Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory II Exam 2 > Dow Pediatric CIS > Flashcards

Dow Pediatric CIS Flashcards

1
Q

The number one cause of cardiac arrest in children is

A

respiratory arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Differences between pediatric patients and adults presenting with possible respiratory illness

A

Anatomically smaller airways
Proportionately more soft tissue in nose and mouth
**“Obligate nose breathers” in early infancy (relatively large tongue and epiglottis): significant proportion are not able to breathe orally

Breathe with diaphragms and can’t use intercostals and other accessory muscles very well
Less reserve than adults: can deteriorate quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

historical features of respiratory illness

A

A toddler may present with “decreased appetite” per mother’s report instead of c/o sore throat

  • A neonate may present with apnea instead of respiratory distress

Parents often inaccurately describe their child as “lethargic”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs of respiratory distress

A

Nasal flaring
Grunting
Head bobbing
Retractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tonsils and adenoids generally diminish in size after age

A

5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

colds per year and duration

A

Children younger than six years have an average of six to eight colds per year (up to one per month, September through April), with a typical symptom duration of 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common URI symptoms

A

fever
nasal congestion/ discharge (yellow or green)
cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Abnormal middle ear pressures

A

viral nasopharyngitis may result in Eustachian tube dysfunction and abnormal middle ear pressure, or
abnormal middle ear pressure may result from the viral infection of the mucosa of the middle ear Eustachian tube

**–> predisposes to otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Typical viral pathogens

A

**Rhinovirus (about 30-50%)
**RSV
Influenza
Parainfluenza
Nonpolio enteroviruses
Echoviruses
Coxsackieviruses
Coronaviruses
Human metapneumovirus (hMTP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

URI transmission

A

Hand contact: Self-inoculation of one’s own ** conjunctivae or nasal mucosa after touching a person or object contaminated with cold virus

Inhalation of small particle droplets that become airborne from coughing (droplet transmission)

Deposition of large particle droplets that are expelled during sneezing and land on nasal or conjunctival mucosa (typically requires close contact with an infected person)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of URI

A

Supportive care only: push fluids, antipyretics PRN, nasal saline with bulb suction, cool mist humidifier

***Do NOT use OTC cough meds/decongestants in young children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

RSV months and syndromes

A

November-March

Broncholitis, Croup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Parainfluenza syndrome

A

croup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Enterovirus syndrome

A

herpangina- coxsackievirus type A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute Otitis Media Risk Factors

A

**young age- - anatomical differences of ear canal
Day care
Tobacco and pollutant exposure
Use of pacifier
Fall or winter season
Absence of breastfeeding, prolonged bottle use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Otitis Media Most common bacterial pathogens and peak incidence

A

**S pneumoniae, H influenzae, Moraxella catarrhalis

**Peak incidence 3-18 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Otitis media treatment

A

**amoxicillin

**Tympanostomy tube placement for recurrent episodes

18
Q

Sinusitis symptoms

A

cough, nasal symptoms, fever, headache, facial pain and swelling, sore throat, and halitosis

19
Q

in pediatric, diagnosis of sinusitis is based on

A

persistence of nasal discharge
severe symptoms
worsening symptoms

20
Q

kids don’t have all their sinuses developed until about…?

A

12 years old?

Frontal sinuses are formed by around 8 years old.

21
Q

workup of sinusitis

A

diagnosed clinically for routine cases

CT- opacification, mucosal thickening of at least 4 mm
air-fluid level

22
Q

Herpangina

A

Coxsackieviruses

macules–> papules that vesiculate and ulcerate centrally

Hand foot mouth also from coxsackieviruses

23
Q

Acute Pharyngitis- Monospot testing for EBV

A

is not accurate under 4-5 years of age or before 2nd week of illness

24
Q

Strep pharyngitis symptoms ***

A 
Sore throat
Fever
Headache
GI symptoms: abdominal pain, nausea, and vomiting (usually mild)
Poor oral intake 
NO cough or rhinorrhea!!

