Pediatric Lung Dz

Question 1

Croup (Laryngotracheobronchitis)

Answer 1

Infxn causing inflammation of the larynx, trachea and bronchi.
Most often the parainfluenza virus.
6 months to 3 years most common age

Question 2

Croup key cough

Answer 2

Barking cough and stridor

Question 3

Croup Tx

Answer 3

Generally steroids are used
Dexamethasone .6mg/kg IM one dose
If stridor at rest:
O2, nebulized racemic oxygen

Question 4

Epiglottitis

Answer 4

A true medical emergency
Most commonly H flu type B
Sudden onset!

Question 5

Epiglottitis S/S

Answer 5

Fever
Dysphagia
Drooling
Hot potato voice
Soft stridor

Question 6

Epiglottitis Tx

Answer 6

Do not examine
Obtain lateral neck x-ray
Prepare to intubate

Question 7

Cherry red swollen epiglottis =?

Answer 7

Epiglottitis

Question 8

How long can RSV survive on countertops?

Answer 8

6 hours

Question 9

Bronchiolitis

Answer 9

Inflammatory process of smaller lower airways, usually caused by RSV.
Can progress to respiratory failure
Presents w/ fever, URI, tachypnea, wheezing

Question 10

Bronchiolitis Tx

Answer 10

Controversial

Airway support, O2

Question 11

Pneumonia

Answer 11

Most peds cases are viral
Tachypnea, elevated WBC
Variable CXR

Question 12

Pneumonia Tx

Answer 12

Antibiotics
Bronchodilators?
Fluids, O2

Question 13

Pertussis (Whooping Cough)

Answer 13

Making a comeback
Caused by bordetella pertussis
Fear is respiratory failure secondary to coughing in the small infant.

Question 14

Pertussis presentation

Answer 14

Mild start … leading to whoop cough in 2 weeks. The cough is described as paroxysmal

Question 15

When to suspect pertussis

Answer 15

Not immunized
Classic presentation
Cough for >2 wks
Nasal swab for culture

Question 16

Pertussis Tx

Answer 16

Erythromycin for 14 days

Azithromycin for 5-7 days

Question 17

Cystic Fibrosis

Answer 17

1 in 1,600 caucasian births
Dz of the exocrine gland system
Defective chloride channels 
Highly viscous secretion
Leads to relative dehydration, abnormal mucociliary clearance

Question 18

What is the adult carrier rate for CF?

Answer 18

1 in 32 adults are a carrier

Question 19

What can diagnose CF?

Answer 19

Sweat chloride test

Question 20

CF clinical features

Answer 20

Respiratory insufficiency
Pulm fibrosis, obstruction, frequent infxns chronic sinusitis
Pancreatic insufficiency
Malabsorption of fats and proteins, failure to thrive, rectal prolapse

Question 21

CF pulmonary Tx

Answer 21

Bronchodilators
Mucolytics (acetylcysteine)
Steroids
Abx

Question 22

CF Pancreatic Tx

Answer 22

Pancreatic enzyme supplements
Vitamin supplements
High-caloric protein diet

Question 23

CF primary morbidity

Answer 23

Obstructive lung dz

Median survival = 31 yrs

Question 24

Respiratory distress syndrome of the newborn

Answer 24

Common problem of preterm infants
Deficiency in pulmonary surfactant
Major cause of death in premature infants

Question 25

Neonatal RDS presentation

Answer 25

Tachypnea
Nasal flaring
Expiratory grunting
Cyanosis

Question 26

Is CF obstructive or restrictive?

Answer 26

Obstructive

Question 27

What is Neonatal RDS also called?

Answer 27

Highline membrane Dz

Question 28

What does a neonate have potentially viable lungs?

Answer 28

28 wks

Question 29

Neonatal RDS Tx

Answer 29

Steroids
Surfactant
CPAP