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PEDS > Lecture 10/29-Resp > Flashcards

Lecture 10/29-Resp Flashcards

1
Q

main organisms that causes croup

A

Parainfluenza virus

also RSV

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2
Q

main cause of epiglottitis

A

H. influenza

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3
Q

what sound is caused by an upper airway obstruction

A

stridor

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4
Q

what sound is due to fluid or atelectasis in small airways

A

crackles/ rales

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5
Q

what sound means fluid in big airways (low note)

A

Rhonchi

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6
Q

little alveoli are popping open

A

crackles

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7
Q

what are signs of work of breathing

A

grunting
retractions
seen more infants due to lack of fixed chest

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8
Q

mainstay for test for respiratory dz?

A

chest x-ray

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9
Q

used to see if there is a structure obstruction the trachea. Also good for trachealesophageal fistula (TEF), GER, vascular rings.

A

barium swallow

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10
Q

what helps to look for malacias, foreign bodies.

A

Laryngoscopy and bronchoscopy

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11
Q

test to look for RSV, influenza, parainfluenza.

A

Viral swab (panel)

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12
Q

what are 2 infections of the upper airway

A

Croup

Epiglottis

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13
Q

Structural problems with upper airway obstruction

A 
Laryngomalacia
subglottic stenosis (from intubation)
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14
Q

Functional problems with the upper airway

A

Vocal cord paralysis

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15
Q

some risk factors of upper airway problems

A 
Difficult delivery
ductal ligation (PDA) 
intubation
foreign body
infection
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16
Q

when in the year is croup common?

A

fall and early winter

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17
Q

what age group is croup common in

A

6 mo- 3 year

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18
Q

what presents with a prodrome URI followed by a barking cough and possibly a low grade fever

A

Croup

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19
Q

what will the xray with croup show?

A

subglottic narrowing and normal epiglottis

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20
Q

what testing do you do for croup?

A

Viral swab for respiratory virus

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21
Q

what sign do you see on x-ray with croup?

A

Steeple sign from laryngeal edema

subglottic narrowing

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22
Q

tx for croup

A

Supportive “go outside in cold air” vasoconstriction
Nebulizers (racemic epi neb)
dexamethasone

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23
Q

if a kid shows up in the ER with croup, what must they have achieved to be able to go home?

A

Not stridor at rest within 3 hours

not recurrent nebs needed (if so- hospitalize)

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24
Q

what viruses are in a viral panel?

A 
Influenza A an B
RSV
human metapneumovirus
parainfluenza 1,2,3
Adenovirus 
Strep pneumo
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25
Q

what is the invasion of bacteria into the mucosa of a patient with viral croup. Will have purulent secretions with high fever and severe obstruction.

A

Croup- Bacterial tracheitis

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26
Q

how do you tx croup- bacterial tracheitis

A

Hospitlization
Suctioning, hydration
IV ABX for staph aureus
probably intubated

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27
Q

Inspiratory stridor with sudden onset and drooling. Will be tripoding and flaring nares

A

Epiglottis

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28
Q

Tx for epiglotitis

A

emergency- need to intubate

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29
Q

what causes epiglotitis if someone is immunized (usually)

A

Group A Strep and Staph Aureus

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30
Q

What will the x-rays look like on epiglottitis?

A

Thumb sign on lateral x-ray (shows thickened tissue of epiglottitis)

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31
Q

Underdeveloped cartilaginous structures

Most common cause of stridor in infants

A

Laryngomalacia

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32
Q

when will a child usually outgrow laryngomalacia?

A

improves with age, resolves by 2 years of age

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33
Q

when is laryngomalacia worse?

A

Supine

Activity (feedings)

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34
Q

how do you diagnose laryngomalacia?

A

laryngoscopy and bronchoscopy

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35
Q

vessels coming off the heart are compressing the upper tracheal

A

vascular ring or sling

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36
Q

Congenital or from intubation
Mild to severe with serious obstruction of airway
Stridor after extubation
Suspect in Pt with recurrent croup

A

Subglottic stenosis

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37
Q

Tx for subglottitic stenosis?

A

Surgical correction- plasty

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38
Q

if there is a progressive wheeze what should you suspect?

A

CF

bronciolitis obliterans

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39
Q

What can be a lower or upper airway disorder?

A

tracheomalacia or vascular ring

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40
Q

how do you treat a severe tracheomalacia?

A

Tracheostomy

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41
Q

what are some txs for lower resp tract infections

A

beta adrenergic nebs

CPT

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42
Q

most common organisms for bronchiolitis?

A

RSV

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43
Q

Cough, coryza, rhinorrhea… over 3-7 days to noisy raspy breathing and audible wheeze

A

Bronchiolitis

44
Q

what is the leading cause of hospitalization of infants?

A

bronchiolitis

45
Q

when does RSV peak?

A

late winter from November to March

46
Q

How do you dx RSV?

A

viral swab

47
Q

what may the CXR show with bronchiolitis?

A

may be normal or show
peribronchial cuffing
increased intestitial markings
hyperinflation

48
Q

what is the monoclonal antibody given every month to help prevent at risk infants?

A

Synagis (palivizumab)

49
Q

symptoms in infants are fever, prominent runny nose, and congestion, coupled with wheezing. Duration of 1-2 weeks

A

RSV

50
Q

are viral or bacterial pneumonias more common in children?

A

Viral

51
Q

What is the most common bacterial pneumonia

A

Strep pneumo

52
Q

what are atypicals that cause pneumonia?

