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Respiratory Flashcards

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1
Q

Viral Croup Etiology

A

Parainfluenza virus or RSV. Fall/winter. 6mo-3yo.

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2
Q

Viral Croup Prodrome

A

URI symptoms

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3
Q

Viral Croup symptoms

A

Hoarseness, inspiratory stridor, barking (seal-like) cough.

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4
Q

Viral Croup Xray

A

To rule our foreign body aspiration. See a “steeple sign”

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5
Q

Mild Viral Croup

A

Stirdor only with activity

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6
Q

Moderate Viral Croup

A

Stridor with only mild retractions

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7
Q

Severe Viral Croup

A

Stridor, retractions, agitation, respiratory distress.

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8
Q

Mild Viral Croup treatment

A

Supportive. Use cool mist.

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9
Q

Moderate Viral Croup treatment

A
  1. ) corticosteroids: Dexamethasone IM 0.6 mg/kg

2. ) nubulized racemic epinephrine

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10
Q

Severe Viral Croup treatment

A

Admit. Airway management.

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11
Q

Epiglottitis Etiology

A

Haemophilus influenze B. EMERGENCY!

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12
Q

Epiglottitis Symptoms

A

Rapid onset. No cough. 3 D’s Dysphagia, drooling, distress. Tripod or sniffing position.

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13
Q

Epiglottitis diagnosis

A

DO NOT use a tongue blade. “thumbs up sign” on Xray.

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14
Q

Epiglottitis treatment

A

airway support (ET tube), +/- corticosteroids, Antibiotics (ceftriaxone)

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15
Q

Tracheomalacia Etiology

A

Floppy trachea due to abnormal collapse caused by inadequate cartilage. Aggravated by respiratory infections.

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16
Q

Tracheomalacia symproms

A

recurrent harsh/barking cough, stridor on expiration.

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17
Q

Tracheomalacia treatment

A

spontaneously resolves may need CPAP.

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18
Q

Foreign body aspiration symproms

A

abrupt onset of cough, wheezing or choking. history is key.

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19
Q

Foreign body aspiration peak incidence

A

12-24 months of age. Usually kids

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20
Q

Foreign body aspiration diagnostics

A

Bronchoscopy (usually in right main bronchus) is diagnostic and curative.

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21
Q

Pertussis (whooping cough) Etiology

A

Bordatella pertussis

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22
Q

Pertussis (whooping cough) complications

A

apnea, pneumonia, seizures, death.

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23
Q

Pertussis (whooping cough) phases

A
  1. ) Catarrhal: URI symptoms with a fever that lasts for 1-2 weeks.
  2. ) Paroxysmal: Persistent paroxysmal cough, inspiratory whooping, post-tussive emesis for 2-6 weeks.
  3. ) Convalescent: cough gradually resolves can last weeks-months.
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24
Q

Pertussis (whooping cough) Diagnosis

A

Nasopharyngeal swab/aspirate for nasal culture (gold standard). CBC will show leukocytosis.