Work Up:
Rapid strep with back up culture if negative

25
Q

Goals of antimicrobial therapy for eradication of group A streptococcus (GAS) from the pharynx in the setting of acute streptococcal pharyngitis include:

A

Reducing duration and severity of clinical signs and symptoms, including suppurative complications
Reducing incidence of nonsuppurative complications (eg, acute rheumatic fever)
Reducing transmission to close contacts by reducing infectivity

Initiation of treatment within 9 days of onset of illness will prevent complications

26
Q

Treatment of strep pharyngitis

A

penicillin (and other related agents including ampicillin and amoxicillin), cephalosporins, macrolides, and clindamycin.

27
Q

Peritonsillar Abscess

A

Most common deep neck infection

symptoms include:
“hot potato” or muffled voice
Trismus

gold standard for diagnosis of peritonsillar abscess remains the collection of pus from the abscess through needle aspiration

28
Q

Retropharyngeal abscess- common ages

A

between the ages of two and four years

hot potato, trismus

29
Q

Epiglottitis

A 
4 D’s: 
Drooling
Dysphagia
Dysphonia
Dyspnea

Toxic appearing

*Direct examination of the airway under anesthesia (with the availability of personnel who can perform a tracheostomy if needed)

Thumb sign

30
Q

Laryngotracheitis

A

croup

barking-type cough
inspiratory stridor that may worsen with crying.

parainfluenza, steeple sign

treat with: Inhaled racemic epinephrine

31
Q

Bacterial Tracheitis

A

commonly influenza A

Acute onset of airway obstruction in the setting of viral upper respiratory infection and in children with laryngotracheitis who are febrile, toxic-appearing, and have a poor response to treatment with nebulized epinephrine or glucocorticoids  these kids generally look sicker than kids with croup

32
Q

Bronchiolitis- what does it look like? When do you admit?

major pathogen?

A

***increased respiratory effort (eg, tachypnea, nasal flaring, chest retractions) and wheezing and/or crackles (rales).
major pathogen: RSV

***Admit if hypoxic (oxygen saturations below 90% on room air) or dehydrated

clinical syndrome characterized by upper respiratory symptoms (eg, rhinorrhea) followed by lower respiratory (eg, small airway/bronchiole) infection with inflammation, which results in wheezing and or crackles (rales).

big risk factor: Preterm birth (specific guidelines for immunization with Synagis = palivizumab)

33
Q

New Bronchiolitis Clinical Practice Guideline in Limerick Format

A

When treating bronchiolitis, Refraining from films would delight us! Please also avoid The neb and the ‘roid… After all it is only a virus!

34
Q

Pneumonia presenting signs

A 
Fever
Cough
Tachypnea
Increased work of breathing (retractions, nasal flaring, grunting, use of accessory muscles) 
Hypoxemia
Adventitious lung sounds
35
Q

Pneumonia: Bacterial (buzz words)

A

CXR may reveal a focal infiltrate (segmental or lobar consolidation).  buzz words for bacterial pneumonia

36
Q

Pneumonia: Viral

A

Most likely cause of pneumonia in children

37
Q

Mycoplasma pneumoniae

A

Adolescents or children over 5
Most commonly URI symptoms without pneumonia
Gradual onset and usually is heralded by headache, malaise, and low-grade fever
Occasionally can be more acute and mimic pneumococcal pneumonia
Nonproductive to mildly productive cough
Wheezing and dyspnea also may occur
Scattered rales and wheezes on lung exam may be present

38
Q

atypical pneumonia CXR

A

diffuse infiltrates

39
Q

Pertussis stages, infants, treatment ***

A

Cattarhal (usually 7-10 days, range 4-21 days)
Paroxysmal (1-6 weeks, but up to 10 weeks)
Convalescence (usually 7-10 days, range 4-21 days)

Infants don’t whoop

Check nasal wash or aspirate for pertussis (PCR)

Macrolides are drug of choice

Antibiotics started during the paroxysmal state will not lessen symptoms  but they are given to prevent spread of illness!

After five full days of treatment the child is no longer contagious

40
Q

influenza testing and treatment***

A

No testing or treatment unless risk factors present:
Age less than 2
Immunocompromised family member in home (including pregnant women, infants)
Asthma
Heart disease

Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of influenza illness onset.

Respiratory II Exam 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions