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Flashcards in Pulmonology Deck (44):
1

Most common congenital syndrome associated with it is CHARGE syndrome

Choanal Atresia

2

CHARGE syndrome

Coloboma
Heart anomalies
Choanal atresia
Retarded growth
Genital hypoplasia
Ear abnormalities

3

Most common cause of common colds

Rhinovirus

4

What are the sinuses present at birth?

Ethmoid and Maxillary

5

Cough and colds for 10-14days, purulent nasal discharge, headache, sinus tenderness

Sinusitis

6

Gradual onset, moderate throat pain, symptoms of viral URTI (conjunctivitis, coryza, cough)

Contacts with colds symptoms

Acute Viral Pharyngitis

7

Sore throat and fever with headache, vomiting, abdominal pain

Palatal petechiae, diffuse erythema of tonsils and pillars

Sandpaper rash in inguinal and antecubital areas

Acute Bacterial (GABHS) Pharyngitis

8

Antibiotics for GABHS

Penicillin or Amoxicillib for 10 days

9

Culture (+) strep pharyngitis that has been severe and frequent: >7 episodes in the previous year OR >5 in each of the preceding 2 years

Recurrent Strep Pharyngitis

Consider Tonsillectomy

10

Bacterial invasion through the capsule of the tonsils

Usually affects adolescents

Fever, sore throat, dysphagia, trismus

Asymmetric tonsillar bulge with displaced uvula

Peritonsillar abscess

11

Drooling, neck held in hyperextension, bulging of the posterior pharyngeal wall, neck pain, muffled voice, respiratory distress

Fever, irritability, refusal to move neck, dysphagia, decreased oral intake

Retropharyngeal abscess

12

Most common etiology of Laryngotracheobronchitis

Parainfluenza Virus

13

Rhinorrhea, pharyngitis, cough and low grade fever (1-3days),
Inspiratory stridor, hoarse voice, barking cough

Laryngotracheobronchitis

14

Subglottic narrowing or Steeple sign

Laryngotracheobronchitis

15

Management for Laryngotracheobronchitis

Racemic Epinephrine
Oral dexamethasone (single dose)

16

Serious and rapidly progressive infection of supraglottic structures

Acute Epiglottitis (Supraglottitis)

17

Most common etiology of Epiglottitis in UNVACCINATED children

H. Influenza type B

18

Most common etiology of Epiglottitis in VACCINATED children

Staphylococcus Aureus

19

Acute onset of high fever, dysphagia, dyspnea, drooling, muffled voice, sniffing dog or tripod position

Cherry red epiglottis

Acute Epiglottitis

20

Thumb sign or leaf sign on lateral neck x-ray

Acute epiglottitis

21

Treatment for Acute epiglottitis

Secure airway
IV antibiotics (Cefotaxime, Ceftriaxone, Meropenem)

22

More of an allergic reaction to viral antigens than direct infection

Symptoms are mostly at night with mild to moderate hoarseness, coryza and hoarseness

Awakens with Metallic barking cough

Spasmodic Croup

23

Most common cause of Bacterial Tracheitis

Staph Aureus

24

High fever, brassy cough, can lie flat, does not drool, no dysphagia

Often follows a viral respiratory infection

Bacterial Tracheitis

25

Most commonly aspirated food

Peanut

26

Sudden onset of respiratory distress, hoarseness, localized wheezing, localized absence of breath sounds

Foreign Body Aspiration

27

Acute inflammation of the small airways in children

Bronchiolitis

28

Most common cause of Bronchiolitis

Respiratory Syncitial Virus

29

Low grade fever, rhinorrhea, cough, wheezing, hyperresonance to percussion, prolonged expiratory phase

CXR: hyperinflation, interstitial infiltrates

Bronchiolitis

30

Dry hacking cough then after several days sputum becomes purulent

Low grade fever, nasopharyngitis, conjunctivitis, rhinitis

Acute bronchitis

31

Most common etiology of Pneumonia

Neonates: Group B Streptococcus
3wks-4y/o: Respiratory Syncitial Virus
>5y/o: M. Pneumoniae and S. pneumoniae

32

Fever, cough, tachypnea
O2 saturation <92%

Pneumonia

33

Cough, wheezing, stridor

Diffuse streaky infiltrates; lymphocytosis

Supportive treatment

Viral Pneumonia

34

Cough, high fever, dyspnea, dullness to percussion

Lobar consolidation; neutrophilia

Bacterial Pneumonia

35

Less ill-looking, nonproductive cough

Interstitial pattern in xray, and usually on lower lobes

Walking pneumonia

Mycoplasma

36

Staccato cough

Maternal history of infection

Hyperinflation "ground glass" appearance; eosinophilia

Tx: erythromycin PO for 14 days

Chlamydia

37

Treatment for non-severe cases of pneumonia without previous use of antibiotic

Amoxicillin 40-50 mg/kg/day TID for 3-7days
Alternative: Azithromycin or clarithromycin

38

Treatment for severe cases of pneumonia without previous use of antibiotic AND requiring hospitalization

Complete Hib vaccination: Penicillin G

Incomplete Hib vaccination: Ampicillin

>15y/o: IV non-antipseudomonal beta lactam plus extended macrolide or respiratory fluoroquinolone

39

3 components of asthma attack

Bronchospasn
Airway edema
Increased mucus production

40

A reversible obstructive airway disease involving both small and large airways

Increased residual lung volumes
Decreased FEV1/FVC ratio

Bronchial Asthma

41

Management of acute asthma attacks

Short-acting inhaled beta2 agonist
Oral or IV steroids
Anticholinergics - never used alone
Methylxanthines - NOT first line

42

(+) exposure to an adult or adolescent with active disease
(-) PPD
No signs/symptoms
Negative CXR

TB exposure

43

(+) exposure to an adult or adolescent with active disease
(+) PPD
No signs/symptoms
Negative CXR

TB infection

44

3 or more of the ff criteria:
(+) exposure to an adult or adolescent with active disease
(+) PPD
signs/symptoms suggestive PTB
Abnormal CXR
Laboratory findings

Tb disease