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25
Pertussis (whooping cough) treatment
Antibiotics: microlides.
26
Pertussis (whooping cough) hospitalization indications
Respiratory distress, cyanosis, apnea, inability to feed or
27
Respiratory Syncytial Virus (RSV) etiology
RSV. Most common cause of lower respiratory infections in kids
28
Respiratory Syncytial Virus (RSV) symptoms
Cough, conjunctivitis, congestion, fever.
29
Respiratory Syncytial Virus (RSV) complications
Brochiolitis, bronchospasm, acute respiratory failure, pneumonia.
30
Respiratory Syncytial Virus (RSV) prophylaxis
Wash hands. Palivizumab for high risk children under 2.
31
Bronchiolitis Etiology
RSV or rhinovirus. LRTI affecting the small airways in children
32
Bronchiolitis prodrom
URI symptoms for 2-3 days.
33
Bronchiolitis symptoms
Low grade fever, cough, expiratory wheezing with signs of respiratory distress.
34
Bronchiolitis treatment
Supportive. Brochodilators can help with symptoms but don't change course of the disease.
35
Bronchiolitis hospitilization
If severe to maintain hydration and oxygenation.
36
Cystic Fibrosis etiology
Most common fatal autosomal recessive disease. abnormal Cl transport causes viscous secretions in the lungs, pancreas, liver, intestine. 1/2 of the children with "failure to thrive" will be diagnosed with CF.
37
Cystic Fibrosis Symptoms
persistent productive cough, hyperinflation on CXR.
38
Cystic Fibrosis Diagnosis
Cl sweat test with >60.
39
Cystic Fibrosis Treatment
antibiotics for infections, chest physiotherapy, mucolytics, steroids, bronchodilators.
40
Bronchiectasis etiology
Abnormal dilation of the bronchi.
41
Bronchiectasis symproms
chronic cough with sputum
42
Bronchiectasis diagnosis
pulmonary function test shows an obstructive pattern.
43
Bronchiectasis treatment
antibiotics, pulmonary drainage, and +/- bronchodilators.
44
Pneumonia Causes by age
Viral (RSV): 1mo-5yo | Bacterial: 5yo-18yo
45
Pneumonia bacterial etiology by age
Chlamydia: neonates S. pneumonia: 1mo-5yo Atypicals (mycoplasm): 5yo-18yo
46
Pneumonia symptoms in infants
poor feeding, irritability, restlessness, often can be afebrile (chlamydia).
47
Pneumonia symproms in children
Fever, cough, myalgia, HA, malaise, pleuritic chest pain and abdominal pain.
48
Pneumonia signs
tachypnea, tachycardia, fever, decreased O2 sats, ill appearing, dehydration, lethargy. Lungs: crackles, ronchi, decreased air movement. Grunting=imminent respiratory failure.
49
Pneumonia atypical LS
wheezing
50
Pneumonia due to chlamydia
inclusion conjunctivitis
51
Pneumonia Outpatient treatment
Need to rule out viral etiology with a rapid flu/RSV Younger: Amoxicillin or a 2nd/3rd generation cephalosporin or clindamycin. Older: Amoxicillin or azithromycin (mycoplasm)
52
Pneumonia inpatient treatment
Ampicillin/sulbactam: 200mg/kg Q6 Cefuroxime: 150 Mg/kg Q8 Ceftriaxone: 50-100 mg/kg Q12-24
53
Pneumonia hospitalization indications
70 (infants) or >50 (kids), inability to eat.
54
Infant Respiratory Distress Syndrome Etiology
Deficiency of surfactant leading to hypoxia. Premies, diabetic mothers, family hx.
55
Infant Respiratory Distress Syndrome symptoms
Starts within minutes of birth. tachypnea, retractions, grunting, nasal flaring, cyanosis. Lasts 2-3 days.
56
Infant Respiratory Distress Syndrome CXR
Diffuse bilateral alectasis with a ground glass appearance.
57
Infant Respiratory Distress Syndrome treatment
O2 with CPAP, fluids, ET tube, exogenous surfactant.
58
Infant Respiratory Distress Syndrome prevention
antenatal glucocorticoids are given to the mother to hasten lung maturing (dexamethasone or betamethasone) if expected to deliver early.
59
Asthma definition
chronic airway inflammation, hyper-responsiveness and reverisble obstruction. With common triggers.
60
Asthma symptoms
cough (often nocturnal), wheezing, dyspnea, chest tightness.
61
Asthma diagnosis
Spirometry. Measure FEV1/FVC which will be decreased (obstructive) then use bronchodilators and see an increase in FEV1.
62
Asthma treatment
Stepwise approach: 1. ) short acting bronchodilators (SABA) PRN 2. ) inhaled corticosteroids 3. ) Long acting bronchodilators (must be perscribed alon with steroids) 4. ) leukotriene antagonists 5. )Oral steroids.
63
Asthma, do they need more than a SABA?
Rules of TWO. More than twice a week, more than twice a month at night, more than two refills a month.
64
Vocal cord dysfunction etiology
Inappropriate vocal cord motion that can cause partial airway obstruction. Often misdiagnosed as asthma.
65
Vocal cord dysfunction symptoms
Inspiratory stridor, cough, choking/throat tightness. Can be triggered.
66
Vocal cord dysfunction treatment
speech therapy.
67
Obstructive sleep apnea definition
habitual snoring, gasping or apnea.
68
Obstructive sleep apnea risk factors
adenotonsillar hypertrophy and obesity.
69
Obstructive sleep apnea diagnosis
sleep study
70
Obstructive sleep apnea treatment
adenoidectomy with/without tonsilectomy or CPAP.

Pediatrics (8 decks)

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