Lunch & Learn - respiratory

Question 1

Step 1 (asthma therapy)

Answer 1

SABA as needed

Question 2

Step 2 (asthma therapy)

Answer 2

Low - Dose ICS

Question 3

Step 3 (asthma therapy)

Answer 3

Medium - Dose ICS

> 5 y.o. then us low does ICS with LABA

Question 4

Step 4 (asthma therapy)

Answer 4

Medium- Dose ICS and LABA

Question 5

Step 5 (asthma therapy)

Answer 5

High -Dose ICS with LABA /or montelukast

Question 6

Step 6 (asthma therapy)

Answer 6

High - Dose ICS with LABA and corticosteroids

Question 7

Intermittent Symptom frequency

Answer 7

less than ir equal to 2 days per week - Well controlled - use of SABA less than or equal to 2 times a day

FEV greater than 80% predicted

Question 8

Mild Symptom frequency

Answer 8

greater than 2 days per week but not daily - not well controlled - use of SABA greater than 2 times a day

FEV greater than 80% predicted

Step 1

Question 9

Moderate Symptom frequency

Answer 9

Daily

FEV 60-80% predicted

Question 10

Severe Symptom frequency

Answer 10

Throughout the day - very poorly controlled - use of SABA several times a day

FEV less then 60% predicted

Step 1-2

Question 11

viral croup (laryngotracheitis)

Answer 11

parainfluenza virus 
bacterial tracheitis - s aureus, H flu, C, dip
steeple sign
1-6 y.o
barking cough
stridor
TX: dexamethasone
if stridor at rest than give nebulized epi

Question 12

Asthma

Answer 12

trigger - URI viral
asthma predictive index - improves dx
PFT - 12% change in FEV - positive response on spirometer

Question 13

no spacer under 6 months

Answer 13

true - all children over 6 months can be given an inhaler

Question 14

careful with LABAs because they what?

Answer 14

can mask airway inflammation and put patient at risk of sudden and life threatening asthma exacerbations

Question 15

Pneumonia

Answer 15

LRTI - fever

Walking pneumonia - school aged children

Question 16

Typical agent for walking pneumonia?

Answer 16

Mycoplasma Pneumoniae

Question 17

Hospital Acquired pneumonia

Answer 17

develops within 48 hours of admission

Question 18

Neonates etiology? pneumonia

Answer 18

HSV, GBS, gram - enteric bacteria (E.coli), listeria, C, trachomatis

Question 19

Infants etiology? pneumonia

Answer 19

Viruses, S. pneumoniae, H, flu

Question 20

Children < 5 yrs etiology? pneumonia

Answer 20

Viruses. S. pneumonia, H. flu

Question 21

children > 5 yrs etiology? pneumonia

Answer 21

Viruses, S. pneumonia, M. pneumoniae

Question 22

Hallmark clinical manifestation of pneumonia?

Answer 22

cough and fever

Question 23

first line pneumonia treatment?

Answer 23

ampicillin or amoxicillin

unasyn, augmentin

Question 24

second line pneumonia treatment?

Answer 24

2nd/3rd generation cephalosporin - ceftriaxone IV

Question 25

M. pneumoniae treatment? seen in etiology in children greater than 5 y.o.

Answer 25

azithromycin

Question 26

neonatal pneumonia treatment?

Answer 26

ampicillin / cefotaxime

Question 27

Bronchiolitis

Answer 27

most common LRTI in infants and children under 2 y.o. - RSV virus
Tx - suctioning
Prevention - Palivizumab (synagis), hand washing, alcohol rubs

Question 28

______________, work of breathing and hypoxia are the most cynically significant parameters in deterring illness severity and should be routinely assessed

Answer 28

respiratory rate

Question 29

Nebulized hypertonic saline 3% should not be administered to infants and children with bronchiolitis in the __?

Answer 29

ED

Question 30

Nebulized hypertonic saline 3% may be administered to infant and children with bronchiolitis that are ____________.

Answer 30

hospitalized