Lecture 6: Respiratory Distress in Children Flashcards

1
Q

What are the 3 components of cardiopulmonary arrest in children?

A
  1. Respiratory (O2)
  2. Cardiac (pump, perfusion, BP)
  3. Circulatory volume (perfusion, BP)
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2
Q

What are the 3 components of the pediatric assessmen triangle which is used for the first, from the door, general assessment?

A
  1. Appearance
  2. Breathing
  3. Circulation
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3
Q

What does a somnolent or lethargic appearance in child with respiratory distress suggest?

A

SEVERE hypoxia, hypercapnia, and/or respiratory fatigue

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4
Q

What does a restless, anxious, and combative child in respiratory distress suggest?

A

Hypoxia

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5
Q

The development of which breathing pattern in child w/ respiratory distress is an ominous sign?

A

Slower, irregular respiratory pattern

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6
Q

Which cause of a sore throat, dysphagia and local pain/swelling in a child is an ENT emergency?

A

Retropharyngeal and peritonsillar abscess

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7
Q

What is the most common cause of infectious airways obstruction in kids age 6-36 months?

A

Croup (acute laryngotracheobronchitis)

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8
Q

Croup in a child is most often due to what etiology, but in some cases may also be due to what?

A
  • Most often viral (parainfluenza virus)
  • Less often allergic (spasmodic croup)
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9
Q

When you hear stridor in a child you should think about what underlying cause?

A

Croup

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10
Q

Which secondary bacterial infection most often arise from croup?

A

Tracheitis (kids are febrile, really sick)

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11
Q

What are 5 known triggers of asthma?

A
  • Infection
  • Exercise
  • Enviornmental irritants
  • Stress
  • GERD
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12
Q

When there is respiratory compromise what is inititally seen with the HR and when the ability to compensate is exceeded how is the HR affected?

A
  • When compromised, will initially see tachycardia to compensate
  • When ability to compensate is exceeded, will see bradycardia (bad sign)
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13
Q

What are the hallmarks and PE findings of tension pneumothorax?

A
  • Severe respiratory distress
  • Ipsilateral chest hyperexpansion
  • Decreased or absent breath sounds on the side of the collapsed lung
  • Shift of mediastinal structures, deviation of trachea AWAY
  • HYPER-resonance to percussion over the collapsed lung
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14
Q

What is Beck’s triad of cardiac tamponade?

A
  • Jugular venous distention
  • Muffled heart sounds
  • Hypotension
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15
Q

What is the drug of choice as an immediate intervention for anaphylaxis?

A

Epinephrine I.M.

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16
Q

Differentiate aspiration of a foreign body into the trachea vs. lower foreign bodies in terms of signs/sx’s

A
  • Trachea –> sudden, dramatic, cough; stridor, drooling, choking
  • Lower foreign bodies –> coughing/choking when FB is first ingested –> delayed sx’s i.e., recurrent pneumonia, chronic cough
17
Q

Which household item is a choking hazard and also may lead to corosion of the esophageal mucosa?

A

Button batteries

18
Q

Aspiration of a foreign body into the right main bronchus leads to what effect during inspiration/expiration?

A
  • Ball valve” effect
  • Air can flow into lung around the object on inspiration, but cannot flow out during expiration
19
Q

In child with neuromuscular disease the initial respiratory compromise is most often due to what?

A

Chronic hypoventilation

20
Q

What disease is seen in a child with sickle cell disease presenting with sudden onset respiratory distress, chest pain, fever, and a new infiltrate in CXR?

A

Acute Chest Syndrome

21
Q

wheezing can be from a multitude of causes, not just asthma. What is the cause of wheezing in high achieving adolescent females?

What does the inspiratory loop look like?

A

Vocal Cord Dysfunciton

Truncated inspiratory loop (basically looks like a triangle with a flat base)

22
Q

Intermittent asthma symptoms (<2’s) puts the patient in which level of the AAP?

when classifying asthma patients, what two categories must be examined?

A

The green zone!

Severity of symptoms and risk (determines if intermittent or persistent)

23
Q

When asthma sx become >2’s, what needs to happen?

Generally, what is the mainstays of treating an acute asthma exacerbation?

A

They need their regimen updated with another agent

Albuterol, Steroids and O2

24
Q

What is the most notorious cause of Broncholitis?

A

RSV

25
Q

Most common cause of PNA in infants/children?

A

S. Pneumoniae, Obviously

26
Q

Meconium ileus is often associated with Hirschprung’s but can also be due to what?

A

Cystic Fibrosis

27
Q

Which ethnic group has the highest rate of CF?

A

Ashkenazi Jew

28
Q

What pathogens are common in CF patients as infants/children?

How about as 20-30s?

A

S. Aureus and H. INfluenzae

Pseudomonas

29
Q

CF patients have a hard time digesting what compounds?

A

ADEK vitamins

30
Q

Newborns are screened for CF after birth. What does a positive screen required?

A

A confirmatory test

Remember, early detection=early intervention