Flashcards in Pulmonology Deck (45):
First investigation of stridor
Upper GI to look for structural abnormalities
Worst days of bronchiolitis
Congenital condition; lack of neural coordination of laryngeal muscles with suppraglottic structures tha hang over airway ( epiglottis, arytenoid cartilages). usually worse stridor in supine position, better in prone.
Relationship of GERD and laryngomalacia
Often GERD is associated. If prophylactically treat GERD, can improve laryngomalacia
What conditions is vocal cord paralysis associated with?
Cardiac abnormality, s/p surgery 2/2 damage to recurrent laryngeal nerve. Hydrocephalus or arnold chiari malformation can often cause b/l paralysis
Produces expiratory stridor.
AD syndrome of telangectasias including pulmonary AVMs
What is the aspirin triad?
Allergy to ASA, nasal polyps, asthma
AR - short ribs, small rib cage and renal disease. Resp failure common
What is genetics of SMA?
Which sinuses are present at birth?
maxillary and ethmoid?
When do sinuses develop?
front and sphenoid start to develop at 1-2 years but are not radiographically visible until 7-8
Remember* Rheumatic fever only occurs after GAS pharyngitis, but PSGN can occur after skin or pharyngitis
Strep throat criteria
Centor Criteria - no cough, fever, cervical LAD, tonsillar exudates. 0-1 no nee dfor antibiotics, 2-3 test, 4 treat with amox
Most common pathogens of retropharyngeal abscess
GAS, staph, oral anearobes
Antibiotic treatment for retropharyngeal abscess.
Unasyn, Amp and clinda
Treatment of ABPA
itraconazole and steroids
What percent of patients with asthma will outgrow symptoms by adulthood?
60% (severe asthma is 30%)
When are cleft lip and cleft palate usually repaired?
cleft lip 10 weeks, cleft palate 6-9months
Do you remove thyroglossal duct cysts? how about lingual thyroid?
you do remove thyroglossal duct cysts. Can keep lingual thyroid
At what age does laryngomalacia present?
What syndrome are glottic webs associated with?
If note pulmonary AV malformation, what syndrome should you think of?
Rendu - Osler - Weber syndrome
What is eventration?
marked elevation of the diaphragm. Usually congenital but can be 2/2 phrenic n. injury as well. More commonly affects the left.
What is the most common complication of a URI?
AFter what infection does rheumatic fever occur?
Strep throat, not strep skin infection
What are infectious indications for tonsillectomy
3 infections per year x 3 years, 4-5 infections in past 2 years, 5-7 infections in last year
Treatment of epiglottitis
antistaph drug (oxacillin, clinda) and ceftriaxone
Treatment of ABPA
steroids and itraconazole
Treatment of cocciodomycosis ( valley fever)
what organism should you think of in hunters or skin animals from Arkansas or Missouri?
What animals transmit Q fever (coxiella)
cattle and sheep
What are the extrapulmonary manifestations of mycoplasma?
hemolytic anemia, splenomegaly, EM and SJS, arthritis, neurologic changes.
What are side effects of theophylline toxicity?
GI upset and behavioral effects
Which meds can worsen theophylline effects? (inhibit p450)
cimetidine, OCPs, erythromycin, cipro
Which meds can diminish activity of theophyilline?
Phenobarb and phenytoin
What age can you use omalizumab
> or = to 12
after which infection is bronchiolitis obliterans most often found
What is Kartagener syndrome
AR, primary ciliary dysfunction, situs inversus and reduced male fertility
Which women should get prenatal steroid?
Women 24-34 weeks gestation with intact membranes who are at risk for premature delivery within the next week.
What is a normal sweat chloride?
What do we use for CF newborn screening?
test for elevated blood immunoreactive trysinogen. Few false negatives, but many false positives
most common cause of lung transplant in kids
Which PaCO2 in an asthmatic suggests need to go to ICU