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Pedia > Lower Airway Obstruction > Flashcards

Lower Airway Obstruction Flashcards

1
Q

Lower Airway Obstruction

A

Bronchiolitis

Asthma

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2
Q

1st 2 years of life
RSV
prodrome of cough, colds, fever

CXR - not routine

A

BRONCHIOLITIS

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3
Q

Chronically inflamed airways and increased production of mucus

NOCTURNAL cough

Bronchospasm

WHEEZING

A

ASTHMA

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4
Q

Signs of Lower Airway Obstruction

A

tachypnea

wheezing - EXPIRATORY
increased respiratory effort

PROLONGED EXPIRATORY PHASE

cough

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5
Q

MC trigger of asthma in children

A

VIRAL URTI

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6
Q

CXR findings in bronchiolitis and asthma

A

Hyperinflation
Atelectasis (+/-)
Infiltrates

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7
Q

GINA Guidelines/PAPP 2021

A

Classify based on Severity

Intermittent
Persistent (mild, moderate, severe)

Classify levels of asthma control
Uncontrolled
Partly controlled
Controlled

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8
Q

Consider hospital admission in asthma when patient has any of the ff clinical criteria

A

use of >6-8 SABA puffs in the past 24 hrs

PEF 50-75% of personal best

history of severe exacerbations warranting ICU admission

hospital admission or previous exacerbations for the past 12 mos

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9
Q

WHO Resting RR (Normal for age)

A

1 mo - 12 mo - < 50
1-5 y/o - < 40
6-10 y/o - < 30
11-18 y/o - < 20

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10
Q

Target O2 sat for 6-11 y/o with asthma

A

94-98%

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11
Q

Target O2 sat for adolescents with asthma

A

93-95%

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12
Q

O2 sat that is a predictor of HOSPITALIZATION

A

92%

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13
Q

O2 sat that warrants AGGRESSIVE THERAPY

A

90%

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14
Q

Patients not on controller meds should be started on

A

regular ICS containing Tx

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15
Q

The most cost effective delivery (inhaler)

A

delivery via pMDI

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16
Q

pMDI plus spacer with face mask

A

0-3 years

17
Q

pMDI plus spacer with mouthpiece

A

4-5 years

18
Q

Systemic Corticosteroids

A

Prednisone/Prednisolone
Methylprednisolone
Dexamethasone

19
Q

Should be given to prevent future severe exacerbations and hospitalizations and to reduce deaths

A

Inhaled corticosteroids

20
Q

For moderate to severe exacerbations across all ages – greater improvement in lung function and fewer hospitalizations

A

Ipratropium bromide

21
Q

NOT routinely given for acute exacerbation

Add on treatment in the 1st hour in severe exacerbations

A

Magnesium sulfate

22
Q

Level of Asthma Symptom Control

A

Well controlled - 0
Partially controlled - 1-2
Uncontrolled - 3-4

23
Q

Symptoms less than 2x a month

A

PREFERRED CONTROLLER
low dose ICS whenever SABA is taken

RELIEVER
as needed SABA or low dos ICS-formoterol reliever for MART

24
Q

Symptoms 2x a month or more but less than daily

A

PREFERRED CONTROLLER
daily low dose ICS

RELIEVER
as needed SABA or low dos ICS-formoterol reliever for MART

25
Q

Symptoms most days or waking at night once or more in a week

A

PREFERRED CONTROLLER
daily low dose ICS-LABA or medium dose ICS or very low dose MART (ICS-formoterol)

RELIEVER
as needed SABA or low dos ICS-formoterol reliever for MART

26
Q

Symptoms most days or waking at night once a week and/or low lung function

A

PREFERRED CONTROLLER
medium dose ICS-LABA or low dose ICS formoterol MART or refer

RELIEVER
as needed SABA or low dos ICS-formoterol reliever for MART

27
Q

(+) wheezing

hx of viral infection among the family members

2 y/o

A

Bronchiolitis

28
Q

(+) wheezing

hx of atopy in the family
recurrent wheezing especially after mild viral infection or exercise

A

Asthma

29
Q

(+) wheezing

wheezes are heard loudest over the trachea

persistent wheezing never seems to go way

A

Chondromalacia

30
Q

(+) wheezing

(-) breath sounds R lung

3 y/o

A

Foreign Body Airway Obstruction

31
Q

4 things to check about asthma control

A

daytime symptoms more than 2x a week
night walking
need for reliever > 2x a week
activity limitation

32
Q

Preferred reliever for adolescents w/ asthma

A

ICS-formoterol

33
Q

MCC of stridor in infants and children

A

Laryngomalacia

34
Q

Differentiates PCAP-B from PCAP-A

A

Malnutrition

Comorbid conditions

35
Q

Respiratory signs present in PCAP D but not in PCAP C

A

Cyanosis
Grunting
Apnea

36
Q

MCC of pneumonia in children worldwide

A

Viruses

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