pediatric pulmonary concerns

Question 1

What body parts are involved in croup? What is the causative agent?

Answer 1

parainfluenza 1 and 2 most common
can be other kinds of parainfluenza, RSV, influenza, rubeola, adenovirus, or mycoplasma
inflamation of the larynx

Question 2

At what age do children get croup? Clinical presentation?

Answer 2

3 months-5 yrs

nasal congestion, barking cough, dyspnea, resp stridor, fever, LAD

Question 3

What are the radiographic findings of croup?

Answer 3

steeple sign- narrowed subglottic airway

Question 4

Treatment for croup

Answer 4

supportive care. aerosolized epi and inhaled steroids if severe. If concerns about resp distress, admit for observation. stridor at rest is an indication for hospitalization

Question 5

Besides Hib, what organisms cause epiglottitis? What age?

Answer 5

strep, non-b type haemophilus influenzae

usually kids 2-7

Question 6

What are the causes of acute stridor in a child?

Answer 6

ABCDEFGH:

abscess, bacterial tracheitis, croup,diptheria, epiglottitis, foreign body, gas (poisonous), hypersensitivity

Question 7

bronchiolitis: causative agents, age of child

Answer 7

usually kids under 2

caused by RSV (most common) or parainfluenza

Question 8

treatment of bronchiolitis. what is a complication?

Answer 8

hydration, humidified air, inhaled corticosteroids, beta agonists. incr risk of developing asthma

Question 9

What is the typical hx for respiratory distress of the newborn?

Answer 9

preterm infant (24-37 wks gestation, but especially high if born before 30 wks)
presentation within 2 days of birth

Question 10

How is amniotic fluid analysis helpful for determining management of respiratory distress of the newborn?

Answer 10

-less than 34 wks: give tx
-34-37 wks: if lecithin:sphingomyelin ratio is less than 2 or there is no phosphatidyl glycerol in the fluid, give mom steroids before delivery
after 37 wks treatment is rarely needed

Question 11

meconium aspiration syndrome: work up and treatment

Answer 11

work-up: consider blood culture to rule out sepsis; CXR will show atelectasis, hyperinflation, pneumothorax
tx: suction, give O2, consider intubation, consider empiric abx

Question 12

complications of meconium aspiration

Answer 12

pulmonary HTN, asthma

Question 13

what is an abnormal sweat test?

Answer 13

over 60 mEq/L in kids; over 80 mEq/L in adults

Question 14

transient tachypnea of the newborn

Answer 14

often seen in delivery room. risk factors include C-section without labor. resolves within 48-72 hrs. give O2, maybe abx

Question 15

What is the most commonly associated condition with congenital diaphragmatic hernia?

Answer 15

trisomy 13