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Pediatric Pulmonary/Respiratory Flashcards

1
Q

What is the most common etiology of Viral Croup?

A

Parainfluenza virus

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2
Q

What condition involves barking cough (seal-like), hoarseness, inspiratory stridor?

A

Viral Croup

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3
Q

What condition involves neck XR shows “steeple sign”?

A

Viral Croup

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4
Q

What is the treatment for mild Viral Croup? Moderate Viral Croup (2)? Severe Viral Croup?

A
  • Mild croup: no stridor = supportive care
  • Mod. croup: stridor + SOME retractions = steroids (Dexamethasone) and Epi nebulizer
  • Severe croup: stridor + retractions + agitation = ER
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5
Q

What pulmonary/respiratory condition is an EMERGENCY?

A

Epiglottitis

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6
Q

What condition is associated with the 4 D’s (dysphagia, drooling, distress, dysphonia)?

A

Epiglottitis

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7
Q

What four symptoms are associated with Epiglottitis?

A

4 D’s:

  • Dysphagia
  • Drooling
  • Distress
  • Dysphonia (muffled/hot potato voice
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8
Q

What is the most common etiology associated with Epiglottitis?

A

Bacterial

- H. influenzae type B/Hib

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9
Q

What condition involves neck XR shows “thumb sign”?

A

Epiglottitis

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10
Q

What are the two recommended treatments for Epiglottitis?

A
  • Hospitalization

- Abx (Ceftriaxone)

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11
Q

What is the peak age for FB Aspiration? What is the most fatal substance that is aspirated?

A

Peak 12-24 months

- Balloons

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12
Q

What condition involves abrupt onset cough → dyspnea?

A

FB Aspiration

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13
Q

What is the diagnostic AND curative test for FB Aspiration? For what type of FB should this be used, and why?

A

Rigid bronchoscopy

- Aspirated food particles (vegetables) because not visible on CXR

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14
Q

What condition involves floppy trachea = abnormal collapse due to poor cartilage support?

A

Tracheomalacia

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15
Q

What condition involves recurrent harsh/barking cough, expiratory stridor?

A

Tracheomalacia

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16
Q

How can you differentiate Viral Croup from Tracheomalacia - both have a barking cough?

A
  • Viral Croup: inspiratory stridor

- Tracheomalacia: expiratory stridor

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17
Q

In what stage is Pertussis most contagious, and time frame?

A

MOST infectious in Catarrhal phase (first 1-2 weeks onset)

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18
Q

What condition involves the classic triad of paroxysms of cough, inspiratory whoop, post-tussive emesis?

A

Pertussis

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19
Q

What classic triad is associated with Pertussis?

A
  • Paroxysms of cough
  • Inspiratory whoop
  • Post-tussive emesis
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20
Q

What is the gold standard test for Pertussis? What other test can be used, and in what stage?

A

Nasal culture = gold standard

- Also PCR if catarrhal stage

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21
Q

During what stage is Pertussis diagnosis clinical?

A

Clinical dx if around 3-8 week period (after incubation and catarrhal)

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22
Q

What is the recommended treatment for Pertussis (2)?

A

Antibiotics

- Macrolides or Bactrim

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23
Q

What antibiotic is associated with pyloric stenosis?

A

Azithromycin

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24
Q

What condition involves LRTI in bronchioles of children less than 2 years; Fall/Winter?

