Pathology: Pediatric Diseases Flashcards
Pediatric pneumonia: symptoms of viral pneumonia
Runny nose, nasal congestion, cough, fever
Pediatric pneumonia: RSV, most commonly occurs in
Winter months (mid-December - march)
Pediatric pneumonia: RSV CXR
Hyperinflated lungs
Patchy infiltrates
Atelectasis
Pediatric pneumonia: RSV confirming diagnosis
Rapid immunofluorescent detection in nasal washings
Pediatric pneumonia: aerosolized treatment for RSV
Ribovirin through SPAG
Most common cause of bronchiolitis in children
RSV
Pediatric pneumonia: how does mortality rate differ in bacterial pna vs viral pna
Higher than viral
Pediatric pneumonia: bacterial pna risk factors
Immunocompromised
Aspiration from GERD
Malnutrition
School attendance
Pediatric pneumonia: causative agents in bacterial pna for neonatal and pediatric
Neonate: group B strep, Ecoli
Pediatric: staph, H flu
Pediatric pneumonia: treatment/management
Oxygen therapy
Nutrition
Fluid
Bronchodilators
Diffusehypoxic lung injury resulting in pulmonary edema and progressive alveolar collapse
ARDS
ARDS: time of onset of respiratory symptoms
Within 1 week of known clinical insult
ARDS: CXR
Bilateral opacities
ARDS: degree of hypoxemia (PEEP >5)
P/F ratio: moderate 100-200
Refractory hypoxemia, pulmonary edema, loss of surfactant function, decreased LC, LV, FRC are all manifestations of
ARDS
ARDS: ventilatory support approaches for treatment
Low VT,PIP
PEEP
Secondary vent strategies
Permissive hypercapnia
Lung recruitment
ARDS: pharmacological therapies
Pulmonary vasodilators (prost)
SABA
Steroids
ARDS: when are antibiotics indicated
Bacterial infection
Inherited, genetic, recessive disorder involving the respiratory, digestive, and reproductive systems
Cystic fibrosis
CF: caused by
CFTR
CF: diagnostic tests
Sweat chloride >60 (30-59 > 6mos intermediate, repeat)
CFTR mutation
CF: early symptoms
Dry, hacking cough
Large amount of secretions
CF: CXR
Atelectasis, hyperinflation, flattening of diaphragm, increase A-P
CF: components of tx/management
SABA/anticholinergics
Mucolytic agent: DNase, hypertonic saline
CPT/aw clearance
High protein diet, enzyme replacement therapy
Reversible airway obstruction
Asthma
Asthma: common triggers
Allergies
Stress
Exercise
Cold exposure
Infection
Inhaled irritants
Asthma: signs/symptoms in early stages
Dyspnea, cough, secretions, expiratory wheezing
Asthma: CXR during acute episode
Hyperinflation, infiltrates
Asthma: control medications
LABA (-almetrol)
Inhaled corticosteroids (-one)
Leukotriene modifiers (montelukast)
Immunomodulators (Zumba)
Asthma: rescue meds
SABA: levalbuterol, albuterol
Anticholinergic: ipratropium
Systemic steroids
Asthma: emergency room care
First, oxygen therapy
Continuous albuterol or 3 tx/hr
Inhaled anticholinergic
Systemic corticosteroids steroids
Status asthmaticus
Acute episode that does not respond to usual bronchodilator treatment
Asthma: additional treatments
Continuous bronchodilator
Subq epi
IV steroids
Mag
Helios
Inhaled anesthetics
Asthma: when is mechanical ventilation indicated
Rising CO2
Increasing MV
Decreasing consciousness
Asthma: what to attempt before intubation
NIPPV
Asthma: what is essential in monitoring and measuring?
Peak flow
Asthma: components of comprehensive management program
Patient and parent education
Identification and avoidance/mgmt of triggers
Peak flow monitoring
Recognizing symptoms
Asthma action plan
Moderate persistent asthma
Symptoms: everyday
Activities: moderate limitation
Lung function: FEV1 60-80%, FEV1/FVC ratio 75-80%
SABA use: everyday
Awakenings: 2nights/week (NOT nightly)
Asthma: yellow zone peak flow range
50-80%
Asthma: yellow zone status
Increase in symptoms
Asthma: yellow zone action
Preventative inhaler
Add rescue
Increase tx with oral steroids
Call doctor
Croup: etiology
Parainfluenza (viral)
Croup: URI
Present
Croup: incidence
Fall or winter
Croup: onset
Gradual
Croup: fever
Low-grade
Croup: admission criteria
Strider at rest
Croup: lateral neck
Subglottic edema, hourglass, steeple, or pencil sign
Croup: tx/drugs
Oxygen
Cool aerosol
Race mic
Steroids
Epiglottitis: etiology
Hemophilus influenza
Epiglottitis: URI
Absent
Epiglottitis: age
2-6 years
Epiglottitis: signs and symptoms
Sudden onset
High fever
Drooling/retractions
Epiglottitis: lateral neck
Supraglottic edema
Thumb sign
Obliterated vallecula
Epiglottitis: tx/drugs
Intubate (in or)
Antibiotics
Oxygen/CPAP
