PedPulm

Question 1

• paroxysmal/spasmodic cough, usually ends in prolonged, high-pitched, ? inspiration?
• Tx: ?

Answer 1

whooping
crowing
azithro

Question 2

• brassy cough?
• can spread to vertebra aka? or epiphyses of long bones
• Dx?
• CXR?
• Tx?

Answer 2

TB
Pott's Dz
TST
hilar lymphadenopathy
isoniazid, rifampin

Question 3

viral- commonly ?, influenza, metapneumovirus, parainfluenza, adeno
bacterial- s. pneum, h flu, chlamydia pneum (? cough), mycoplasma pneum

Answer 3

pneumonia
RSV
staccato

Question 4

pneumonia- ? varies by age
Sx: viral? bacterial?
Dx:
Tx:
Px: ?

Answer 4

• CAP
• viral: wheezing, fever, cough, retractions, staccato/paroxysmal cough, muscle soreness
• bacterial: rales, dec breath sounds, retractions, ill-appearing, fever, CP, N/V, consolidation (ego phony, dullness to percuss)
• CXR- multilobar infiltrates (s. pneum, legionella); interstitial pneum (viral/mycoplasma)
• empiric a/b, antivirals, SUPPORTIVE- fluids, antipyretics, analgesics, O2 prn
• <2 PCV & Hib; adult PPV & influenza

Question 5

wheezy bronchitis <24 mo., often epidemic, MC 3-6mo in Jan-Feb?

Answer 5

bronchiolitis

Question 6

bronchiolitis
Sx: rhinitis w/ ?, tachypnea, wheezing, rales, retractions, nasal flaring, rales, retractions, nasal flaring
Dx: clinical, pulseox, CXR prn, for RSV (also?)
Tx: ?
Px: prevention in high-risk infants?

Answer 6

inc resp distress
EZ-RSV; pneumonia- NASAL SWAB
supportive
Synagis

Question 7

• adenovirus (<2), RSV, parainfluenza, rhinovirus, coronavirus
• Sx: ? cough preceded by viral URI, nontoxic, low-grade fever, diffuse ? clear after cough
• Dx:
• Tx?
• excellent Px

Answer 7

bronchitis
nonproductive
rhonchi
clinical
supportive

Question 8

croup - MC type? organism? 
Sx: ? prodrome, ?, spasmodic cough (worse at night), hoarseness, stridor, nasal flaring, retractions, tachypnea
Dx: ?
Tx: 
Px:

Answer 8

• laryngotracheobronchitis, parainfluenza virus**; others: RSV, influenza, A&B, adenovirus, enterovirus, rhinovirus
• barking
• clinical, steeple sign
• antipyretics, hydration, nebulized racemic epinephrine q2h, c/s w/in 1st 24hrs
• excellent, most self-lmtd, duration <5d

Question 9

epiglottitis- in 2-6 yrs it’s ?

• h flu type B, s pyogenes, s pneum, s aureus (includes MRSA)
• Sx:
• Dx:
• Tx:
• Px: excellent w/ protocol- critical care, otolaryngology, anesthesia, & peds

Answer 9

supraglottitis

• acute severe sore throat, odynophagia, dysphagia, high fever, drooling, inspiratory stridor, & tripod position***, FATAL asphyxia
• beefy red, stiff, edematous epiglottitis; thumb sign
• airway protection, cefotaxime (claforan), ceftriaxone (rocephin), vancomycin

Question 10

CF:

• most common?
• gene mutation?
• Sx:
• Dx:
• Tx:
• Px:

Answer 10

• lethal genetic dz
• 7q31.1
• chronic/recurrent cough, sputum prod, dyspnea, and wheezing, recurrent pneumonia, clubbing, CXR: bronchiectasis and scarring
• *sweat test >60mEq/L, 66% *gene mutation F508, spirometry obstructive, panc insuff.
• supportive
• median survival age - 35 yrs

Question 11

LRI in 1-6 mo or 6mo-5yrs caused by?

Answer 11

RSV

Question 12

pneumonia MC virus?

Answer 12

RSV (others- parainfluenza, influenza, adeno)

Question 13

greater than 50% of infants and children w/ CXR and mod-severe pulm TB have no ? discovered by ? and ?

Answer 13

physical findings

contact tracing, PPD (TST)

Question 14

Bronchiectasis

-chronic cough producing? during?

Answer 14

copious thick, tenacious purulent sputum, infxn

Question 15

50% CF have ? on chromosome 7 DELETED
50% have acute or persistent ?
Dx:?

Answer 15

F508
respiratory Sx
sweat chloride test

Question 16

sudden onset of cough, wheeze, and dyspnea?

Answer 16

FBA

Question 17

bronchogenic cysts

-Tx- Sx? aSx?

Answer 17

surgical excision for both, but in aSx only if there is a 75-90% infection rate!

Question 18

pneumonia from acute bronchitis Sx on auscultation?

Answer 18

egophony