A

Bronchiolitis

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25
What is the leading cause of hospitalization?
Bronchiolitis
26
What is the most common etiology of Bronchiolitis?
RSV
27
What condition involves 1-3 days of URI → worsens to fever, cough, respiratory distress?
Bronchiolitis
28
How is Bronchiolitis diagnosed?
Clinically based on sxs, age, time of year
29
What is the recommended treatment for Bronchiolitis? What if it is moderate/severe?
Supportive care with 1-2 day follow-up | - If moderate/severe (toxic-appearing, nasal flaring) = hospitalize with Albuterol trial
30
How can you differentiate Bronchiolitis from RSV Bronchiolitis?
RSV Bronchiolitis = LRTI in bronchioles PLUS PNA or apnea
31
What condition involves parenchymal involvement; often colder months?
Pneumonia (PNA)
32
What is the most common etiology of PNA for ages 1 month to 5 years, and what pathogen?
Viral (RSV)
33
What is the most common etiology of PNA for ages 5 to 18 years (2), and what pathogen?
Bacterial or atypical | - S. pneumoniae
34
What condition involves ill-appearing, grunting = BAD; crackles/rales?
PNA
35
If PNA presents with conjunctivitis, what etiology should be considered?
Chlamydia
36
What condition involves consolidation with +egophony, +bronchophony, +whispered pectoriloquy, +tactile fremitus?
PNA
37
If round PNA is present on imaging, what are the two most likely etiologies?
- Strep pneumoniae | - Staph aureus
38
Under what conditions should a CXR be ordered for PNA (___ + _(6)_)?
Fever + 1 of... - Tachypnea - Nasal flaring - Retractions - Grunting - Rales - Resp. distress
39
If older patient, is a CXR necessary?
NO just treat OP
40
Regardless of etiology, what treatment is recommended for PNA?
SUPPORTIVE CARE | - Avoid antitussives
41
What type of PNA involves gradual onset, diffuse findings on auscultation, non-toxic?
Viral PNA
42
What is the recommended treatment for typical bacterial PNA? Atypical bacterial PNA?
- Typical: Amoxicillin | - Atypical: Macrolides
43
What is the most common fatal autosomal recessive disease?
Cystic Fibrosis
44
What is the mutation associated with Cystic Fibrosis?
CFTR gene
45
What condition is associated with meconium ileus?
Cystic Fibrosis
46
What is the recommended diagnostic test for Cystic Fibrosis? What other two tests can be used, and what is seen on each?
Sweat Chloride Test - CXR shows hyperinflation - PFTs show obstructive pattern
47
What is the most common cause of Bronchiectasis?
Cystic Fibrosis
48
What condition involves chronic cough with purulent sputum?
Bronchiectasis
49
What 3 conditions involve obstructive PFTs?
- Cystic Fibrosis - Bronchiectasis - Asthma
50
What condition shows “tram tracks” on CXR?
Bronchiectasis
51
What condition shows “ring shadows” on CXR?
Bronchiectasis
52
What is another name for Infant Respiratory Distress Syndrome (IRDS)?
“Hyaline membrane disease”
53
What condition involves immediately post-birth with difficulty breathing → resp. distress?
Infant Respiratory Distress Syndrome (IRDS)
54
What condition involves arterial blood gas shows hypoxemia?
Infant Respiratory Distress Syndrome (IRDS)
55
What condition involves CXR shows “ground-glass appearance”?
Infant Respiratory Distress Syndrome (IRDS)
56
What is the recommended treatment for Infant Respiratory Distress Syndrome (IRDS)?
Dexamethasone | - ACS therapy (antenatal corticosteroid) given to mothers
57
What is the pathophysiology triad associated with Asthma?
- Chronic airway inflammation - Hyper-responsiveness - Reversible obstruction
58
What condition involves triad of chronic airway inflammation + hyper-responsiveness + reversible obstruction?
Asthma
59
What condition involves smooth muscle contracts = air trapped in alveoli?
Asthma ATTACK
60
What condition involves diagnosis with Methacholine Challenge Test?
Asthma
61
What condition is associated with the “Rule of Two’s”, and what does this mean (3)?
Asthma Two meds if... - 2+ times/week - 2+ times/month at night - 2+ times/year refills
62
What condition involves partial airway obstruction, often misdiagnosed as asthma bc also triggers?
Vocal Cord Dysfunction
63
What is the recommended diagnostic test for Vocal Cord Dysfunction?
Laryngoscopy
64
What condition involves snoring (3+ nights/week), gasping?
Obstructive Sleep Apnea (OSA)
65
What condition involves restless sleep, mouth breathing, ADHD-like issues?
Obstructive Sleep Apnea (OSA)
66
What are two risk factors associated with Obstructive Sleep Apnea (OSA)?
- Obesity | - Adenotonsillar hypertrophy

Peds II (12 decks)

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