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CPR III > Newman > Flashcards

Newman Flashcards

1
Q

Step 1 tx

A

SABA prn

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2
Q

Asthma (etiology and findings)

A
  • Triggers = infection, exercise, irritants, stress, GERD
  • Sudden worsening of sx can occur (d/t atelectasis or alveolar dz)
  • Inflammation, bronchospasm, edema, mucus production
  • Wheeze/prolonged expiration
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3
Q

When to refer to specialist for UTI?

A
  • Dilating VUR (Grades 3-6)
  • Obstructive uropathy is present
  • Renal abnormalities identified
  • Kidney function impaired
  • HTN
  • Bowel/bladder dysfunction refractory to PCP measures
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4
Q

Quick relief asthma meds?

A
  • SABA (albuterol)
  • Anticholinergics (ipratropium)
  • Systemic corticosteroids
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5
Q

MCC of UTI in children

A

E coli (followed by Klebsiella, Proteus, enterococcus, pseudomonas)

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6
Q

BP cuff too small?

A

BP falsely elevated

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7
Q

3 components of pediatric assessment triangle

A

Appearance
Breathing
Circulation

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8
Q

MCC of obstructive uropathy in children

A
  • VUR
  • Posterior urethral valves (boys)
  • Cysts/ureteroceles
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9
Q

Tx of UTI

A

2nd or 3rd gen cephalosporin (cefixime or cefdinir), fluoroquinolone can also be used (empiric tx)

*Modify if culture dicates

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10
Q

What to look for in circulatory?

A
  • Skin exam good to assess perfusion (decreased perfusion may be d/t decreased PVR to maintain BP) via cap refill
  • HR changes (tachy, then brady w/ increasing severity)
  • Cyanosis
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11
Q

Long-term asthma meds?

A
  • Inhaled corticosteroid
  • Leukotriene modifers
  • LABA
  • Anticholinergic (tiotroprium)
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12
Q

Pneumonia (etiology and findings)

A
  • Bacterial (strep pneumoniae) usually gives lobar
  • Can be viral or atypical (usually gives interstitial, but can be lobar)
  • high fever, ill-appearance
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13
Q

Signs of pt w/ respiratory arrest imminent?

A
  • Breathless @ rest
  • Silent
  • Drowsy/confused
  • RR > 30
  • Unable to recline
  • Rocking respirations
  • No wheeze
  • Bradycardia
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14
Q

Describe VCD curve?

A

Truncated inspiratory loop and straight diagonal line

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15
Q

Step 4 tx

A

Medium dose ICS + LABA

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16
Q

Appropriate tx for anaphylaxis

A

Epinephrine
O2
Steroids

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17
Q

DDx for newborn w/ tacypnea

A
  • Cardiac in nature
  • ARDS
  • Fever
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18
Q

What is possible dx for chronic rhinorrhea and sinusitis

A

CF

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19
Q

What are some nonspecific irritants for asthma triggering?

A
  • Exercise
  • URI
  • Aspiration
  • Pollution
  • NSAID
  • GERD
  • Temperature change (cold air)
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20
Q

How to obtain urine sample?

A

Clean catch if they can void on demand

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21
Q

How to obtain urine sample when they cannot void on demand?

A
  • Catheterization
  • Suprapubic aspiration
  • Bag samples
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22
Q

Common asthma triggers

A
  • Exposure to inhaled allergens (dust mites, cockroaches, pollens)
  • Nonspecific irritants
    3 groups (inflammatory, irritants, other)
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23
Q

When to image for girls?

A
  • After 2nd or 3rd
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24
Q

What type of curve is seen w/ asthma?

A

Scooped out curve

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25
Q

How is albuterol inhaler used?

A

Up to 2 tx 20 mins apart (2-6 puffs each) and measure response

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26
Q

What is possible dx for coughing/choking when eating?

A

oropharyngeal dysphagia w/ aspiration

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27
Q

What to look for in appearance?

A
  • Overall demeanor
  • Tone
  • Interaction
  • Consolability
  • Look/gaze
  • Speech/cry
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28
Q

What is especially dangerous to swallow?

A

Button batteries b/c they eat through mucosa

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29
Q

How is level of severity determined?

A

Assessment of impairment and risk

30
Q

What is possible dx for poor growth/low BMI?

A

CF, immunodeficiency

31
Q

Anaphylaxis (etiology and findings)

A
  • Allergy to food or meds
  • Retropharyngeal edema
  • Bronchospasm in lower airway
  • *WHAT HAPPENS when exposed?
32
Q

When to image for boys? and what to get?

A
  • After 1st UTI

- Renal/bladder US (anatomic abnormalities, obstruction or duplication)

33
Q

What is possible dx for FH of sterile males

A

CF

34
Q

What is the prognostic indicator of long-term renal damage w/ Henoch-Scholein Purpura

A

Development of proteinuria alongside hematuria

35
Q

What is possible dx for > 2 pneumonia episodes

A

Immunodeficiency

36
Q

Bronchiolitis (etiology and findings)

A
  • RSV, influenza, parainfluenza, adenovirus, others
  • Children < 2 yo
  • URI sx w/ progressive/productive cough
  • wheezing/atelectasis
37
Q

Step 3 tx

A

Low dose ICS + LABA

OR medium dose ICS

38
Q

What to look for in breathing?

