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מבחן גמר בילדים > פולמונולוגיה > Flashcards

פולמונולוגיה Flashcards

1
Q

בכמה ירדה השכיחות של מוות בעריסה בהשכבת תינוק על הגב?

A

ירדה בלמעלה מ-50%

אבחון של מוות בעריסה- נתיחה שלאחר המוות

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2
Q

Definition of BRUE (Brief resolved unexplained event)

A

כחלון/ חיוורון / הפסקת נשימה / נשימה לא סדורה / שינוי בטונוס או ברמת התגובתיות בתינוק מתחת לגיל שנה ונמשך פחות מחצי דקה

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3
Q

what are the low risk conditions in BRUE?

A
  • age > 60 days
  • delivery > 32 weeks +correct now > 45 wks
  • first episode
  • less then 1 min
  • did not rq resusitstion
  • no clinical or Hx findings
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4
Q

How to manage low risk BRUE?

A
  1. patrossis PCR?
  2. ECG- rule out long QT
  3. PCR viral
  4. O2% sat
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5
Q

How to asses high risk BRUE

A
  1. hospitalization with cardial and respiratory monitoring
  2. swallowing test
  3. Brain imaging- rule out abuse
  4. neurologic asses- epilepsy?
  5. rule out anatomical lesions in respiratory tracts
  6. rule out respiratory abnormalites- OSA, central apnea
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6
Q

Dgx of PE?

A

CT- contrast
gold standart- lung angiography

די דימר לא מקדם בילדים

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7
Q

which coagulation factor is most a/w PE in childrens?

A

5- leiden

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8
Q

the following spirometry can be a/w which common disease?

low FEV1
FEV1/FEV < 0.8
12% improve of FEV1 after inhale beta agonists

A

Asthma

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9
Q

Definition of Transient Non ectopic Wheezing

A

שיעול וצפצופים בעיקר לאחר מחלה רספירטורית ויראלית

נעלמת במהלך הילדות עד הגעה לגיל ביה”ס, ללא סיכוי מוגבר לאסתמה בהמשך החיים

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10
Q

1st line for community aq pneumonia?

also 2nd line and for penecillin sensetive and a-typical penumonia

A

amoxicillin

2nd line- augmentin

if atypical suspect or senetivity to penecillin > macrolides

if resistance to multiple lines > susp. MRSA

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11
Q

hospitelized pneumonia

under 1 month
2m-2yr
> 2 yres

A
  • < 1 month- Ampicillin + gentamycin
  • 2m-2yr- augmentin / Chephalosporins 2rd generations
  • > 2 yrs- ampicillin
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12
Q

Complication of pneumonia and Tx?

A

Para-pneumonia and amphyema

Tx- Abx IV + drainge

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13
Q

pathogens a/w pleuropneumonia?

tx?

A

Pathogens
pneumoccoc
SA
GAS

Tx
Abx IV
second- drainage

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14
Q

emphyema definition

A

הצטברות מוגלה בחלל הפליאורלי

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15
Q

emphyema in XCR

A

הנוזל לא זז כיוון שהוא תחום בספטות

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16
Q

מהם האינדיקציות להנחת נקז באמפיאמה?

A

Positive gram culture
PH < 7.2
PMN > 100K

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17
Q

Tx for emphyema?

A

Ceftriaxone (rochipin) + clindamycin 4 wks + drainage + fibrinolytic (aurokinase)

18
Q

Dgx for eosinophilic lung disease?

A

Bronchoalvelolar lavage with > 25% eosinophilis in acute phase

19
Q

What is the most common esoinophilic lung disease in kids?

what is the etiology?

A

Loffler eosinophlic pneumonia = pulmonary infilitrates with esosinophilia syndrome

mostly cause by Ascaris lumbricoides

20
Q

a teenager present with hypoxemia, dyspnea, fever and cough. the kid is telling you he is smoking ciggarte. on blood reasults there are no signs of infection and eosinophils counts are normal. on BAL there is eleveted eosinophils.

what is the most likley disease?
what is the Tx?

