History and PE of a Pediatric patient Flashcards
Breathing through a closed glottis because of alveolar collapse; spontaneous PEEP
Grunting
DIfferent signs of respiratory failure
tachypnea, use of accessory muscles, abnormal sounds, bobbing of head, cyanosis
Duration of symptoms (Pedia)
<3 weeks - acute
3 weeks to 3 months - subacute
>3 months - chronic
How do you define”recurrent” symptoms
discontinuous with documented intervals of well being (6-8 TI’s/year in first 2 years)
Most common reason for pediatric consult
infection
Most common indicators of infection in PE
Fever, lymphadenitis, inflamed mucous membrane, purulent dscharge
most common illness in children affected by triggers
Asthma
Cough, wheezing, dyspnea, most commonly exercise induced
asthma attack
Effect of Position (symptoms)
Recumbent - PND or GERD
Diurnal - asthma (agrravated during the night)
What is the cut off time for bronchodilators to be consdered to have poor response
not lasting 4 hours
Good indicator for positive/negative response to treatment
Respiratory rate
Time required for air to travel from the mouth to the alveoulus; computed as airway resitance x compliance
Time constant
DDX for loud pulmonic sound heard on auscultation of the pulmonic component of S2
Vascular lung disease
Abnormally deep breathing; occurs with fever, sever anemia, metabolic acidosis, respiratory alkalosis
Hyperpnea
abnormally shallow breathing; occurs with metabolic alkalosis and respiratory acidosis
hypopnea
It is a benign condition in premature infants observed after 24 hous; 5-10 seconds apneic episodes; not associated with cyanosis or bradycardia
Periodic breathing
- immaturity of the integrating pathways in the CNS
- preterm to 10 months
- absent by 6 months
pAthologic apneic episodes; lasts more than 20 seconds; associated with cyanosis and bradycardia
Apnea of prematurity
Waxing and waning of depth of breath with periods of apnea after each sequence
Cheyne-Stokes breathing
one or several deep breaths or an irregular depth (irregularly irregular), indicated in severe brain damage
Biot’s breathing
Occurs in paralysis of intercostal muscles, premature and newborn infants due to compliant ribcage, upper airway obstruction, respiratory muscle fatigue
Paradoxical breathing
Normal breath sound in an infant
Vesicular
Normal breath sound in adults
bronchovesicular
Non musical, discontinuous lung sounds, requires the presence of lung fluid interface or during sudden opening and closing of airways
Rales or crackles
have musical and non musical qualities, produced by fluid films and airway wall vibration in larger airways , problem in the middle RT
Rhonchi
