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CSI Exam 5 > Neuro Respiratory > Flashcards

Neuro Respiratory Flashcards

1
Q

Risk factors for pulmonary disease in neonates

A

C-section, pre-term, meconium-stained amniotic fluid

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2
Q

S/S of pulmonary disease

A

cyanosis, retractions, crackles/rhonchi, temp instability, split S2, grunting

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3
Q

Fetal hgb has a _____ affinity for O2

A

higher

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4
Q

Fetal hgb shifts the oxygen binding curve

A

left

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5
Q

S/S of CHD in neonate

A

cyanosis, weak peripheral pulses, quiet tachypnea

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6
Q

What is tachypnea in infants?

A

0-2mo >60, 2-12mo >50

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7
Q

Hyperoxia Test

A

On 100% O2, if paO2 increases >150, suspect pulmonary dysfunction; if no change in paO2, suspect cardiac

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8
Q

Retained Fetal Lung Fluid/Transient Tachypnea S/S

A

tachypnea, cyanotic, retractions

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9
Q

Retained Fetal Lung Fluid/Transient Tachypnea Risk Factors

A

C-section, male, perinatal asphyxia, umbilical cord prolapse

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10
Q

Retained Fetal Lung Fluid/Transient Tachypnea Maternal Complications

A

asthma, diabetes, analgesia in labor

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11
Q

Retained Fetal Lung Fluid/Transient Tachypnea Treatment

A

Supportive; O2 is needed or CPAP; IV fluids; Improves w/ minimal treatment

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12
Q

Meconium CXR

A

atelectasis or plugging, hyperexpanded (tarry stools allow air to enter, but cannot exit)

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13
Q

Air Leak CXR

A

partial expansion of lungs

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14
Q

Grunting

A

sound made on expiration against a partially closed epiglottis; helps open alveoli

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15
Q

Findings in cardiac dysfunction

A

increased RR, but no increased work of breathing, Single S2, decreased peripheral pulses, hepatomegaly, unchanged paO2 on O2 challenge test

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16
Q

Neonatal Respiratory Disease/Surfactant Deficiency S/S

A

tachypnea, grunting, retractions, nasal flaring, cyanosis, pulse ox <90%, temp instability

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17
Q

Neonatal Respiratory Disease/Surfactant Deficiency risk factors

A

pre-term, mother w/ uncontrolled diabetes

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18
Q

Neonatal Respiratory Disease/Surfactant Deficiency Labs

A

low pH, high paCO2, low paO2; hyperoxia challenge -> paO2 155mmHg

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19
Q

Neonatal Respiratory Disease/Surfactant Deficiency Tx

A

intubate, CPAP, surfactant, Abx

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20
Q

Testing before birth

A

Lecithin:Sphingomyelin in amniotic fluid is < 2 (or 1.5) indicates immature fetal lung

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21
Q

If Lecithin:Sphingomyelin <1.5 how could treat this

A

antenatal steroids (beta-methasone) given 2d before delivery, decreased the risk in pre-term infants < 32wks; glucocorticoids (production) & beta-adrenergic (secretion)

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22
Q

Hyaline Membrane disease

A

aka Neonatal Respiratory Disease/Surfactant Deficiency

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23
Q

Which cells make surfactant

A

type II alveolar pneumocytes

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24
Q

Surfactant composition

A

DPPC, SP-A, SP-D, SP-B, SP-C, Unsat phosphatidylcholine

25
Q

Meconium Aspiration S/S

A

brown amniotic fluid, infant deteriorates, grunting, retractions, tachycardia

26
Q

Meconium Aspiration Risk Factors

A

post-due date, diabetic mother, HTN, hypoxia or acidosis in utero (stress), pre-mature + Listeria infection

27
Q

Meconium Aspiration Complication

A

pneumothorax

28
Q

Meconium Aspiration Tx

A

Supportive + Abx

29
Q

Neonatal pneumonia peri-natal causes

A

GBS, E. coli, Klebsiella, Chlamydia, Listeria

30
Q

Neonatal pneumonia post-natal causes

A

RSV, Strep, Staph, etc

31
Q

Premature infant + brown amniotic fluid, unstable, rash, mom had fever

A

Listeria

32
Q

C-section at 35wks, mom had uncontrolled diabetes

A

Hyaline membrane disease

33
Q

C-section, tachypnea + grunting, good color, strong suck

A

Transient tachypnea

34
Q

Cystic Fibrosis genetics

A

autosomal recessive, mutation of CFTR gene on chromosome 7

35
Q

Cystic Fibrosis S/S

A

infant failure to thrive, poor weight gain, cough, dyspnea, increased sputum, rhinitis/sinusitis, nasal polyps, meconius ileus, prolapsed rectum

36
Q

Pathognomonic for Cystic Fibrosis Sx

A

meconius ileus

37
Q

Cystic Fibrosis Labs

A

elevated IRT (pancreatic enzymes)

38
Q

Diagnostic Test for Cystic Fibrosis

A

Cl- sweat test

39
Q

Cystic Fibrosis CXR

A

peribronchial cuffing, tram lines, infiltrates, fibrosis, blebs

40
Q

Cystic Fibrosis Triad

A

chronic pulmonary disease, pancreatic insufficiency, elevated sweat Cl

41
Q

Cystic Fibrosis complications

A

respiratory (pHTN, RSHF), GI, Endocrine, male infertility, hemoptysis, pneumothorax, cirrhosis, diabetes

42
Q

Cystic Fibrosis Tx

A

bronchodilators, mucolytics, pancreatic enzyme replacement, Abx, O2, vitamins, supportive

43
Q

Infections in Cystic Fibrosis pts in infants, think

A

S. aureus, NTHi, GNRs

44
Q

Infections in Cystic Fibrosis pts in children > 10, think

A

P. aeurginosa

45
Q

Pertussis S/S

A

infant with wet, barky cough

46
Q

Pertussis Testing

A

Serology (EIA, DFA, PCR), culture

47
Q

Pertussis Tx

A

Macrolides

48
Q

RSV S/S

A

young child in acute respiratory distress, Hx of URTI & low-grade fever, tachypneic, tachycardic, retractions, nasal flaring, hypoxia, apnea

49
Q

Poor prognostic factors for RSV

A

O2 SAT < 3mo, pre-mature, toxic appearance, atelectasis, tachypnea > 70,

50
Q

RSV Tx

A

Supportive (albuterol, O2, fluid)

51
Q

RSV complications

A

apnea, pneumonia, atelectasis, deydration, respiratory failure, superinfection, air leaks

52
Q

Most likely cause of pneumonia in a newborn

A

GBS > E. coli > Listeria > Chlamydia

53
Q

6 week old child with pneumonia who has a Hx of eye infection would likely have

A

Chlamydia

54
Q

Tx for mycoplasma pneumonia infection

A

Macrolides (erythromycin)

55
Q

Tx for Chlamyida pneumonia

A

Macrolides (erythromycin)

56
Q

Empiric therapy for child with suspected bacterial pneumonia

A

amoxicillin + ceftriaxone

57
Q

Young adults empiric therapy for pneumonia

A

fluoroquinolons

58
Q

Neonates w/ bacterial pneumonia Tx

A

ampicillin + cefotaxime

CSI Exam 5 (4 decks)

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