Mehl. pulmo: TTN, meconium, bronchopulm dyspl., foreign b., alergic rinitis 04-03 (4)

Question 1

TTN = Transient tachypnea of the newborn.

Answer 1

.

Question 2

TTN. how sounds vignette?

Answer 2

vignette sounds like NRDS but the kid is term

Question 3

Vignette sounds like NRDS but the kid is term?

Answer 3

TTN.

Question 4

they’ll say neonate has difficulty breathing, but then you’ll notice he’s >37 weeks, Dx?

Answer 4

TTN.

Question 5

TTN. usually seen following what?

Answer 5

Usually seen following C-section or fast vaginal delivery.

Question 6

TTN. mechanism?

Answer 6

Mechanism is insufficient time for the pulmonary lymphatics to clear amniotic fluid from the lungs

Question 7

TTN. xray?

Answer 7

CXR shows “fluid within fissure lines.”

Question 8

Bronchopulmonary dysplasia. definition? what causes?

Answer 8

Fibrotic lung disease in an infant caused by continued use of supplemental oxygen.

Question 9

Q: Vignette will give you a kid who was born at 26 weeks’ gestation who was
in ICU on oxygen + now is 4 months old and is on home oxygen. They will
say ECG shows right-axis deviation +/- CXR shows increased pulmonary
vascularity. Dx?

Answer 9

this reflects RVH (ensuing cor pulmonale) from pulmonary hypertension caused by the bronchopulmonary dysplasia.

Question 10

Foreign body aspiration.
answer in what case?

Answer 10

Answer on 2CK for kid under 2 who was crawling around on the floor who
now has acute-onset respiratory distress.

Question 11

kid under 2 who was crawling around on the floor who now has acute-onset respiratory distress.
Dx?

Answer 11

Foreign body aspiration.

Question 12

Foreign body aspiration. vignette will add one of features:
1) Unilateral hyperresonance in one lung (but not pneumothorax);

2) Unilateral atelectasis + ipsilateral tracheal shift

Answer 12

.

Question 13

Foreign body aspiration. hyperresonance?

Answer 13

vignette will add one of features:
1) Unilateral hyperresonance in one lung (but not pneumothorax);

Question 14

Foreign body aspiration. trachea?

Answer 14

2) Unilateral atelectasis + ipsilateral tracheal shift

Question 15

Foreign body aspiration. what to do for examination?

Answer 15

Exam will ask for “bronchoscopy,” or “fiberoptic examination of the airways” as the answer

Question 16

Meconium aspiration syndrome.
mechanism?

Answer 16

newborn aspirates a mixture of meconium (infants first stool) and amniotic fluid into their lung during parturition.

Question 17

Meconium aspiration syndrome. can cause what pathologies of lungs?

Answer 17

airway obstruction, infection, inflammation, dyspnea.

Question 18

Meconium aspiration syndrome. Q will mention ,,dark, meconium-stained fluid”.

Answer 18

.

Question 18

Meconium aspiration syndrome. what is highest yield risk factor?

Answer 18

POST-TERM BIRTH (ie after 40 weeks)

Question 19

Meconium aspiration syndrome. can cause what cardio patho?

Answer 19

persistent fetal hypertension

Question 20

Allergic rhinitis.
Not limited to kids, but can be part of atopy in patients with asthma.

Answer 20

.

Question 21

Allergic rhinitis. what buzzy for nasal mucosa?

Answer 21

“Cobblestoning” of nasal mucosa is buzzy for allergy.

This same word is used to describe the tarsal conjunctiva in allergic conjunctivitis on Peds.

Question 22

Allergic rhinitis.
cause in 2CK Q was

“use of pillow and mattress covers” as the answer”.

Answer 22

.

Question 23

Allergic rhinitis.
first line med? usmle wants this

Answer 23

USMLE wants intra-nasal corticosteroids as first-line med.

Question 24

Allergic rhinitis. what usmle doesnt want as first line med?

Answer 24

USMLE does not want anti-histamines as first-line med.

Question 25

Allergic rhinitis. If intranasal corticosteroids are not mentioned, what is right answer?

Answer 25

2nd-gen H1 blockers (i.e., loratadine) are the answer if intra-nasal corticosteroids are not listed.

Question 26

Allergic rhinitis. what meds are WRONG answer?

Answer 26

Oral prednisone is a wrong answer.