pediatrics Flashcards
1
Q
croup
A
- viral infection
- subglottic edema
- age 6mos-6yrs
- low grade fever
- substernal retractions
- stridor
- steeple sign
2
Q
croup tx
A
- O2 28-40% immediate
- racemic epi 0.5-1 in 3ml saline
- decadron if unresponsive to racemic epi
3
Q
epiglottitis
A
- supraglottic edema
- bacterial infection (haemophilus infuenza b)
- rapid progression
- high fever
- body bent at waist, head in sniffing position
4
Q
epiglottitis management
A
- sedate and intubate
- xray to confirm diagnosis
- IMV 2-8breaths/min to maintain PCO295%
- antibiotics
* attempt extubation after upper airway leak detected
5
Q
bronchiolitis
A
-viral infection (RSV)
-
6
Q
bronchiolitis diagnosis
A
- immunoflourescent assay (IFA) -antibody staining of nasopharyngeal secretions
- xray- hyperinflation, alveolar infiltrates, consolidation
7
Q
bronchiolitis tx
A
- fluid intake
- decongestants
- O2 w/humidity
- bronchodilator
- IV fluids
- bronchial hygiene
- antibiotics
8
Q
CF
A
- polycythemia
- cor pulmonale (end stage)
- sweat test: >60 children, >80 adults
- decreased flows, increases FRC and TLC
- Xray similar to COPD
9
Q
CF tx
A
- aggressive CPT
- bronchodilators
- expectorants
- mucolytics (acetylcysteine, pulmozyme)
- antibiotics (aerolized tobramycin 2xday, every other month
10
Q
near drowning
A
- fluffy infiltrates
- 100% O2 therapy
- nasal/bronchoscope assisted intubation
11
Q
need for neonatal resuscitation
A
based on
- term gestation
- breathing/crying
- muscle tone
12
Q
newborn HR less than 100
A
- institute PPV 40-60 breaths/min with bag-valve device
2. pressures of 20-40cmH2O
13
Q
newborn HR less than 60
A
consider intubation
- PPV
- chest compressions
14
Q
meconium aspiration tx
A
- supplemental O2
- intubation
- suction
- mech ventilation
- CPAP for hypoxemia
15
Q
RDS
A
hyaline membrane disease - deficiency in surfactant associated with prematurity
16
Q
L/S ratio
A
less than 2- increased risk for RDS
less than 1-high risk for RDS
17
Q
RDS tx
A
- nasal CPAP (4-6 cmH20)
- mech ventilation (PEEP, HFV)
- surfactant replacement therapy
18
Q
infant apnea
A
cessation of breathing >15secs
19
Q
apnea tx
A
- CPAP
- aminophylline(theophylline)
- O2 for hypoxemia(24-50%)
- mechanical vent
20
Q
bronchopulmonary displasia
A
ALI or barotrauma/atelectasis due to prolonged mech vent
21
Q
bronchopulmonary displasia tx
A
- CPAP w low FiO2
- low volumes, PEEP, PIP
- diuretics
- antibiotics
- bronchodilators (theophylline)
22
Q
right to left shunt
A
- severe/marked cyanosis
- use low PIP/PEEP
- FiO2 24-50%
1. tetrology of fallot *boot-shaped heart
2. transposition of great vessels *egg-shaped heart
23
Q
left to right shunt
A
- no/mild cyanosis
- use high PIP/PEEP
- FiO2 24-50%
1. PDA
2. coarctation of aorta
