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Flashcards in Respiratory Deck (42)
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1
Q

surfactant production begins

A

b/w 22-24 weeks, survival possible at 27-28 weeks

2
Q

adult lung function is achieved by age

A

8

3
Q

how does a decrease in airway diameter affect an infant?

A

a decrease of 50% results in a 16x increase in resistance, since their airway is so small it’s bad

4
Q

common cold is aka

A

rhinosinusitis, symptoms of rhinorrhea and nasal obstruction w/o systemic fever or myalgia

5
Q

rhinosinusitis treatment

A
  • first gen antihistamines may help bc of the anticholinergics in them
  • symptomatic
6
Q

peritonsilar abscess is commonly seen in

A
  • adolescents and young adults w/history of pharyngotonsilitis caused by group a strep
  • presents w/fever, sore throat, trismus, dysphagia
  • tx antibiotics and drainage
7
Q

retropharyngeal abscess

A
  • emergency!!! infection of retropharnygeal space down into superior mediastinum in kids age 3-4, doesn’t occur after 5 bc these nodes involute
  • treat w/IV antibiotics and possible drainage
8
Q

absolute indications for tonsilectomy

A
  • airway obstruction

- partial obstruction w/chronic alveolar hypoventilation and possible cor pulmonale

9
Q

probably indications for tonsilectomy

A
  • S/P peritonsilar abscess
  • tonsil hypertrophy interfering w/swallowing
  • dysphagia leading to poor weight gain
10
Q

possible indications for tonsilectomy

A
  • 7 bacterial infections in one year
  • 5 per year for 2 years
  • 3 per year for 3 years plus history of fever, lymphadenopathy >2 cm, + strep culture + adequate antibiotic coverage to ensure it is not a l=prolonged initial illness
11
Q

probable vs

possible adenoidectomy

A
  • obstruction leading to mouth breathing, snoring, SA or adenoid facies leading to deformity of oral cavity
  • recurrent serous otitis media w/hearing loss
12
Q

mild sore throat progressing to acute respiratory obstruction/distress in hours, pt has neck extended and is in tripod position

A

epiglottitis

13
Q

barking or brassy cough

A

croup

14
Q

sudden onset cough in the middle of the night, afebrile, age 1-3

A

acute spasmodic croup, treat by increasing humidity

15
Q

MC form of croup, preceeded by viral illness, barking cough and inspiratory stridor, agitation and crying worsen the symptoms

A

laryngotracheitis, treat w/steroids

16
Q

a bacterial superinfection after having croup

A

laryngotracheobronchitis, may need anbx

17
Q

presents w/purulent airway secretions, no drooling or dysphagia (unlike epiglottitis), MCC staph aureus

A

bacterial tracheitis

18
Q

croup tx

A
  • racemic epi

- 2-3 hr observation mandatory after tx

19
Q

viral disease of lower airway resulting in edema, increased mucus

A

bronchiolitis, caused by RSV

20
Q

how to prevent RSV?

A
  • synagis (palivizumab) in high risk infants <2 such as premies/chronic lung disease
  • Tell pts to take a big bath towel and put over crib, take a cold air humidifier and let it run
21
Q

infants to 3 months of age MCC of non-bacterial and bacterial pneumo

A

RSV

group B strep

22
Q

4 month-5 year old MCC of non-bacterial and bacterial pneumo

A

RSV

strep pneumo

23
Q

infants vs older children presentation of pneumonia?

A

no cough, minimal systemic signs

cough, fever

24
Q

nonbacterial vs

bacterial presentation of pneumo

A

gradual progression of symptoms over -10 days

sudden change

25
Q

how to treat mycoplasma pneumo

A

erythromycin (doesn’t work on cell wall)

26
Q

signs of pneumo

A

rales (crackling) on inspiration, wheezing initially expiration, rhonchi on inspiration and expiration (coarse breath sounds)

27
Q

when to do a CXR for pneumo?

A

if breath sounds are unequal, palpate above suprasternal notch for tracheal deviation

28
Q

TB spreads to the regional lymph nodes, this is known as

A

primary complex, t-cells respond leading to an immunologic response

29
Q

PPD >5mm
>10
>15

A
  • immunocompromised, xray evidence of TB, close contact of known TB case
  • infants and children <4 years, DM/renal/hematological diseases
  • pts w/o any risk factors
30
Q

how to treat TB

A

Latent TB you should still treat with 4 months of rifampin

INH + Rifapentin once/week for 3 months

31
Q

MC complication of TB in kids

A

meningitis

32
Q

MC chronic illness of childhood

A

asthma

33
Q

asthma presentation

A

Wheeze on expiration at beginning (alveoli get smaller when you breathe out), then air trapping begins causing inspiratory and expiratory wheezing

34
Q

mild intermittent asthma tx
mild persistent tx
moderate persistent
severe persistent

A

SABA
short burst of ICS
montelukast as young as 6
everything

35
Q

rules of 2 for asthma

A

pts require an ICS if….

  • using SABA >2x per week
  • awaken at night >2x per month
  • refill SABA rx more than 2x per year
36
Q

what should you do is you suspect a FBA?

A

bronchoscopy

37
Q

upper (extrathoracic) vs

lower (intrathoracic) FB presentation

A

inspiratory stridor

expiratory wheeze

38
Q

if pt has expiratory wheezing, lesion is….

if pt has inspiratory wheezing, lesion is…

A

within the chest, below the vocal chords

outside of the chest, above the vocal chords

39
Q

cough stimulus

A

can be stimulated from cough receptors in the nose, sinuses, ear canals, etc

40
Q

MC lethal genetic disease of white people

A

cystic fibrosis, F508 deletion is MC

abnormal CFTR gene results in decreased Cl ion transport results in activation of Epitheal Na channel

41
Q

hwo to dx cystic fibrosis

A

chloride sweat test >60 mEq

42
Q

CF treatment options

A
  • ivacaftor

- lumacaftor + ivacaftor