Pediatric Pulmonology Flashcards
What is the most common chronic disease in childhood?
Asthma
Leukotrienes are a bigger culprit in pediatric asthma therefore what symptom is more prominent?
Cough
What is the diagnosis of asthma in kids?
Primarily a clinical diagnosis
- PFTs and allergy testing to confirm diagnosis
When is cough more persistent in asthma?
Nighttime
Number of nighttime awakenings can define severity
Is the annual flu vaccine recommended for children diagnosed with asthma?
Yes
What is status asthmaticus?
Medical emergency in which a severe asthma attack is refractory to treatment
What is the treatment for status asthmaticus?
Mainstay of medical therapy is frequent administration of beta-agonists, combined with corticosteroids
- IV magnesium
- Theophylline
- May have to consider mechanical ventilation
What is the leading cause of death in children with asthma?
Hypoxia - during exacerbations or status asthmaticus oxygen via nasal cannula or ventilation
Do you hear apical crackles in cystic fibrosis?
Yes
How is cystic fibrosis diagnosed?
Sweat chloride test
How is cystic fibrosis definitively diagnosed?
Genetic test
What value on sweat chloride testing is diagnostic of cystic fibrosis?
> 60 mmol/L
What will PFT’s show in cystic fibrosis?
A restrictive pattern that won’t respond to a bronchodilator
Can sweat chloride testing be done in the neonatal period?
No, can be done after 30 days of life
What are the GI related treatments for cystic fibrosis?
- Pancreatic enzymes
- Fat soluble vitamins
- Nutritional support
What are the respiratory treatments for cystic fibrosis?
- Geared toward airway clearance/rehab therapy and antibiotic use
- Pulmozyme
- Inhaled mucolytic agent
- Inhaled tobramycin (TOBI)
- Oral azithromycin
- Bronchodilators and anti-inflammatory agents
What vaccines are recommended for cystic fibrosis?
- Pneumococcal
- Influenza
What is a newer agent in treating CF that is an ion channel modulator and can return some function of chloride channels, resulting in less mucus accumulation?
Trikafta
Where is the obstruction if the child can not vocalize?
Upper complete obstruction
May also have cyanosis, respiratory distress
What is the immediate treatment for a complete obstruction?
Heimlich maneuver appropriate for age
< 1 year: head down position, back blows x5 then roll child over for 5 chest compressions
> 1 year: Heimlich maneuver
**No blind finger sweeps
Is the chest film normal in bronchitis?
Yes
What is the etiology of acute bronchiolitis?
most commonly RSV
Can be other viral etiology, PCR panel can confirm
Should infants less than 6 months be hospitalized with RSV?
Yes
What is the treatment for bronchiolitis?
- Fluids and supportive care
- Bronchodilators remain controversial
What is the gold standard for treating Pertussis?
Erythromycin 40-50 mg/kg/day, max 2 grams day
Zithromax is becoming more of a popular agent due to a simpler course
A pediatric patient presents with a barking cough, stridor, and respiratory distress. What is the most likely diagnosis?
Croup
Which medication is commonly used as a first-line treatment for acute asthma exacerbation in children?
Albuterol
What is the most common bacterial pathogen responsible for causing acute otitis media in children?
a) Haemophilus influenzae
b) Streptococcus pneumoniae
c) Staphylococcus aureus
d) Escherichia coli
How is it treated?
Streptococcus pneumoniae
Amoxacillin or Augmenten
