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Clinical Medicine 4 > Pediatric Pulmonology > Flashcards

Pediatric Pulmonology Flashcards

1
Q

Etiology of Epiglotitis?

A

Bacterial. S Pyogenes, S Pneumonia, Staph.

H Flu way down d/t vaccines.

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2
Q

Epiglotitis is acute inflammation of which glottic region?

A

Supraglottic

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3
Q

Speed of onset in Epiglotitis?

A

RAPID onset

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4
Q

Do kids like well or toxic in Epiglotitis?

A

Toxic

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5
Q

Voice sounds like what in Epiglotitis?

A

Muffled, hot potato

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6
Q

Stridor happens early or late in Epiglotitis?

A

Late finding

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7
Q

Lateral neck xray shows what in Epiglotitis?

A

Thumbprint sign

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8
Q

Dx of Epiglotitis?

A

Clinical and direct visualization endoscopy while intubating

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9
Q

Stat treatment for Epiglotitis?

A

Intubation

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10
Q

Abx for Epiglotitis?

A

Ceftriaxone or Cefotaxime

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11
Q

Who to PPX if exposed to Epiglotitis? What to use?

A

Unvaccinated, immunocompromised, or <6mo.

Rifampin.

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12
Q

Croup aka?

A

Laryngeotracheal Bronchitis

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13
Q

Croup is inflammation of which region of the glottis?

A

Subglottic

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14
Q

Etiology of Croup?

A

Viral Parainfluenza 1,2,3

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15
Q

Age of Croup?

A

3mo-5mo, peak at 2y/o

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16
Q

Seasons for Croup?

A

Fall and Spring

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17
Q

Sx in day 1-3 in Croup?

A

Rhinorhea, low grade fever. Like common cold.

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18
Q

Sx in day 3-5 Croup?

A

Barking, seal like cough mostly between 10am-4pm.

+/- Stridor

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19
Q

Sx in day 5-7 of Croup?

A

Resolves

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20
Q

Dx for Croup?

A

Clinical. Don’t need xray d/t not being a lung issue.

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21
Q

Tx of Croup without stridor?

A

Decaron IV 0.6mg/kg PO, max 20mg and go home to rest.

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22
Q

Tx of Croup at home?

A

Cold night air, open freezer door. Humidified air.

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23
Q

Tx of Croup with stridor?

A

HOSPITAL
Decadron IV PO, Racemic Epi via nebulizer, watch 2-3h. Admit if no improvement and give continuous Racemic Epi neb. Consider PICU.

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24
Q

Broncholitis is infection of upper or lower respiratory tract?

A

Lower resp tract

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25
Q

Who gets Broncholitis?

A

<2 y/o

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26
Q

Increased risk factors in Broncholitis?

A

Premies, asthma, immunocompromised

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27
Q

Etiology of Broncholitis?

A

RSV 50%. Parainfluenza and Adenovirus the rest.

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28
Q

If Broncholitis is bacterial which one?

A

Mycoplasma

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29
Q

When does Broncholitis occur?

A

Late fall, throughout winter

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30
Q

How Broncholitis transmitted?

A

Respiratory droplets into mucosa of the victim

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31
Q

Broncholitis lasts for how many days?

A

10-12

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32
Q

Sx in Day 1-2 of bronchiolitis?

A

URI, congested, low grade fever

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33
Q

Sx in day 2-4 of Broncholitis?

A

WHEEZING, tachypnea, belly breathing, prolonged expiration, retractions, nasal flaring, circumoral cyanosis, >2sec cap refill, pallor, and mottling

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34
Q

Dx of Broncholitis is <3mo or with risk factors?

A

Nasal wash for PCR and RSV

35
Q

What will CXR show in Broncholitis?

A

Perihilar markings

36
Q

When to hospitalize in Broncholitis?

A
  • SaO2 below 91% and need oxygen
  • Apenic episodes
  • <12 week premie
  • <12 week normal birth buy days 1-3 sick
  • Underlying risk factors
  • Parent can’t care at home
37
Q

Tx of Broncholitis is mainly?

A

Supportive

38
Q

Give high flow O2 when in Broncholitis?

A

If sat <92%. Keep >94%.

39
Q

Meds for Broncholitis?

A

Bronchodilators and PO Steroids (Decadron, Prednisone). NO ABX unless pneumonia superinfection.

40
Q

ICS recommended in Broncholitis?

41
Q

What to do is resp failure in Broncholitis?