A

Mycoplasma pneumonia

chlamydial pneumonia

53
Q

URI prodrome + wheezing and stridor +/-fever

Myalgia, malaise, headache

A

Viral pneumonia

54
Q

what causes viral pneumonia?

A

RSV
parainfluenza
influenza A and B
Human metapneumovirus

55
Q

what will you see on CXR with viral pneumonia?

A

Perihilar streaking

increased interstitial markings or patchy bronchopneumonia

56
Q

what virus can cause necrotizing pneumonia?

A

Adenovirus

57
Q

what will there be an elevation of (cell wise) with viral pneumonia?

A

lymphocytes

58
Q

Tx for viral pneumonia?

A

Supportive

hospital at risk patients (asthma, RSV, CHD)

59
Q

Present with Fever, chills, cough, dyspnea. Rales or decreased breath sounds

A

bacterial pnuemonia

60
Q

what cells will be elevated for bacterial pneumonia?

A

neutrophils

61
Q

tx for bacterial pneumonia?

A

Amoxicillin
augmentin
erythromycin
cerfuroxime

62
Q

when does bacterial pneumonia occur (season)?

A

anytime of year

63
Q

when are viral pneumonias more common (season)

A

fall and winter

64
Q

More common causes of pneumonia in ages 1-5?

A

RSV in infants
Parainfluenza viruses
influenza viruses
adenoviruses

65
Q

Most common causes of pneumonia >5 years?

A

Mycoplasma pneumoniae

streptococcus penumoniae

66
Q

most common cause of bacteria for pneumonia in kids >5?

A

mycoplasma pneumoniae

67
Q

how do you tx mycoplasma pneumoniae?

A

Erythromycin

68
Q

in teenagers what is almost always the cause of pneumonia?

A

Mycoplasma penumoniae

69
Q

what 2 immuniztions have helped prevent penumonia in children?

A

Prevnar (PCV13)

Hib

70
Q

What organism causes pertussis?

A

Bordetella pertusis

71
Q

peak age for pertussis?

A

<4 months of age

72
Q

When is pertussis immunized?

A

2, 4, 6, 12-15 moths and 4-6 years

73
Q

when does pertussis peak?

A

July-October (via cough)

74
Q

3 stages of pertussis?

A

Catarrhal
Paroxysmal
Convalescent

75
Q

what stage is a URI 1-2 weeks for pertussis?

A

Catarrhal

76
Q

what is the stage of pertussis that is a dry cough 1-2 weeks?

A

Convalescent

77
Q

what is the stage of pertussis with Staccato cough with inspiratory whoop and post tussive vomiting 2-4 weeks

A

paroxysmal

78
Q

how do you dx pertussis?

A

NP swab

79
Q

tx for pertussis?

A

Erythromycin /azithromycin

80
Q

who else should you tx if someone is infected with pertussis?

A

family members

81
Q

Adolescents present with prolonged bronchitis, persistent non-productive cough – often begins as a URI.
Don’t whoop but may have paroxysms
Cough can last weeks to months

A

Pertussis

82
Q

chronic progressive disease that can present with protein and fat malabsorption (failure to thrive, hypoalbuminemia, steatorrhea), liver disease (cholestatic jaundice), or chronic respiratory infection

A

Cystic fibrosis

83
Q

dx of CF

A

sweat test (elevated sweat chloride >60 mEq/L)

84
Q

what will you find on PE of a CF patient?

A

digital clubbing
chronic sinusitis
nasal polyposis

85
Q

tx for CF

A

manage infections
pancreatic enzyme replacement
ADEK vitamins

86
Q

what may an infant present with that suggest CF?

A

meconium ileus

87
Q

non functioning pulmonary tissue that does not communicate with tracheobronchial tree. Blood supply from anomalous blood supply

A

Pulmonary Sequestration

88
Q

decreased in alveolar number and airways

A

Pulmonary hypoplasia

89
Q

what can cause pulmonary hypoplasia?

A

diagphramtic hernia

achondroplasia

90
Q

Congenital cystic lung dz. have large airspaces.

A

CCAM (Congenital Cystic Adenomatoid Malformation)

91
Q

tx for CCAM and pulmonary sequestration

A

remove the defective part of the lung

92
Q

elevation of part or all of diaphragm

diaphragm muscle is weak and stretched up

A

Enventration

93
Q

depression of sternum/ anterior chest wall

A

Pectus Excavatum

94
Q

protrusion of sternum/ anterior chest wall – more common in males,

A

Pectus Carinatum

95
Q

what alveolar cells form the structure of an alveolar wall

A

Type I cells

96
Q

What alveolar cells secrete surfactant?

A

Type II cells

97
Q

Due to a surfactant deficiency

A

Respiratory Distress Syndrome (RDS)

98
Q

what is another term for RDS?

A

bronchopulmonary dysplasia

99
Q

what are infants with RDS at risk for?

A

pulmonary HTN

reactive airway dz

100
Q

chronic lung dz is considered when an infant needs oxygen when?

A

at 28 days

101
Q

What is an ALTE?

A

Apparent LIfe Threatening Events in infancy

102
Q

what are some ALTEs?

A 
apnea
color change
decreased muscle tone
emesis
choking 
gagging
103
Q

when doe most deaths with SIDS occur?

A

2-4 months and between midnight and 8 am in winter

104
Q

What is SIDS?

A

Sudden Death of infant < 1yr old that remains unexplained

105
Q

what is the risks for SIDS?

A 
male
low birth weight
smoking
teen mom
drug addicted mom

PEDS (11 decks)

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