Aquifer Case 21

Question 1

what are PE findings indicative of a lung consolidation?

Answer 1

1. crackles
2. dullness to percussion
3. egophony
4. increased tactile remits
5. whispered pectoriloquy

Question 2

what are wheezes?

Answer 2

expiratory or inspiratory spasms of the bronchioles

wheeze that is entirely inspiratory and louder in the neck indicates partial obstruction of the airway in the neck and is called stridor

Question 3

what are crackles?

Answer 3

sign of fluid in the lungs and can be a sign of consolidation

they happen when an abnormally closed airway opens during inspiration or closes at the end of expiration; they’re discontinuous unlike wheezing which is continuous

Question 4

what is the modified centor criteria?

Answer 4

this decides iff you should do a rapid strep test; give 1 point each

1. tonsillar exudate or erythema
2. anterior cervical adenopathy
3. cough absent
4. fever present
5. 3-14 years old
6. over 45 years old is -1 point

get a strep test f score is 2+

Question 5

what is the clinical presentation of bacterial pneumonia?

Answer 5

1. fever
2. usually strep pneumo
3. does not have prodromal symptoms like rhinorrhea or myalgia
4. pleuritic chest pain, fever, chills, dyspnea, productive cough
5. pleural effusion
6. crackles

Question 6

what is the clinical presentation of viral pneumonia?

Answer 6

chills, fever, dry nonproductive cough with extra pulmonary symptoms like GI upset and arthralgia

Question 7

when do you give antiviral medication?

Answer 7

only within first 48 hours of illness

Question 8

how do you treat acute bronchitis?

Answer 8

acute bronchitis is usually viral so you just provide symptomatic relief

it’s inflammation of the large airways with a cough lasting more than 5 days – inflammation leads to purulent sputum in 50% of patients

Question 9

what are the most common complications of influenza?

Answer 9

1. otitis media

2. lower respiratory tract infections like bronchitis and pneumonia

Question 10

how are kid BMI calculated?

Answer 10

healthy: 5-85 percentile
overweight: 85-95 percentile
obese: 95+%

Question 11

incidence of which diseases has increased in children?

Answer 11

1. DMII
2. HTN
3. high cholesterol

Question 12

if a rapid strep comes back negative on a kid with risks, what do you do?

Answer 12

if their centor score is 2+ then get a throat culture and order an influenza test