42
Q

Eti of Pertussis?

A

Bortadella Pertussis, G- coccobacillus

43
Q

Where does Pertussis bacteria colonize?

A

Ciliated epithelium

44
Q

How Pertussis transmitted

A

Via droplets

45
Q

What age does vaccine wane in Pertussis?

46
Q

3 stages of Pertussis?

A
  1. Catarrhal
  2. Paroxysman
  3. Convalescent
47
Q

Pertussis most infectious during which stage?

48
Q

How long does Catarrhal stage last in Pertussis?

49
Q

Sx of Catarrhal stage in Pertussis?

A

Common cold

50
Q

How long does Paroxysman stage last in Pertussis?

A

1-6wk, up to 10 weeks

51
Q

Sx of Paroxysmal stage of Pertussis?

A

Bursts of rapid coughing with long inhalf effort at end. High-pitched “whooping” sound

52
Q

Cough lasts for how long in Pertussis?

53
Q

Convalescent stage lasts for how long in Pertussis?

54
Q

Dx for Pertussis?

A

Highly clinical dx. Can do nasopharyndeal swab but takes days to weeks for results.

55
Q

Abx for Pertussis?

A

Zithromax or Erythromycin. Supportive care.

56
Q

80% of Foreign Body Aspirations occur under what age?

57
Q

Peanuts account for what percent of Foreign Body Aspirations?

58
Q

What are often fatal Foreign Body Aspiration?

59
Q

Where do FBs lodge in kids?

A

Right or Left proximal mainstem bronchus

60
Q

Where do fatal FBs lodge?

61
Q

Where do FBs lodge in adults?

A

Right mainstem

62
Q

Life threatning S/Sx in FBA?

A

Resp distress, cyanosis, altered mental status

63
Q

Non-life threatening S/Sx in FBA?

A

Wheezing, cough, decreased air entry

64
Q

Dx for FBA?

A

H+P, xray, then rigid broncoscopy

65
Q

Tx for FBA?

A

Rigid broncoscopy. Steroids if inflammation occurs after removal.

66
Q

Etiology of Cystic FIbrosis?

A

Genetic error of chloride channel CFTR

67
Q

Where do viscous secretions build up in Cystic FIbrosis?

A

Lungs, pancreas, liver, intestine, repro tract

68
Q

Meconium Ileus in newborn with Cystic FIbrosis?

A

Pathognomonic!!!

69
Q

Cough and lungs in Cystic FIbrosis?

A

Persistent productive cough, hyperinflation of lungs

70
Q

Which bacteria in lungs of kids with Cystic FIbrosis?

A

S Aureus and H Flu

71
Q

Which bacteria in lungs in adults with Cystic FIbrosis?

A

P Aeruginosa

72
Q

Primary test for Cystic FIbrosis?

A

Sweat test

73
Q

Dx for Cystic FIbrosis must have S/Sx in how many organ systems?

A

At least 1+

74
Q

Tx for Cystic FIbrosis?

A

CFTR modulators, abx (Azithromycin for PPX and antiinflammatoruy), nebilized abx, bronchodilators

75
Q

Respiratory Distress Syndrome occurs in who?

A

93% of premature babies under 28 weeks gestated

76
Q

Respiratory Distress Syndrome due to?

A

Decreased surfactant

77
Q

S/Sx of Respiratory Distress Syndrome?

A

Tachypnea, retractions, nasal flaring, grunting on espiration, cyanosis, decreased breath sounds, pallor, decreased peripheral pulses, peripheral edema, poor urine output

78
Q

What does CXR show in Respiratory Distress Syndrome?

A

Ground glass appearance, low lung volume, pneumothorax

79
Q

ABG in Respiratory Distress Syndrome shows what?

80
Q

Hyponatremia in Respiratory Distress Syndrome due to….?

A

Water retention

81
Q

Tx of Respiratory Distress Syndrome if preggers and at risk of delivery <34 weeks?

A

Atenatal steroids

82
Q

Tx of preterm <30 newborn with Respiratory Distress Syndrome?

A

Exogenous Surfactant, down the ETT with PEEP

83
Q

PEEP corrects what in Respiratory Distress Syndrome?

A

Atelectasis, improves arterial oxygenation

84
Q

PEEP drawbacks in Respiratory Distress Syndrome?

A

Pressure trauma, oxygen toxicity, BPD

Clinical Medicine 4 (10 decks)

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