A
  • Tachypnea usually seen initially
  • Development of slow/irregular breathing indicates worsening state
  • Nasal flaring, grunting, retractions, stridor, rocking resp all may be seen on PE
39
Q

Pathophys of asthma

A
  • Episodic/chronic sx of airway obstruction
  • Reversibility of sx either spontaneously or via bronchodilator
  • Sx worse @ night or early am
  • prolonged expirations and diffuse wheezing
40
Q

Which congenital malformations are CYANOTIC?

A
  • Tetrology of Fallot
  • Truncus Arteriosis
  • Tricuspid atresia
  • Transposition of great vessels
  • Total anomalous pulmonary vascular return
41
Q

Dx criteria for catheter

A

BOTH pyuria and 50,000 colonies OR 10-50,000 colonies on repeat

42
Q

Wheezing

A

Air passing through narrowed airways

d/t inflammation/bronchoconstriction

43
Q

Epiglottitis (etiology and findings)

A
  • Haemophilus influenzae type B
  • Vax available now (so its rare)
  • Airway obstruction possible
44
Q

What is possible dx for chronic wet cough

A

Bronchiectasis

45
Q

What is going on if there’s no audible speech, cry or cough?

A

Foreign body aspiration, angioedema from anaphylaxis or epiglottitis

46
Q

Newborn pulse ox screening test

A
  • Used to detect possible ductal dependent lesions prior to leaving hospital
  • See notes for details
47
Q

Asthma vs COPD?

A

Asthma sx are reversible, whereas COPD isn’t

48
Q

PSGN description

A
  • Gross hematuria w/ glomerular involvement
  • HTN
  • Swelling/edema
  • ELEVATED ASO titers
  • Low serum C3

Supportive care usually fine

49
Q

What is possible dx for sudden onset of sx?

A

foreign body

50
Q

When to get VCUG?

A
  • any anomalies seen on RBUS
  • Temp > 39*C and pathogen other than E coli
  • Poor growth and HTN present
51
Q

Signs and sx of UTI in children

A
  • fever (unattributable to another cause)
  • Decreased intake
  • Increased urinary frequency, dysuria, urgency
  • dark/strong-smelling urine
  • loss of control
52
Q

Foreign Body aspiration (etiology and findings)

A

@ trachea - sudden dramatic coughing w/ stridor, drooling and choking
@ lower tract - coughing, choking @ first, then recurrent pneumonia and cough
@ esophagus - drooling, swallowing problems

53
Q

Diagnostic criteria for clean catch

A

BOTH pyuria and > 50,000 colonies of single organism

54
Q

3 components of CP arrest?

A

Respiratory (O2)
Circulatory (pump, perfusion, BP)
Circulatory volume (perfusion, BP)

55
Q

What is VCUG looking for?

A

Evidence of vesicoureteral reflux

56
Q

Step 5 tx

A

High dose ICS + LABA

AND omalizumab

57
Q

Croup (etiology and findings)

A 
AKA acute laryngeotracheobronchitis
MCC of infectious airway obstruction (6-36 m)
- Parainfluenza virus or allergic 
- Steeple sign on CXR
- Fast onset
58
Q

Dx criteria for suprapubic aspiration

A

BOTH pyuria and any growth on culture

59
Q

When are bag samples helpful?

A

Only when negative, and should never be used for cultures

60
Q

What is possible dx for acute onset w/o hx of asthma in teenager?

A

VCD

61
Q

Rales

A

Moist sounds d/t air passing through narrowed airways

d/t airway inflammation and thick mucus

62
Q

Grunting

A

Expiratory sound in an attempt to maintain airway patency

d/t breathing out of a partially closed glottis and desire for decreased chest wall expansion

63
Q

When to refer to cardiologist?

A
  • Grade 4 murmur and above
  • Diastolic murmur
  • Increased intensity w/ standing
  • Sx murmur
  • Obscured heart sounds
  • Weak femoral pulses
  • Clicks
  • Hyperactive precordium
  • FH of sudden cardiac death
  • Extra heart sounds
  • Conditions predisposing to heart conditions (Downs)
64
Q

Signs/sx of asthma

A
  • Cough
  • Wheezing
  • Chest tightness
  • Prolonged expiration
  • SoB
65
Q

BP cuff too large?

A

BP falsely lowered

66
Q

Step 2 tx

A

Low dose ICS

67
Q

Different grades of VUR?

A

See website link

https://www.chop.edu/conditions-diseases/vesicoureteral-reflux-vur

68
Q

Step 6 tx

A

High dose ICS + LABA + OCS

AND omalizumab

69
Q

Well controlled asthma vs poorly controlled?

A
  • Less sx frequency
  • Less nighttime awakenings
  • No interference w/ daily activities
  • SABA use <2/week
  • FEV1 > 80% expected
  • 0-1 exacberations/yr requiring OCS
70
Q

Stridor

A

Prominent w/ inspiration

Laryngeal or tracheal narrowing

CPR III (2 decks)

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