How do you diagnose Epiglottitis?
Clinical diagnosis with X-ray showing "thumbprint sign"
30
What is seen on x-ray in Epiglottitis?
Thumbprint sign
31
How is Epiglottitis treated?
Intubate and give Ceftriaxone and Vancomycin
32
What antibiotics are used in Epiglottitis?
Ceftriaxone and Vancomycin
33
What is the most common cause of Epiglottitis?
Haemophilus Infuenzae Type B
34
What is Whooping Cough?
a type of Bronchitis caused by Bordetella Pertussis
35
What pathogen causes Whooping Cough?
Bordetella Pertussis
36
How many stages of disease does Whooping cough have?
3
37
What are the 3 stages of whooping cough?
1) Catarrhal 2) Paroxysmal 3) Convalescent
38
How does the Catarrhal Stage of Whooping cough present?
1st stage lasting 14 days with severe congestion and rhinorrhea
39
How does the Paroxysmal Stage of Whooping cough present?
2nd stage lasting 14 to 30 days: severe coughing with extreme gasp for air (inspiratory whoop) followed by vomiting
40
What phase of respiration does the whooping cough occur in?
Inspiration
41
How does the Convalescent stage of Whooping cough present?
3rd stage lasting 14 days: decrease in frequency of coughing
42
How is Whooping cough diagnosed?
Clinically based on whooping inspiration, vomiting and burst blood vessels in the eyes
43
What diagnostic modalities can aid the diagnosis of Whooping Cough?
CXR showing butterfly pattern PCR or nasal secretions or Bordetella Pertussis Toxin ELISA
44
What can be seen on CXR in whooping cough?
Butterfly pattern
45
How is Whooping cough treated?
Azithromycin or Clarithromycin: only in catarrhal or paroxysmal stage Isolation Macrolides to all close contacts DTaP vaccine to reduce incidence
46
What stages of Whooping cough are antibiotics given for?
Catarrhal (1st) and Paroxysmal (2nd)
47
What antibiotics can be used in whooping cough?
Azithromycin or Clarithromycin
48
What causes Bronchitis?
Various bacteria and viruses leading to inflammation of the airways
49
How does Bronchitis commonly present?
Productive cough lasting 7-10 days
50
How is Bronchitis diagnosed?
Clinically
51
How is Bronchitis treated?
Supportive care
52
What Causes Pharyngitis?
Group A Beta Hemolytic Strep: leading to inflammation of the pharynx and adjacent structures
53
How does Pharyngitis commonly present?
Cervical Adenopathy, petechia, fever >104F Acuter Rheumatic Fever and glomerulonephritis possible
54
How is Pharyngitis diagnosed?
Rapid DNase Ag detection test
55
How is Pharyngitis Treated?
Oral Penicillin x 10 days: If allergic to penicillin use Macrolides
56
What Causes Diptheria?
Corynebacterium Diphtheriae: leading to membranous inflammation of the pharynx due to bacterial invasion
57
How does Diptheria commonly present?
Gray high vascular Pseudomembraenous plaques on the pharyngeal wall: DO NOT SCRAPE
58
What should be avoided in Diptheria?
Scraping the membranes: do not scrape the membranes
59
How is Diptheria Diagnosed?
Cx of a small portion of superficial membrane
60
How is Diptheria Treated?
Antitoxin: abx do not work
61
What does not work to treat Diptheria?
Abx: you must treat with antitoxin
62
What is the most common cause of mortality in infants ages 1 month to 1 year?
Sudden infant death syndrome (SIDS)
63
What is Sudden Infant Death Syndrome (SIDS)?
sudden, unexpected death that cannot be explained
64
What are the most common risk factors for SIDS?
Maternal smoking Passive smoke exposure Maternal age <20 years Prematurity Prone or side-sleeping positioning of the infant

Master the boards: Pediatrics (13 decks)

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