A

acute eosinophilic syndrome

Tx- Few weeks steroids

21
Q

a teenager present with hypoxemia, dyspnea, fever and cough lasting for . the kid is telling you he is smoking ciggarte. on blood reasults there are is no signs of infection and eosinophils counts are eleveted. on BAL there is eleveted eosinophils.

what is the most likley disease?
what is the Tx?

A

Chroni eosinophilic pneumonia

Tx- steroids

22
Q

Tx for sinusitis?

A

1st line- amoxicillin
2nd line- augmentin

23
Q

a 4 yr old boy is present with high fever, torticolis, stirodr with normal orophyngeal testing.
his mother mentioned that a 2 wks ago he had an ear infection

what is the most likely dgx?
what is the Tx?

A

Retrophyrngeal abcess- CT
Tx- IV augmentin, consider drainge

24
Q

Tx for croup / lryngotracheobronchilitis?

A

Steroids PO

X-ray- steeple sign

25
Q

what is the clinical presentation and treatment of Spasmodic croup?

A

sudden stridor in night hours, usally w/o fever

Tx- as croup (steroids PO)

26
Q

Tx for Epiglottitis?

A

intubation and Ceftriaxone IV 10d

27
Q

Bacterial trachitis clinical presentation

Dgx? Tx?

A

barking cough, stridor, dyspnea and high fever.

dgx- abcsence of epiglottitis + clinical

Tx- Ceftriaxone + Vanco / clindamycin, oxygen. think about intubation

28
Q

Main etiology for subglottic stenosis??

A

Prolong intubation

dgx- bronchoscopy

bi-phasic stridor

29
Q

most common cause of stridor in babeis?

A

layngomalacia- low tonus of muscles in pharynx area&raquo_space; lead to collapse of glottic structures during inspirium

develop in first few weeks and worsen until 6 months of age

30
Q

Clinical presentation of laryngomalacia?

when stridor is ease or worsening and how we dgx?

A

inspiratory stridor
worsen in effort- crying agitation ,eating
relief in resting / laying on abdomen

dgx- confirmation by flexibale laryngoscope

31
Q

Which type of respiratory infection is a/w adenovirus?

A

Bronchiolitis obliterans

32
Q

clinical presenation of CPAMמום מולד בדרכי הנשימה

Dg and Tx

A

mainly a-symp in childhood. but later can presented with reccurent lung infections and chest pain

Dgx- CT = consolidation and marks with contrast
Tx-surgery (fear for malignant transformation)

33
Q

What is pulmonary sequestration?

A

lung anomelis in creating lung tissue outside of the lung tree.

could present with reccurent lung infections and hemoptysis
or left lung and boys&raquo_space; diaphragmatic hernia and other anomalies

Tx- surgrty

34
Q

most common nose anomaly?

A

Choanal atresia
תינוק לא יכול לנשום דרך האף
יכול להיות חד צדדי או דו צדדי

35
Q

A recent deliver new born present with porminant cyanosis while eating which pass when the baby stop and start crying
what is most likley the dgx? how can we confirm it?

A

choanal atresia
dgx- try to pass nasal tube

36
Q

CF tx for pt with acute infection?

A

מינון מקסימאלי למשך שבועיים
לעיתים פי 2-3 מהמומלץ

בחשד לפסאודומונס- קוינולונים (2 תרופות)

37
Q

Which CF complication is a/w high levels of IgE and rusty colour sputum

A

ABPA
Allergic- broncho pulmonary aspergillosis

tx- Steroids PO

38
Q

מתי תבחין זיעה עם כלור נחשב לחיובי?

CF

A

> 60 microL/L

39
Q

False positive sweat test for CF etiologies?

5

A

hypothyroidism
hypoparathyroidism
anorexia
atopic dermatitis
addison

40
Q

Which disease is a/w the following triad?
* bronchoectasis
* chronic sinusitis
* recurent ear infections

A

Primary cilliary dyskinesia

50% - present with situs inversus

41
Q

Dgx for primary cilliary dyskinesia?

A

epithel nose biopsy or airways and check on electron microscope

42
Q

Tension pneumothroax
location of the trachea?

A

deviation of the trachea to the healty side (also the mediastenum)

מבחן גמר בילדים (23 decks)

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