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emerg med exam III > airway and respiratory emergencies > Flashcards

airway and respiratory emergencies Flashcards

1
Q

time of complete airway obstruction to brain damage

A
  • 4 minutes
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2
Q

swallowed FB is most likely to be stuck where

A

right main stem of lung

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3
Q

clinical presentation in toddler

  • persistent cough
  • unilateral wheezing
  • decreased breath sounds
A

foreign body aspiration

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4
Q

anaphylaxis is mediated by what antibody

A

IgE -> histamine release

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5
Q

DOC for anaphylaxis if hypotension present

A

epinephrine

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6
Q

dosage and route for epinephrine in anaphylaxis

A
  • IV 0.3 - 0.5 mg of 1:10,000
  • SC 0.3 - 0.5 mg of 1:1,000
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7
Q

what type of antihistamines should be given in anaphylactic shock

A
  • H1 and H2
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8
Q

hereditary cause of angioedema

A
  • insufficient synthesis of C1-esterase inhibitor (rare)
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9
Q

medication associated with angioedema

A

ACE-inhibitor

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10
Q

function of Danazol in tx of angioedema

A
  • increase the synthesis of C1-esterase inhibitor
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11
Q

causes of retropharyngeal abscess

A
  • tonsillitis
  • otitis media
  • pharyngeal trauma

*mixed gram negative and anaerobic bacteria

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12
Q

clinical presentation

  • fever
  • odynophagia: painful swallowing
  • neck swelling
  • drooling
  • torticollis
  • cervical adenopathy
  • stridor
  • airway obstruction
A

retropharyngeal abscess

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13
Q

how is retropharyngeal abscess diagnosed

A
  • clinical
  • soft tissue lateral neck xray
  • CT neck
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14
Q

tx of retropharyngeal abscess

A
  • airway management
  • abx
  • admission
  • surgical drainage
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15
Q

an infection of the supraglottic structures including the epiglottis, lingual tonsillar area, epiglottic folds, and false vocal cords

A

epiglottitis

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16
Q

cause of epiglottitis

A
  • H influenza B, strep, staph
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17
Q

clinical presentation

  • abrupt onset over several hours
  • fever
  • stridor
  • dysphagia
  • odynophagia
  • drooling
  • tripod
A

epiglottitis

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18
Q

what should never be done if you suspect epiglottitis

A

never stick a tongue blade in throat

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19
Q

how is epiglottitis diagnosed

A
  • clinically
  • soft tissue lateral neck xray if very stable
    • thumb sign
20
Q

thumb sign is consistent with

A

epiglottitis

21
Q

tx of epiglottitis

A
  • control airway
  • abx once airway is secured
    • 3rd generation cephalosporin: ceftriaxone
22
Q

croup: laryngotracheobronchitis

A

inflammatory condition of the trachea below the level of the vocal cords (subglottic)

23
Q

croup: laryngotracheobronchitis is usually caused by what pathogen

A
  • parainfluenza virus
  • RSV
24
Q

croup: laryngotracheobronchitis usually affects what age population

A
  • 6 months - three years
  • inc in winter
25
Q

clinical presentation

  • 2-3 day h/o URI
  • low grade fever
  • gradual, worsening “barking seal” cough, especially at night
  • dyspnea, retractions, stridor
A

croup: laryngotracheobronchitis

26
Q

PA CXR showing steeple sign is consistent with

A

croup: laryngotracheobronchitis

27
Q

tx of croup: laryngotracheobronchitis

A
  • nebulized epinephrine (must obsreve for 3-4 hours after tx)
  • steriods
    • prednisolone
    • dexamethasone (decadron)
28
Q

whooping cough is caused by what pathogen

A
  • bordetella pertussis
    • gram neg aerobe
29
Q

who is at the highest risk for developing whooping cough

A
  • unvaccinated infants and toddlers
30
Q

clinical presentation

  • URI symptoms
  • fever usually absent
  • coughing
  • post-tussive vomiting
A

whooping cough

31
Q

how is whooping cough diagnosed

A
  • nasopharyngeal swab: gold standard
  • PCR: shorter turn around time
32
Q

tx of whooping cough

A
  • erythromycin/azithromycin
    • need to tx unprotected contacts too
33
Q

bronchiolitis is a clinical syndrome in infancy characterized by what 3 things

A
  • rapid respiration
  • chest retractions
  • wheezing
34
Q

bronchiolitis is caused by what pathogen

A
  • RSV: respiratory syncitial virus
35
Q

bronchiolitis most commonly affects what age range

A
  • 0-2 years
    • peak 2-6 months
36
Q

what is bronchiolitis

A
  • bronchiolar obstruction from submucosal edema and mucous plugging
37
Q

how is bronchiolitis diagnosed

A
  • clinical
  • CXR: hyperinflated lungs
  • hypoxia
  • viral cultures/fluorescent monoclonal antibody testing of nasopharyngeal swabs
38
Q

treatment of severe bronchiolitis

A
  • admit
  • oxygen, beta 2 agonist
  • steroids not indicated
  • Ribavirin for severely ill or intubated
39
Q

paroxysmal attacks of reversible bronchospasm

A

asthma

40
Q

tx of acute emergent asthma

A
  • beta 2 agonist: albuterol
  • steriods: prednisone PO or solumedrol IV
41
Q

what is the protocol for stacked SVN tx of acute asthma

A
  • 0.5 cc albuterol in 2.5 cc normal saline, 3 treatments given every 30 minutes
  • peak flow rate before 1st and 3rd
42
Q

what is status asthmaticus

A
  • FEV1 that does not increase to greater than 40% of predicted value with treatment
  • pt who develops major complications like pneumothorax
43
Q

tx of status asthmaticus

A
  • admit
  • beta agonist
  • high dose steroids
  • oxygen
44
Q

clinical presentation

  • fever
  • cough
  • dyspnea
  • pleuritic CP
  • respiratory failure
A

PNA

45
Q

what is a pneumothorax

A
  • any breech of the lung surface or chest wall allowing air to enter the pleural cavity, causing the lung to collapse
46
Q

treatment for pneumothorax < 15-20% involvement

A
  • observation only
  • repeat CXr in 48 hours
47
Q

treatment for pneumothorax >20% involvement

A
  • needle decompression
  • tube thoracostomy: mid axillary incision at 5th interspace, tunnel to 4th rib
  • simple aspiration

emerg med exam III (6 decks)

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