Peds Lung Diseases

Question 1

Pediatric pulmonary disease accounts for almost 50% of deaths in children younger than _____.

Answer 1

1 year

Question 2

______ accounts for almost 50% of deaths in children younger than 1 year.

Answer 2

Pediatric pulmonary disease

Question 3

An infant’s larynx and trachea are significantly _____ than an adult.

Answer 3

smaller

Question 4

The narrowest part of the pediatric airway is ______.

Answer 4

just below the vocal cords at the level of the cricoid cartilage

Question 5

The narrowest part of the adult airway is _____.

Answer 5

the vocal cords

Question 6

Extrathoracic airway obstruction usually causes _____.

Answer 6

stridor or a barking cough

Question 7

What are the 4 D’s of airway obstruction?

Answer 7

• Dyspnea
• Drooling
• Dysphagia
• Distress

Question 8

What is Laryngomalacia?

Answer 8

a benign congenital disorder in which the cartilaginous support for the supraglottic structures is underdeveloped

Question 9

When does Laryngomalacia present?

Answer 9

within the first few months of life

Question 10

This is a benign congenital disorder in which the cartilaginous support for the supraglottic structures is underdeveloped.

Answer 10

Laryngomalacia

Question 11

This is the most common cause of persistent stridor in infants and usually is seen in the first 6 weeks of life.

Answer 11

Laryngomalacia

Question 12

What are the s/s of croup?

Answer 12

upper respiratory tract symptoms is followed by a barking cough and stridor but no (or only low grade) fever

Question 13

How do xrays look in croup?

Answer 13

subglottic narrowing-steeple sign

Question 14

What is the steeple sign on xray indicative of?

Answer 14

croup

Question 15

What is the tx for croup w/o stridor at rest?

Answer 15

supportive care, maybe inhaled mist

Question 16

What is the tx for croup w/ stridor at rest?

Answer 16

• Nebulized epinephrine
• glucocorticoids

Question 17

What usually causes epiglottis?

Answer 17

Haemophilus influenzae type B

Question 18

Why is epiglottitis a medical emergency?

Answer 18

it can rapidly lead to life-threatening upper airway obstruction

Question 19

What are the s/s of epiglottis?

Answer 19

• sudden onset of high fever
• dysphagia
• drooling
• muffled voice
• inspiratory retractions
• cyanosis
• soft stridor
• often sit in the sniffing dog position

Question 20

How is epiglottitis definitively diagnosed?

Answer 20

visualization of the airway

Question 21

What is the first step in treating epiglottitis?

Answer 21

endotrach intubation

Question 22

What is bacterial tracheitis?

Answer 22

a severe, life-threatening form of laryngotracheo-bronchitis

Question 23

This is a severe, life-threatening form of laryngotracheo-bronchitis.

Answer 23

Bacterial tracheitis

Question 24

What is the most common cause of bacterial tracheitis?

Answer 24

Staphylococcus aureus

Question 25

What are the s/s of bacterial tracheitis?

Answer 25

starts similar to viral croup, but patients develop higher fever, toxicity, and progressive or intermittent severe upper airway obstruction that is unresponsive to standard croup therapy

Question 26

This dz starts similar to viral croup, but patients develop higher fever, toxicity, and progressive or intermittent severe upper airway obstruction that is unresponsive to standard croup therapy.

Answer 26

bacterial tracheitis

Question 27

Pediatric airways are _____ and the cross sectional area is \_\_\_\_\_.

Answer 27

smaller; lower

Question 28

How are infant chest walls different than that of an adult?

Answer 28

* Weak intercostal muscles * Ribs are horizontal--\>infants rely mostly on their diaphragm * Diaphragm is flat limiting the change in tidal volume and fatigues easily

Question 29

Intrathoracic airway obstruction usually causes \_\_\_\_\_.

Answer 29

expiratory wheezing

Question 30

Name 3 congenital disorders of intrathoracic airway obstruction.

Answer 30

1. Tracheomalacia and bronchomalacia 2. Tracheoesophageal fistula 3. Vascular Rings, Pulmonary slings, and other vascular anomalies that can cause airway compression

Question 31

What is the most common acquired cause of intrathoracic airway obstruction?

Answer 31

infection

Question 32

What is bronchiolitis?

Answer 32

* acute onset tachypnea, labored breathing, and/or hypoxia * Irritability, poor feeding * Wheezing and crackles

Question 33

Dx? * acute onset tachypnea, labored breathing, and/or hypoxia * Irritability, poor feeding * Wheezing and crackles

Answer 33

bronhiolitis

Question 34

\_\_\_\_\_ is the most common serious acute respiratory illness in infants and young children.

Answer 34

Bronchiolitis

Question 35

Respiratory syncytial virus (RSV) is by far the most common viral cause of \_\_\_\_\_.

Answer 35

acute bronchiolitis

Question 36

\_\_\_\_\_ is by far the most common viral cause of acute bronchiolitis.

Answer 36

Respiratory syncytial virus (RSV)

Question 37

Pts with bronchiolitis can potentially develop \_\_\_\_.

Answer 37

asthma

Question 38

Dx: * Recurrent symptoms of airway obstruction (cough, SOB, chest tightness) * At least partial reversal of bronchospasm and symptom relief with a bronchodilator (e.g. a beta agonist such as albuterol) * All other diagnoses ruled out

Answer 38

asthma

Question 39

What is the chronic tx of choice in asthma?

Answer 39

corticosteroids

Question 40

What is parenchymal lung disease in children?

Answer 40

any disorders that affect the alveoli, associated structures, and the airways

Question 41

What is the most common acquired cause of parenchymal lung disease in children?

Answer 41

Viral or bacterial pneumonia

Question 42

What is bronchopulmonary dysplasia?

Answer 42

* Acute respiratory distress in the first week of life * Required oxygen therapy or mechanical ventilation, with persistent oxygen requirement at 36 weeks gestational age or 28 days of life * Persistent respiratory abnormalities, including physical signs and radiographic findings

Question 43

Dx? * Acute respiratory distress in the first week of life * Required oxygen therapy or mechanical ventilation, with persistent oxygen requirement at 36 weeks gestational age or 28 days of life * Persistent respiratory abnormalities, including physical signs and radiographic findings

Answer 43

bronchopulmonary dysplasia

Question 44

\_\_\_\_\_\_ is a developmental disorder characterized by decreased surface area for gas exchange, reduced inflammation, and dysmorphic vascular structure.

Answer 44

bronchopulmonary dysplasia (BPD)

Question 45

The cause of _____ is a defect in a single gene on chromosome 7 that encodes an epithelial chloride channel.

Answer 45

CF

Question 46

The cause of CF is a defect in a single gene on chromosome ___ that encodes an epithelial chloride channel.

Answer 46

7

Question 47

The cause of CF is a defect in a single gene on chromosome 7 that encodes an epithelial _____ channel.

Answer 47

chloride

Question 48

The most common CF mutation is \_\_\_\_\_\_.

Answer 48

ΔF508

Question 49

What is meconium ileus? What disease is it assoc. with?

Answer 49

a severe intestinal obstruction resulting from inspissation of tenacious meconium in the terminal ileum; CF

Question 50

What is the dominant lung pathogen in CF patients?

Answer 50

Pseudomonas aeruginosa

Question 51

CF pts should also take daily multivitamins that contain vitamins \_\_\_\_\_\_.

Answer 51

A, D, E, and K