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Flashcards in Respiratory Deck (31):
1

LGA age baby born to a mother with gestational diabetes has issues with breathing and and decreased tone in his arm. What is the cause of the breathing and arm issue

LGA babies are at risk for birth trauma i.e. shoulder dystocia leading to damaged
-brachial plexus-->Erbs/Duchenne's palsy
-phrenic nerve-->hemidiaphragm-->trouble breathing
-->Dx: Ultrasound of chest/diaphragm

2

kid <2 years old with fever, runny nose, cough (URI symptoms) followed by respiratory distress (cyanosis, retractions, nasal flaring, tachypnea wheezing, crackles)

Bronchiolitis
<2 years of age
cause: RSV>parinfluenza, influenza
mech:inflamm of lower airways (bronchioles)

3

Bronchiolitis
-how to diagnose
-treatment

diagnose
-clinical signs (URI signs cough, sneezing, runny nose, then resp distress)
-chest xray: interstitial infiltrates, hyperinflation, atelectasis

4

lung empyema are usually in the setting of

Bacterial pneumonia
-xray: whiteout of the lung with loss of costophrenic angle
-def:accum of pus in the pleural space
-causes
1. bacterial pneumonia>rupture of lung abscess, extension of mediastinits,

5

child with recurrent hemoptysis, anemia, pneumonia, rapidly clearing chest x-ray

idiopathic pulmonary hemosiderosis

hemoptysis-due to alveolar hemorrhage-->crackles
dyspnea-
anemia-due to loss of blood
occult blood stool loss-blood is swallowed and enters the GI tract

6

A child with pulmonary hemosiderosis with a hypersensitivity to _______has this disease______

hypersensitiv. to cow's milk
Heiner syndrome
RX: dairy free diet

7

Dx for pulmonary hemosiderosis

bronchoscopy to obtain a bronchioalveolar lavage
findings-hemosiderin laden macrophages

8

croup like symptoms followed by toxic appearance, high fever

Bacterial tracheitis
Tx: Intubation+IV antibiotics

9

Croup vs Bacterial Tracheitis

Croup
-viral symptoms: low fever, inspir. stridor, seal like cough
-Rx: mild-cool mist, moderate-racemic epi+steroids

Bacterial tracheitis
-viral like symptoms of croup (or no viral like symptoms) then a high fever, toxic appearance
-or croup like symptoms that don't respond to epi+steroids
-RX: intubate+IV antibiotics

10

cold for >10 days+fever+facial pain

rhinosinusitis

11

what is the first step in treating anaphylaxis

Airway intubation (not epi treatment)

12

Rule of 2s for asthma

Determines whether asthma is intermittent or persistent
-asthma attacks >2x per week
-use of rescue inhaler>2x per week
-nightime symptoms>2x per month

13

Rule of 2s for asthma

Determines whether asthma is intermittent or persistent
-asthma attacks >2x per week
-use of rescue inhaler>2x per week
-nighttime symptoms>2x per month

14

Neonatal conjunctivitis caused by: Neisseria vs Chlamydia

Neisseria gonorrhea
-purulent discharge, occurs 1st days of life
-toxic baby: septic, febrile
-RX: IM ceftriaxone

Chlamydia
-watery eye discharge, occurs usually after 1st week of life
-nontoxic baby, nonfebrile
-RX: oral macrolide (for active infection), topical macrolide for prophylaxis

15

recurrent unilateral pneumonia in a healthy child

-foreign body aspiration
-on xray inspiration film normal, expiration film will see air trapping (blacker) distal to the obstruction
Dx: bronchoscopy

16

kartegeners vs cf

kartegeners: dynein arm defect, bronhiectesis (recurrent pneumonias), situs inversus, infertility

CF: (+) sweat test, diabetes (pancreatic insuff), infertility, malabsorption (failure to thrive) recurrent pneumonias

17

cause of infertility in kartegeners vs cf

Kartegeners-dynein arm of cilia abnormal
men-sperm immotile
women-cilia in fallopian tubes abnormal, can't move egg normally

CF-male infertility: bc absence of vas deferens to due inspissated mucous blocking vas deferens development-->obstructive azoospermia (sperm have normal motility though)

18

acetaminophen or ibuprofen should be given to pts who experience febrile seizures after taking antibiotics. T or F?

False
-antipyretics can reduce the antibody response to vaccinations
-antipyretics have not been shown to reduce fever or prevent febrile seizures

19

boy is at a picnic and develops wheezing and inc work of breathing
-diagnosis
-treatment

anaphylaxis-type 1 hypersensitivity rxn
symptoms: wheezing, +/-hives, pruritis
treatment-IM epinephrine

20

point of maximum impulse is displaced to the right.....disease

Kartegeners (primary ciliary dyskinesia)
-PMI displaced to the right-->situs inversus
-sinusitis/pneumonias
-bronchiectasis

21

stress, trauma, dental procedures followed by facial swelling, colicky pain

hereditary angioedema=c1 inhibitor deficiency

-kallekrien-->bradykinin->angioedema
-C1-->angioedema
-Ci inhibitor inhibits both C1 and kallekrein
-without C1 inhibitor, increased bradykinin, dec C4 (C1 cleaves C4), dec C1 inhibitor

22

CF mediated pneumonia
-in adults
-in kids

adults-pseudomonas-->RX: fluoroquinolones
peds-staph aureus-->for MSSA, strep cover with nafcillin, for MRSA cover with vancomycin

23

complication of bacterial pneumonia

pleural inflammation->pleural effusions
-signs: loss of costophrenic angle
-fluid layering on lateral decubitus film

24

Name the B cell deficiencies and unique characteristics

Brutons x linked agammaglobulinemia
-tyrosine kinase deficiency->failure of pre B cell maturation into B cells
-dec B cells, dec in all Igs
-baby>6 months: bc for 1st 6 months there's maternal IgG protection

CVID
-milder version of brutons, recurrent sinopulm infections in teenager
--dec in all Igs, but normal B cells

IgA deficiency
-dec Iga, inc IgG and IgM which compensate so pt often asymptomatic
-after blood transfusion-->anaphylaxis

hyper IgM syndrome
-can't convert IgM to IgG
-inc IgM, dec IgG, IgA, IgE

25

CATCH 22

Digeorge syndrome-Chrom 22q11 microdeletion
C-cardiac abnormalities
A-abnormal facies: wide set eyes, low set ears
T-absent thymic shadow (no T cells)and absent parathyroid glands
C-cleft palate
H-hypocalcemia

26

what infections do pts with DiGeorge syndrome get

recurrent fungal and Pneumocystis pneumoniae-RX TMP, SMX

27

recurrent lung infections and skin abscesses

Chronic granulomatous disease (CGD)
-dihydrorotamine test and nitroblue test to check for neutrophil oxidative burst (produce H2O2 function)

28

Leukocyte adhesion deficiency

L-leuokocytosis-neutrophils trapped in bv bc of defective integrins
A-absent neutrophils in pus
D-delayed umbilical cord separation

recurrent
-mucosal infections (periodontitis)
-skin infections: omphalitis, abscesses, cellulitis

29

recurrent skin and mucosal infections

LAD

30

scant lymphoid tissue

Brutons X linked agammaglobulinemia

31

cryptochordism, wrinkled belly, vesicouteral reflux

Prune belly syndrome=bladder outlet blockage that impairs renal function